question

Facilitation

answer

Encourage continuation of story Similar to active listening Phone etiquette

question

Reflection

answer

Repeating part of the what the person just said Similar to echoing

question

Empathy

answer

Recognizes a feeling and puts it into words states the unstated

question

Therapeutic Communication

answer

Facilitation Silence Reflection Empathy Clarification Confrontation Interpretation Explanation

question

Clarification

answer

Used to summarize words, clear up ambiguous language use, simplify Confirm that you are correct before moving on

question

Confrontation

answer

Focuses the person's attention on a certain action, feeling, or statement

question

Interpretation

answer

Based on your inference or conclusion

question

Explanation

answer

Inform the person Factual and objective information

question

OLD CARTS

answer

Onset Location Duration Characteristcis Associated symptoms Relieving or aggravating factors Treatment Severity (pain scale) and signs of understanding

question

History of Present Illness

answer

The 7 attributes of a symptom OPQRST

question

Family History

answer

Pedigree or Genogram should include at least 3-4 generations

question

Episodic History

answer

Includes chief complaint, HPI, pertinent past history and any relevant family history

question

Head examination

answer

Start with palpation and inspection Hair distribution Masses or lesions Foreign objects

question

Inspection of the face

answer

Look for symmetry Assess cranial nerves V (Trigeminal) and VII (Facial)

question

CN V: Trigeminal

answer

Mixed. Motor=chewing. Sensory = face and scalp, cornea, mucous membranes and nose.

question

CN VII: Facial

answer

Mixed. Motor = facial muscle, closing eyes, labial speech, closing mouth. Sensory = taste, anterior 2/3 of tongue. Parasympathetic - tear and saliva production

question

Nodes to palpate and name

answer

Post auricular, Pre auricular, occipital, submandibular, Anterior and posterior cervical chains, supraclavicular

question

Lymphadenitis

answer

most frequent form of extrapulmonary TB. Depends of immunosuppression of children with HIV. Presents as painless, firm, red , usually matted mass, localized in one region. Fine needle aspiration demonstrates cytologic evidence of granuloma, but smears or cultures are usually negative. TB skin test is almost always positive.

question

Physical examination of eye

answer

Know structures Inspect lids and external structures Pupillary reaction Extraocular movements - 6 positions retinal exam with opthalmoscope Visual acuity and visual fields Sclera should be white and conjunctiva should be clearC

question

Diopter

answer

Farsighted - green (+) or black Nearsighted - red (-)

question

Papilledema

answer

occurs when there is increased brain pressure caused by tumor, head injury, or other problems causing swelling of the optic nerve. Vision usually no affected initially and it is a bilateral condition. Patient may have symptoms of intracranial pressure like headache, nausea, and vomiting.

question

Optic disk edema

answer

Usually caused by: increased intracranial pressure - papilledema infarction inflammation infiltration by cancer

question

Location of Macula

answer

Two disc diameters temporal to disc

question

Examining the eye

answer

Allergies: both eyes usually involved. Glaucoma gets immediate referra Periorbital cellulitis: can lead to more serious infection so may send to ER

question

Conjunctivitis

answer

Rarely painful Bacterial/classic: green discharge Allergic: clear discharge

question

Chalazion

answer

Higher up on the lid

question

Hordeolum

answer

right on the lid next to eye (on the bottom lid)

question

uveitis

answer

emergent referral, goes right up to the limbus

question

Pterygium

answer

growth across the limbus, tissue

question

Pinguecula

answer

bump in the sclera caused by dust/UV light. See in migrant farm workers.

question

Flourescin stain

answer

look for corneal abrasion, hepatic keratitis, ulcers. Use different color stains and lights

question

Cranial nerve II

answer

Fundascopic exam - Pupillary light reflex The patient stares into the distance as the examiner shines the penlight obliquely into each pupil. Pupillary constriction should be noted on the eye examined (direct response) and on the opposite eye (consensual response). The swinging flashlight test involves moving the light between the two pupils. Normally both direct and consensual responses are elicited when the light shines on an eye, and some dilation will occur during the swing between., visual fields, and visual acuity.

