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ASCM Clinical Skills

ASCM Clinical Skills. Shoulder. LOOK. Inspection. Swelling, bony prominence Bruising / lacerations Position of arm Asymmetry Atrophy Surgical scars. FEEL. Palpation. Expose both shoulders Palpate bony prominences Soft tissue palpation, least tender areas first

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ASCM Clinical Skills

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  1. ASCM Clinical Skills Shoulder

  2. LOOK

  3. Inspection • Swelling, bony prominence • Bruising / lacerations • Position of arm • Asymmetry • Atrophy • Surgical scars

  4. FEEL

  5. Palpation • Expose both shoulders • Palpate bony prominences • Soft tissue palpation, least tender areas first • Compare to contralateral side

  6. AC Joint

  7. MOVE

  8. ACTIVEPASSIVEABNORMALCompare both shoulders

  9. Range of Motion Forward Flexion: 180°

  10. Range of Motion Abduction: 180°

  11. Range of Motion External Rotation: 60-80°

  12. Range of Motion Internal Rotation: T7

  13. Range of Motion Internal Rotation at 90° Forward Flexion: 90°

  14. Rotator Cuff Injury • Tendonopathy or tear • Partial or complete • Acute or chronic

  15. Rotator Cuff Injury Jobe Test: Supraspinatus Middle deltoid

  16. Rotator Cuff Injury External Rotation: Teres minor Infraspinatus

  17. Rotator Cuff Injury Internal Rotation: Subscapularis Pectoralis major Latissimus dorsi

  18. Rotator Cuff Injury • Drop Arm Test: Unable to resist pressure at 90°abduction • Painful Arc: Between 45 °and 120° abduction

  19. Impingement • Usually subacromial space • Irritation between AC joint, RC tendons and bursae

  20. Impingement Neer’s Test

  21. Impingement Hawkin’s Test

  22. Biceps tendonitis/tear • Usually long head • Related to overuse/activity • Anterior shoulder pain • Acute or chronic • Weakness with resisted flexion/supination

  23. Biceps Tendon

  24. Biceps tendonitis Yergason’s Test

  25. Biceps tendonitis Speed’s Test

  26. AC Joint arthritis Crossed Adduction Test

  27. GH Joint Laxity • Apprehension Test • Relocation

  28. GH Joint Laxity Sulcus Sign

  29. GH Joint Laxity Load and Shift Test

  30. Referred Pain Neck Elbow Heart Diaphragmatic Pan coast

  31. Neurological Examination Radial nerve – Thumbs up Median nerve – Thumb to hypothenar eminence Ulnar nerve – Abduct V Axillary nerve - Deltoid

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