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posterior apprehension test (magee) supine
- arm flexed to a bit less than 90 so it's in line w scap
- elbow flexed a bit more than 90
- forearm in IR so it's over the lower contralat nipple
- press down on elbow to push the hum head posteriorly
- observe the pt's face
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posterior apprehension test (magee) seated
one hand on pt's elbow, other hand on post shoulder, feeling for hum head
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sulcus sign/test at shoulder
- seated
- pull south on humerus
- look at shoulder for distance created btwn hum head and acromion
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Faegin Test - what's it for?
inverior instability at shoulder joint
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how to do the Faegin test
- seated or standing
- pt's arm in 90 degrees abduction, resting on your shoulder or being cradled in your armpit
- put hour hands on his prox hum and depress, looking at humeral head inferior subluxation.
Inferior Glenohumeral Ligament
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Rowe test
- it's for multidirectional instability
- pt leans forward at waist (one foot ahead, or hand on table for support) so arm can hang vertically
- PT stabilizes GH joint proximally and glides the prox hum ant, post, inf
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3 tests for the bicesp
- bicipital groove (transverse ligament)
- yergason
- speeds (w 2 positions)
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the bicipital groove / transverse lig test for the biceps
- (magee)
- palpate the biciptal groove
- feel the tendon rolling under yr fingers in the groove as you go thru rotation
- shouldn't feel it clicking out of the sulcus - should be held by the transverse humeral lig
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Yergason test ... what's it for?
tests the quality of the bicipital tendon
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Yergason test - how?
- pt is seated w elbow flexed, forearm pronated
- PT palpates/stabilizes bicipital groove
- PT passively abd the arm 10-20 degrees
- NOW, have pt move to supination & ER against resistance from the PT
- (can also resist elbow flexion at the same time)
- positive sign is pain or "snap" of long head of biceps tendon
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Speed's test - 2 varieties
- pt has arm in 90 degrees shoulder flexion, ER, sup, elbow straight (palms up shoulder flexion)
- PT provides isometric resistance
- pt has arm in ext, ER, elbow straight (thumb up)
- resists moving into flexion isometricly
pos sign: pain in bicipital groove area
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drop arm test looks at what?
supraspinatus, specifically its eccentric control over arm descent from abd
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drop arm test - how?
- pt lifts arm into abd and then slowly lowers it to side
- if pt can do this, tap the arm during the test
- apply pressure to the arm
- ... be ready to catch the arm, it might fall
can be done "empty can" or "full can"
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empty vs full can tests - how?
- empty = thumbs down
- elevate arm to 90 degrees scaption
- see if pt has pain or weakness when doing an isometric contraction agains the PT's applied force
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3 tests that look at impingement in the shoulder (suprahumeral joint - tests the supraspinatus' ability to move in there)
- Neer (close to the ear)
- Hawkins-Kennedy (hike & crank)
- Yocum (yolk)
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Neer test
- pt seated or standing
- bring arm into full flexion with ER, then do it again with IR
- see if there's pain or limitation
pos sign is pain 2/2 compresion of structures under coracoacromial lig and acromion
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Hawkins-Kennedy test - for what? how?
- shoulder impingement
- arm at 90 degrees flexion or in plane of scapula
- elbow at 90
- PT applies sudden overpressure for the arm cranking it into IR
- look for pain
pos sign is pain 2/2 compresion of structures under coracoacromial lig and acromion
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Yocum test - for what, how?
- put affect hand on opposite shoulder
- pt lifts elbow to face (or PT tries if pt can't)
- pos sign is pain 2/2 compresion of structures under coracoacromial lig and acromion
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4 tests for labral tears
- labral crank test (labral pathology)
- o'brien's shoulder test (superior labral problem vs AC jt)
- mimori new pain provocation (superior labral problem)
- biceps load test (superior labral pathology in pts w recurrent dislocation)
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labral crank test
- pt arm in 160 degrees abd in scap plane, elbow bent 90
- PT stabilizes pt's post shoulder and pushes the elbow bringing it back by the ear (into ER) while puttin gsome pressure on it to screw it home to the labrum
- pos sign: pain w ER or reprodcution of the cardinal sign during overhead activities
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O'Brien's test aka active compression test - tests for what? how?
- labral tears
- pt flexes arm to 90, elbow straight, shoulder in IR (pronation)
- part 1: PT give isometric downward force
- part 2: repeart w arm in sup
- pos sign: pain w part 1 and no pain in part 2 ... if pain in both, may be AC jt problem
- (differs from Speed's by pos of hand)
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the pt can stick out her arms straight in 90 degrees flexion and you can push on them, and depending on when pain (pronation, sup, both), it means...?
- If painful only in pronation, it's O'Brien's and it's labral.
- If painful only in sup it's Speed's and it's the biceps tendon.
- If painful in both it may be an AC joint problem
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Mimori New Pain Provocation Test
tests for what? how?
- labral tears
- PT moves pt's arm abd to 90, elbow at 90, full ER, pronation
- repeat w supination
- pos sign: pain provoked w pronation or pain greater in pro than sup
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Biceps load test -- for what? how?
- labral tears
- pt supine, same as ant apprehension test, but now add resistance to isometric elbow flexion at 90 degrees
- pos sign: feeling of apprehension increases when elbow flex is resisted
- neg sign: if resisted elbow flexion relieves sx
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accessory motion testing and mobilization techniques can look so similar... basic diffs?
- assessment/testing: checking joints ability to move, done in resting pos
- mobs: done with a grade (1234), can be in various positions
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how to do ant glide mobilization of GH jt
- pt prone
- arm in resting pos
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how to do lat GH joint mob
- arm in resting pos
- PT's hand right up in axilla, other hand creating counter-pressure at distal humerus
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