question

Opthalmoscopic exam

answer

Right eye to right eye and vice versa Farsighted use green (+ or black) Nearsighted use red or - Look for red reflex first. If no reflex, may have detached retina or tumor (esp in kids). Needs referral.

question

Opthalmoscopic exam know how

answer

When you look at the disk, the patient is ok. It is when you look at the macula that the pt tears up or gets uncomfortable. Big vessels are veins and the little vessels are arteries. Follow the vessels to the optic disc. 1st thing to assess is the state of the vessels and the 2nd thing is the optic disc.

question

AV nicking

answer

HTN narrows the arteries and creates indentions in the veins, where the arteries cross the vein. Rigid arterioles compress the vein as they cross within a common adventitial sheath. Thickening of vessels.

question

Retinopathy

answer

microaneurysms, retinal hemorrhages, and cotton wool spots associated with Diabetes. Vision loss occurs. Disc to cup ratio should be 1 to 2

question

Hints for using opthalmascope

answer

Use a smaller light because brightness of light allows for less light so pupil doesn't constrict too much. Red free lense (green light) is better viewing of the vessels, specifically for nicks and for neo-vascularization. Blue light is used with flourescin for corneal abrasions as is slit

question

Loss of vision

answer

\"shade coming down\" Aura reduced color less bright \"looking through smoke\" last 2-3 hours

question

Extraocular movements for CN III, IV, and VI

answer

6 cardinal fields of gaze Cover and uncover eye Corneal light reflection test PERRLA - direct, consensual, accommodation -The examiner tests ocular movements by standing one meter in front of the patient and asking the patient to follow a target with eyes only, and not the head. The targets is moved in an \"H\" shape and the patient is asked to report any diplopia. Then, the target is held at the lateral ends of the patient's visual field. Nystagmus should be noted. One or two beats is a normal finding. The accommodation reflex is tested by moving the target towards the patient's nose. As the eyes converge, the pupils should constrict. The optokinetic nystagmus test is optional and involves asking the patient to look at a moving strip of horizontal lines. Nystagmus is normally observed.

question

Anoscoria

answer

Unequal size of the pupils Need to darken the room Can be caused by head injury, Horner's syndrome

question

Accomodation

answer

move finger in to the nose and back out to see if pt is following your finger appropriate and pupils adjust accordingly

question

Cover test

answer

Cover on eye and the weak eye will wander. When the paper is removed, the eye will go back into the right place. Muscle weakness test.

question

Strabismic amblyopia EOMs

answer

use corneal light reflex, Hirshburg's test, and the Cover test

question

Cranial Nerve VIII

answer

Ear exam Can the person hear? Examine external ear structures Otoscope exam Any inflammation of the middle ear? Always question for external ear pain: Dental problems, TMJ, cervical, mouth or facial disorders.

question

Peripheral ear

answer

Canal, ear drum, ossicles, round window, cochlea

question

Hearing and the brainstem

answer

location of sound indentification of sound 0 decibels heard by person with normal hearing

question

Cerebral cortex and hearing

answer

interpretation Reaction

question

Conductive hearing loss

answer

External otitis (acute and chronic) wax Exostoses/osteomas Acute otitis media Otitis media with effusion TM performance Chronic suppurative otitis media (safe or mucosal CSOM or cholesteatoma) Otosclerosis

question

Sensorineural hearing loss

answer

occupational or noise induced loss presbycusis meniere's disease ototoxicity - systemic and topical cochlear otosclerosis trauma acoustic neuromas sudden loss

question

Vestibular apparatus

answer

detects position and movement of the head. Consists of the saccule, the utricle, and three semicircular ducts these are parts of a system of tubes and cisterns, the membranous labyrinth, that is entombed in the petrous part of the temporal bone The membranous walls are separated from the lining of the bony labyrinth by perilymph, a fluid similar to CSF The fluid inside the membranous labyrinth is endolymph, a liquid similar to intracellular fluid, with a high concentration of potassium and a low concentration of sodium

