February 16, 2010

Shoulder Exam

Last week I did a presentation at the HOME project on the shoulder exam with a few clinical cases I saw in clinic. It was a smashing success -- everyone seemed to appreciate an introduction/review of some of the maneuvers!

One of the toughest parts of the physical exam is remembering all of the routine shoulder maneuvers.

Here's a few mnemonics I shared that I use to help myself remember things:

Arm Movements

  • Flexion of the arm = Forward to the Face
  • Internal Rotation of the arm = In handcuffs
  • (alternatively, External Rotation = Execution of Ex-Convict)
  • ADduction of the arm = ADDing to the midline
    • Scarf sign = toss a scarf around opposite shoulder

Forearm Movements

  • Supination = Holding a Bowl of "Soup"
  • Pronation = Putting away Palm

Special Maneuvers

  • Range of Motion (and Impingement Signs)
    • Neer = arm "Near" to the ear
    • Hawkins = flap like a "Hawk"
    • Apley scratch test = Applying Suntan lotion to back
  • Rotator Cuff Tears
    • Supraspinatus
      • Jobe's Empty Can (duh!)
    • Hornblower's (ditto!)
  • Biceps
    • Speed's = speedin' down the highway
  • Labral Tear
    • O'Brian = *Irish accent*
      What, so O'Brien gets the thumbs down, but Leno gets a thumbs awp?  I'm cryin' heah!!
  • Subscapularis
    • Gerber's lift off = wiping baby food off the back (okay, its a stretch, but you can't win 'em all!)


That's not my second opinion! :)

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