- WIPE, blah blah 🙂
- “Take vital signs”
- Position: standing
- Proper exposure: from the waist up
- General inspection of the patient + surroundings
- Look:
- Swelling, Skin changes, Scars
- Muscle wasting
- Deformities\asymmetry\alignment
- Winging of the scapula (ask pt to press against the wall)
- Feel: (first ask pt if they have any pain?)
- Temperature
- Bony landmarks: sternoclavicular joint, clavicle, acromio-clavicular joint, coracoid process, humerual head, GT, spine and borders of scapula
- Muscle bulk: SCM, pectoralis major, trapezius, deltoid, biceps, triceps
- Axillary LN!
- Move: (first ask pt if they have any pain?)
- Active + passive + against resistance: (comment on pain, ROM, crepitus, power)
- Flexion\extension
- Abduction\adduction
- External\internal rotation
- Special test: (choose one test for each domain)
- Apley scratch test -> for the shoulder ROM
- Infraspinatus -> Resisted ER w\ arm by the pt’s side
- Supraspinatus -> Empty can test = Jobe’s test
- Teres minor -> Hornblower’s test
- Subscapularis -> Lift off test
- Impingement syndrome -> Painful arc, Neer sign, or Hawkin’s test
- Biceps -> Yergason’s test, or Speed’s test
- AC joint -> Cross arm test
- Shoulder instability -> Apprehension test
- Neurovascular:
- Axillary:
- M -> shoulder abduction
- S -> lateral shoulder patch
- Musculocutaneous:
- M -> elbow flexion
- S -> lateral forearm
- Median:
- M -> Ok sign
- S -> tip of the index finger
- Ulnar:
- M -> fingers abduction\adduction
- S -> ulnar side of the little finger
- Radial:
- M -> wrist extension
- S -> 1st web space
- M -> wrist extension
- Reflexes:
- Biceps: C5
- Brachioradialis: C6
- Triceps: C7
- Pulses:
- Brachial A
- Radial A
- Ulnar A
- Axillary:
- Joint above (cervical spine) + joint below (elbow)