question

Focus ear history

answer

Age: acute otitis media declines after age 6 Fever: high fever more likely a systemic infection URI: organisms forced up the eustachian tube Previous infections: chronic otitis can result in anatomical changes family history: child is two times more likely if parent or sibling

question

Environment exposure (ear)

answer

smoke exposure swimming b/c protective wax is lost airplane travelers and divers: failure of the eustachian tube to open which causes pain, tinnitus, and temporary deafness

question

Physical exam of the ear

answer

inspect external ears palpate external ears inspect ear canals inspect tympanic membranes test hearing acuity (CN VIII) Weber and Rinne test

question

Red ear drum

answer

A red ear drum does not always mean otitis media. If a child has been crying, their ear drums will be red.

question

Weber Test

answer

If hearing complaints on history If fails hearing test Ask patient to tell you which side they hear louder Normal finding: equally loud Abnormal: sound heard better in one ear - the good ear

question

Rinne Test

answer

Place tuning fork on mastoid process unless it is infected When pt tells you the sound disappears, place the tuning fork in front of their ear 1 or 2 cm. Normal is AC > BC.

question

Cranial Nerve I

answer

Olfactory - don't generally test

question

Nose exam

answer

examine nasal septum examine nasal turbinates Inspect the face Regional exam of the head and neck examine teeth and mouth nasal mucosa and turbinates inspect for masses Check for discharge: color? Transilluminate the sinuses Palpate the sinuses and for facial fullness Check lungs Do neuro testing

question

Diagnostic testing for nose

answer

Nasal smear testing sinus x-rays - not done as much anymore CT of sinuses skin testing for allergies Cranial nerve I: olfactory

question

Cranial nerves IX, X, XII

answer

Inspect the mouth and throat by examining the buccal mucosa, tongue, and sublingual area for the presence of ulcers. Note the location, number and size of lesions if present. Types of lesions Inspect the posterior pharynx and observe swallowing Movement of tongue Say \"ah\" Edema, color, exudate presences and condition of tonsils. GRADE TONSILS If ENLARGED Must have a light Use gloves or tongue blades

question

Throat

answer

For sore throat: pharyngitis. Inspect the entire anterior and posterior pharynx. Note any lesions and their locations.

question

Goals of throat assessment and diagnosis

answer

Identify patients with Group A beta hemolytic strep Reduce the possibility of sequelae of peritonsillar abscess Identify epiglottis

question

Peritonsilar abscess

answer

Emergent! Don't look into throat with blade b/c can spasm and occlude airway See often with strep

question

3 Most Important Questions in Neuro exam

answer

1. Is the mental status intact? 2. Are the right and left sides symmetric? 3. If asymmetric, does the causative lesion lie peripherally or centrally?

question

Lethargy

answer

requires a loud verbal stimulus to arouse

question

Stupor

answer

require tactile stimulation to arouse

question

Coma

answer

unable to arouse with noxious stimulus

question

Dysarthria

answer

disturbance in motor control of speech and difficulty of articulation

question

Dysphonia

answer

difficulty with phonation

question

dysphagia

answer

difficulty with swallowing

question

Aphasia

answer

difficulty with language broken into sensory and motor

question

Fluency

answer

rate and accuracy of language and thoughts. Best done by having patient describe a picture

question

Comprehension

answer

able to perform a series of actions that are asked of patient. For example, take your right hand and touch your left ear. Can make 1, 2, or 3 step commands.

