Shoulder Injury Assessment Quiz

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Questions and Answers

Which test is used to evaluate biceps tendon pathology?

Yergason's maneuver

Speed's test

Pronation resistance test (correct)

Spurling's compression test

Which of the following is NOT a typical clinical feature of carpal tunnel syndrome?

Loss of sensation in the median nerve distribution

Night pain

Pain or numbness in the small finger (correct)

Weak abduction of the thumb

Which test is used to assess for De Quervain's tenosynovitis?

Tinel's sign

Finkelstein's test (correct)

Phalen's sign

Compression test

What is a common clinical feature of trigger finger?

Flexed finger that 'catches' and opens with a painful 'pop' Signup and view all the answers

Which test is used to evaluate shoulder instability?

Speed's test Signup and view all the answers

What should be inspected during a wrist and hand evaluation?

Smoothness of motion, surface contour, alignment, and bony deformities Signup and view all the answers

What is the MOST important first step in evaluating a patient with shoulder pain?

Performing a detailed history and physical examination Signup and view all the answers

Which of the following is a key component of the cervical spine evaluation for a patient with shoulder pain?

Assessing range of motion with caution, as it is often limited by pain Signup and view all the answers

A patient presents with shoulder pain and reports a history of shoulder instability. Which of the following special tests would be MOST appropriate to perform?

Apprehension test Signup and view all the answers

Which of the following is a common misconception in the evaluation of a patient with shoulder pain?

I can perform a complete physical examination without touching the patient Signup and view all the answers

A patient presents with gradual-onset shoulder pain without a history of injury. Which of the following is the MOST likely diagnosis?

Adhesive capsulitis Signup and view all the answers

What is a common symptom of acute rotator cuff injury?

Minimal or NO motor strength Signup and view all the answers

Which test is used to assess the overall shoulder rotation?

Apley scratch test Signup and view all the answers

Which condition is characterized by pain deep in the glenohumeral joint while the forearm is pronated?

SLAP tear Signup and view all the answers

What type of athletes are more prone to experiencing a SLAP tear injury?

Throwing athletes Signup and view all the answers

Which test involves the elbow being flexed to 90 degrees with the forearm pronated?

Yergason's test Signup and view all the answers

Which condition is characterized by an unstable feeling in the shoulder during certain movements?

Shoulder subluxation Signup and view all the answers

Study Notes

Upper Extremity Evaluation

Idealism vs. Realism: the difference between the ideal and real-world approaches to musculoskeletal care
Importance of taking a detailed history, performing a complete physical exam, and making an accurate diagnosis

Neck and Cervical Spine Evaluation

Location and characteristics of pain (injury, acute or gradual onset, associated symptoms)
Inspection: head position, stiffness
Palpation: spinous process, paraspinal muscles
Range of motion: use caution, often limited by pain
Neuro evaluation: Spurling compression test (foraminal compression test)

Shoulder Evaluation

"Red flags": injury with fracture, septic bursa or joint, acute rotator cuff injury, fever, chills, severe pain
Inspection: swelling, deformity, muscle atrophy, fasciculations, or abnormal positioning
Palpation: bony landmarks, areas of tenderness
Range of motion: flexion, extension, abduction, adduction, internal and external rotation
Maneuvers: acromioclavicular joint, subacromial and subdeltoid bursae, overall shoulder rotation (Apley scratch test)

Shoulder Anatomy

Humeral head, glenoid, scapula (golf ball on a tee)
Rotator cuff: compressor cuff, glenoid labrum
Shoulder pain cycle: instability, weakness

Shoulder Problems

"Tendonitis" and "bursitis"
Impingement: overhead pain, Hawkins, Neers, crossover tests
Instability: dislocation, subluxation, repetitive activity, apprehension, relocation
Weakness: painful vs. non-painful, abduction, internal rotation/external rotation
SLAP/Labrum: superior labrum anterior to posterior, occurs in throwing athletes, O'Brien's test

Biceps Tendon

Yergason's test: elbow flexed to 90 degrees, forearm pronated, pain in bicipital groove
Speed's test: patient attempts to forward elevate shoulder against resistance, elbow extended, forearm supinated

Wrist and Hand Evaluation

Inspection: smoothness of motion, surface contour, alignment of wrist and fingers, bony deformities
Palpation: distal radius and ulna, carpal bones, MCP, PIP, and DIP joints
Range of motion: wrist (flexion, extension, ulnar/radial deviation), fingers (flexion, extension, abduction, adduction), thumb (flexion, extension, abduction, adduction, opposition)
Test hand grip strength, sensation on palmar and dorsal surfaces

Carpal Tunnel Evaluation

Clinical features: pain or numbness in fingers, night pain, loss of sensation in median nerve distribution
Assess: weak abduction of the thumb, carpal tunnel compression test, Tinel's sign, Phalen's sign

DeQuervain's Teno-synovitis

Clinical features: moving the thumb, forming a fist, grasping, turning the wrist, lifting
Assess: tenderness over thumb tendons, APL, EPB, Finkelstein's test

Trigger Finger

Clinical features: flexed finger, "catches", opens with painful "pop"
Assess: palpate lump in midpalm over A1 pulley, finger triggers on exam
Treatment: splint in extension, inject, surgery

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Description

Test your knowledge on assessing shoulder injuries including fractures, septic bursa or joint issues, acute rotator cuff injuries, and high-risk injuries. Learn about important signs such as fever, chills, severe pain, and muscle weakness. Explore evaluation techniques like inspecting for swelling, palpating bony landmarks, and checking range of motion.