Ch. 13 – The Shoulder Ch. 13 – The Shoulder and Upper Armand Upper ArmReview of Special TestsReview of Special Tests

Apley’s Scratch TestApley’s Scratch Test

Drop Arm TestDrop Arm Test

ImplicationsImplications Inability to lower arm in Inability to lower arm in

controlled manner is controlled manner is indicative of lesions to indicative of lesions to the rotator cuff, the rotator cuff, especially the especially the supraspinatussupraspinatus

Apprehension testApprehension test ImplicationsImplications

Anterior capsule, Anterior capsule, inferior GH L., or inferior GH L., or glenoid labrum glenoid labrum compromised, compromised, allowing humeral allowing humeral head to dislocate or head to dislocate or subluxate anteriorly subluxate anteriorly on glenoid fossaon glenoid fossa

Gerber Lift-off TestGerber Lift-off Test ImplicationsImplications

Tears or Tears or weakness of weakness of subscapularis subscapularis musclemuscle

GH Glide TestsGH Glide Tests

GH Glide TestsGH Glide Tests Implications – laxity of the static Implications – laxity of the static

stabilizers of the GH jointstabilizers of the GH joint

Anterior – coracohumeral L., superior and Anterior – coracohumeral L., superior and middle GH L., anterior jt capsule, labral tearmiddle GH L., anterior jt capsule, labral tear

Posterior – posterior jt capsule, labral tearPosterior – posterior jt capsule, labral tear

Inferior-anterior – inferior jt capsule, superior Inferior-anterior – inferior jt capsule, superior GH L., coracohumeral L.GH L., coracohumeral L.

AC Traction TestAC Traction Test ImplicationsImplications

Sprain of AC or Sprain of AC or costoclavicular costoclavicular ligamentsligaments

AC Compression TestAC Compression Test ImplicationsImplications

Damage to AC L., Damage to AC L., and possibly and possibly coracoclavicular L.coracoclavicular L.

Relocation TestRelocation Test

Posterior Apprehension Posterior Apprehension TestTest

ImplicationsImplications Laxity in the Laxity in the

posterior GH posterior GH capsule, torn capsule, torn posterior labrumposterior labrum

Test for Posterior Instability Test for Posterior Instability in the Plane of the Scapulain the Plane of the Scapula

ImplicationsImplications Laxity in posterior GH Laxity in posterior GH

capsule, coracohumeral capsule, coracohumeral L.L.

Sulcus SignSulcus Sign ImplicationsImplications

Humeral head slides Humeral head slides inferiorly on glenoid inferiorly on glenoid fossa, indicating fossa, indicating laxity in superior GH laxity in superior GH ligamentligament

Neer Impingement TestNeer Impingement Test

Implications – Impingement of rotator cuff and/or long Implications – Impingement of rotator cuff and/or long head of biceps tendon between greater tuberosity and head of biceps tendon between greater tuberosity and inferior side of acromion process and AC jointinferior side of acromion process and AC joint

Hawkins Impingement Hawkins Impingement TestTest

Implications – Impingement of rotator cuff and/or long Implications – Impingement of rotator cuff and/or long head of biceps tendon between greater tuberosity and head of biceps tendon between greater tuberosity and inferior side of acromion processinferior side of acromion process

Empty Can TestEmpty Can Test

Implications – the supraspinatus tendon is Implications – the supraspinatus tendon is being impinged between humeral head and being impinged between humeral head and coracoacromial arch or is inflamed or contains coracoacromial arch or is inflamed or contains a lesiona lesion

Yergason’s TestYergason’s Test

Implications – snapping or popping = tear Implications – snapping or popping = tear or laxity of transverse humeral L.; pain or laxity of transverse humeral L.; pain only = bicipital tendinitisonly = bicipital tendinitis

Speed’s TestSpeed’s Test ImplicationsImplications

Inflammation of long Inflammation of long head of biceps head of biceps tendon in groove; tendon in groove; possible tear of possible tear of transverse L. with transverse L. with concurrent instability concurrent instability of tendon in grooveof tendon in groove

O’Brien TestO’Brien Test

Implications – SLAP lesionImplications – SLAP lesion

Adson’s TestAdson’s Test ImplicationsImplications

Subclavian Subclavian artery is being artery is being occluded occluded between anterior between anterior and middle and middle scalene muscles scalene muscles and pec minorand pec minor

Allen TestAllen Test ImplicationsImplications

Pec minor is Pec minor is compressing compressing neurovascular neurovascular bundlebundle