question

Naming

answer

able to identify common objects as well as more complex parts of projects

question

Repetition

answer

able to repeat a sentence such as \"no ifs, ands, or buts\"

question

Reading and writing

answer

part of language exam

question

Wernicke's Aphasia

answer

Also called fluent or sensory aphasia or receptive aphasia Difficulty with comprehension, typically called fluent speech Difficulty with naming and repetition Paraphasic errors Lesion is in posterior superior temporal lobe

question

Broca's Aphasia

answer

Called motor aphasia or non-fluent aphasia Patients have marked impairment in fluency Unable to name and repeat Lesion in the front operculum

question

Outpatient Mental Status exam

answer

1. Attention: should be assessed early in the exam (have patient recall random digits. Should be able to recall 7 forward digits 2. Memory testing: mini-mental status 3. Perseverance: difficulty holding attention 4. Apraxia: inability to perform complex motor task (for example, show me how you would hammer a nail with your hands)

question

Cranial Nerve I - olfactory

answer

can be damaged in frontal lobe disorder, aging, smoking, cocaine use Test each nostril with eyes close. Use strong, easily identifiable odors Rare disorders cause this such as a large meningioma of the frontal lobe on the cribiform plate.

question

Cranial Nerve II: Optic

answer

Visual acuity is the vital sign of the eye For acuity, use the Snellen chart For visual fields, use confrontation Do fundoscopic exam

question

Cranial Nerve III: Oculomotor

answer

Controls most eye movements Pupillary constriction and accommodation Vertical and horizontal movements of the eyes Muscles innervated include the medial, superior, inferior rector and inferior oblique

question

PCOM aneurysm

answer

Pupil involvement with complete third nerve palsy

question

Cranial Nerve IV: Trochlear

answer

Moves the superior oblique muscle Medial rotation \"down and in\"

question

Cranial Nerve V: Trigeminal

answer

supplies sensation to the face, nasal/bucchal mucosa, and teeth. 3 major divisions: opthalmic (V1): corneal reflex Maxilliary (V2): sensory function Mandibular (V3): motor function -Light touch is tested in each of the three divisions of the trigeminal nerve and on each side of the face using a cotton wisp or tissue paper. The ophthalmic division is tested by touching the forehead, the maxillary division is tested by touching the cheeks, and the mandibular division is tested by touching the chin. Be careful not to test the mandibular division too laterally, as the mandible is innervated by the great auricular nerve (C2 and C3). A common mistake is to use a stroking motion, which will trigger pain and temperature nerves. Instead, a point stimulus should be applied. For pain and temperature repeat the same steps as light touch but use a sharp object and a cold tuning fork respectively. Corneal reflex is conducted along with the facial nerve section of the test. Note the sensory innervation of the cornea is provided by the trigeminal nerve while the motor innervation for blinking the eye is provided by the facial nerve.- Muscles of mastication (temporalis, masseter) should be inspected for atrophy. Palpate the temporalis and masseter as the patient clenches the jaw. The pterygoids can be tested by asking the patient to keep the mouth open against resistance, and move from side to side against resistance. A jaw jerk reflex can be tested by placing a finger over the patient's chin and then tapping the finger with a reflex hammer. Normally the jaw moves minimally.

question

Disease Involving the Trigeminal Nerve

answer

Tic Doloureaux (Trigeminal Neuralgia) which affects the V2 and V3 territory Cavernous sinus lesions Herpes Zoster infection of the nerve

question

Cranial Nerve VI: abducens

answer

Movement of the lateral rectus muscle: \"Away from the nose\" Impaired abduction

question

Cerebral Sinus Venous Thrombosis

answer

Occurs in younger women typically due to hypercoagulable conditions, use of OCP's, dehydration, and pregnancy Bilateral 6th nerve palsies are a marker of ICP

question

Cranial Nerve VII: Facial

answer

Motor function: muscles of facial expression Parasympathetic: lacrimal, submaxillary, submandibular glands Sensory: anterior 2/3 of the tongue Upper motor neuron vs. Lower motor neuron facial palsy? Lower involves forehead and upper spares the forehead. Upper means it is in the brain tissue and lower means it is in the nerve itself Inspect for facial asymmetry and involuntary movements. Motor 1) Raise both eyebrows 2) Frown 3) Close both eyes tightly so that you can not open them. Test muscular strength by trying to open them 4) Show both upper and lower teeth 5) Smile 6) Puff out both cheeks Sensory : test for taste

question

Cranial Nerve VIII: Vestibulacochlear

answer

Responsible for hearing, balance, and awareness of position. Auditory testing Rinne/Weber test

