Title: Bone Wizardry / OMM Mastery / 18.Special Tests / II.Shoulder
Tags: #BW_OMM::Content::Diagnosis #BW_OMM::Region::Upper_Extremity #BW_OMM::Type::Cloze BoneWizardry bonewizardry-free omm omt
On every note of this deck, unless a note says otherwise:
Review Links: - Bone Wizardry rotator cuff impingement
- Practice: Shoulder Special Tests QBank
Show outside sources
- Stanford shoulder exam
- AAFP painful shoulder exam
- PMC subacromial impingement tests

Q: With your fingers on the radial pulse, you extend the patient's elbow and shoulder, externally rotate with slight abduction, then ask the patient to take a deep breath and turn the head toward that arm. This maneuver is:
[...]
A: Adson's Test
Q: What indicates a positive Adson's Test?
[...]
A: Decreased/absent radial pulse
Topic: Shoulder
Bone Wizardry Lock: Adson's is a vascular compression test. The scalene triangle tightens with deep inhalation and head turn toward the arm. A disappearing radial pulse points to thoracic outlet syndrome.

Q: What test is being described? The physician hyperabducts the arm above the head with some extension.
[...]
A: Wright's Test
Q: The Wright's Test indicates a compromise in the neurovascular bundle where?
[...]
A: Under the Pec Minor at the Coracoid Process
Q: What indicates a positive Wright's Test?
[...]
A: Decreased/absent radial pulse
Comment: This is also known as the hyperabduction test.
Topic: Shoulder
Bone Wizardry Lock: Wright's (hyperabduction test): arm hyperabducted overhead. Radial pulse disappears because the neurovascular bundle is compressed under the pec minor at the coracoid process.

Q: A positive Adson's Test indicates a compromised neurovascular bundle where?
[...]
A: Scalene muscles
Topic: Shoulder
Bone Wizardry Lock: Adson's isolates the scalenes. Have the patient turn toward the affected side, extend the neck, and inhale. Disappearing radial pulse means the scalenes are compressing the neurovascular bundle.

Q: What test is being described? The examiner palpates the radial pulse while depressing and extending the shoulder.
[...]
A: Military Posture Test
Q: Where does a positive Military Posture test indicate neurovascular bundle compromise?
[...]
A: Clavicle and first rib
Q: How do you know you have a positive Military Posture Test?
[...]
A: Decreased/absent radial pulse
Comment: This is also known as the Costoclavicular syndrome test.
Topic: Shoulder
Bone Wizardry Lock: Military Posture (Costoclavicular test): pull the shoulder back and down while palpating the radial pulse. The pulse fades when the clavicle and first rib pinch the neurovascular bundle between them.

Q: The Apley's Scratch Test is used to evaluate the range of motion of the [...].
A: shoulder
What motions are tested with the Apley's Scratch Test?
1. Abduction
2. External Rotation
3. Internal Rotation
4. Adduction
Q: Apley's Scratch Test:
To test [...] and [...], ask the patient to reach behind the head and touch the opposite shoulder.
A: abduction; external rotation
Q: Apley's Scratch Test:
To evaluate [...] and [...], ask the patient to reach in front of the head and touch the opposite shoulder as well as reach behind the neck and touch the inferior angle of the opposite scapula.
A: internal rotation; adduction
Topic: Shoulder
Bone Wizardry Lock: Apley's Scratch gives a fast ROM screen. Cannot reach behind the head = abduction or external rotation is limited. Cannot reach behind the back = internal rotation or adduction is limited.

Q: The Drop Arm Test detects tears in the [...].
A: rotator cuff
Q: What test is being described? The patient is instructed to abduct the shoulder to 90°, and then to slowly lower the arm.
[...]
A: Drop Arm Test
Q: What indicates a positive Drop Arm Test?
[...]
A: The arm drops to the side
Topic: Shoulder
Bone Wizardry Lock: Drop Arm: patient abducts to 90 degrees and tries to lower slowly. If the arm falls instead of lowering under control, the rotator cuff is torn, most commonly the supraspinatus.

Q: The Speed's Test assesses the [...] in the [...].
A: biceps tendon; bicipital groove
Q: What test is being described? The patient fully extends the elbow, flexes the shoulder and supinates the forearm. The physician resists the flexion of the shoulder.
[...]
A: Speed's Test
Q: What indicates a positive Speed's Test?
[...]
A: Tenderness in the bicipital groove
Topic: Shoulder
Bone Wizardry Lock: Speed's loads the biceps with the elbow straight and forearm supinated, then resists shoulder flexion. Pain in the bicipital groove points to biceps tendon pathology, not a rotator cuff tear.

Q: The Yergason's Test determines the [...] of the [...] in the [...].
A: stability; biceps tendon; bicipital groove
Q: What test is being described? The patient flexes the elbow to 90° while the physician grasps the elbow with one hand and the wrist with the other hand. While pulling downward on the patient's elbow, the physician externally rotates the forearm as the patient resists this motion.
[...]
A: Yergason's Test
Q: What indicates a positive Yergason's Test?
[...]
A: Pain as the biceps tendon pops out of the bicipital groove
Topic: Shoulder
Bone Wizardry Lock: Yergason's tests the transverse humeral ligament. Elbow at 90 degrees, resist supination while pulling down on the elbow. Biceps tendon popping out of the groove means the ligament is not holding it.