question

Rinne/Weber Test

answer

Normally AC>BC If BC> AC = conductive hearing loss If AC>BC with hearing loss = sensorineural hearing loss With Weber test: conductive hearing loss: tone is louder on the affected side. Sensorineural hearing loss: tone is louder on normal side Conduction diseases involve the bone, auditory canal, tympanic membrane Sensorineural affects the nerve itself

question

Cerebellopontine Angle Tumor

answer

Involves: CN V (V1): corneal CN VII: taste anterior 2/3 of tongue CN VIII: hearing loss

question

Cranial Nerve IX: Glossopharyngeal

answer

Supplies sensation to the pharynx, posterior 1/3 of tongue, tympanic membrane Test \"gag reflex\" Check for symmetrical elevation of the soft palate

question

Cranial Nerve X: Vagus

answer

Motor fibers to the Pharynx and Larynx. Tested along with Cranial Nerve IX. Should see midline uvula Evaluate for dysphonia and dysarthria

question

Cranial Nerve XI: Spinal accessory

answer

Supplies the SCM and trapezius muscles Ask patient to shrug their shoulders and turn head side to side

question

Cranial Nerve XII: Hypoglossal

answer

Supplies the motor fibers of the tongue Ask patient to stick out their tongue and check to see if it is midline

question

Motor exam: muscle bulk

answer

Assess for atrophy, fasciculations, and compare their contours for symmetry

question

Motor exam: muscle tone

answer

Check for resistance to passive movement: spasticity, hyperreflexia, clonus, cogwheeling

question

Motor exam:

answer

focus on the body position, involuntary movements, charas of muscles and coordination

question

Spasticity

answer

resistance varies with speed and direction of passive movement. Has increased reflexes.

question

Rigidity

answer

increased muscle tone of flexors and extensors and resistance to passive movement. Does not have increased reflexes.

question

Hypotonicity

answer

Loss of normal tone with flabby and soft muscle

question

Fasciculations

answer

twitches of the muscles at rest

question

Grading Muscle Strength: ABSENT (0)

answer

no contraction

question

Grading muscle strength: Trace (1)

answer

slight contraction

question

Grading muscle strength: Weak (2)

answer

Movement with gravity eliminated

question

Grading muscle strength: Fair (3)

answer

Movement against gravity

question

Grading muscle strength: Good (4)

answer

Movement against gravity with some resistance

question

Grading Muscle strenght: Normal (5)

answer

Movement against gravity with full resistance

question

Coordination

answer

All four areas of the nervous system must function in an integrated way: 1. Motor - strength 2. Cerebellum 3. Vestibular 4. Sensory system Assess rapid alternating movements, point to point movements, gait, and standing

question

Rapid alternating movements

answer

Fingers (FFM): dysdiadokinesia (abnormal alternating movements) Finger - Nose - Finger (FNF): past pointing Heel to shin: ataxia (abnormal trajectory and oscillatory movements to target) Appendicular versus truncal:

question

Gait assessment

answer

Walk: observe posture, balance, arm swing Heel to toe: \"tandem walking\" Walk on toes and then heels: observe balance

question

Romberg test

answer

the patient stands with feet together and the arms at their sides. Note any swaying (slight is ok). Ask pt to close eyes for additional testing.

question

Pronator drift

answer

sensitive and specific for a lesion in the contralateral hemisphere

question

Superficial reflexes

answer

Abdominal: umbilical response Cremasteric: testicular response Corneal Anal reflex

question

Deep Tendon reflexes

answer

Biceps - C5 Brachioradialis - C6 Triceps - C7 Patellar - L4 Achilles - S1

question

DTR scale

answer

0 - no response 1+ - diminished response 2+ - normal 3+ - increased 4+ - hyperactive

question

Cervical Disc Disease

answer

Patient is exhibiting myelopathy at C5-C6 and C6-C7 levels Exhibited by weakness of right bicep and tricep and reflex increased Reflexes increase because of cord involvement

question

Sensory exam Components

answer

Light touch Pain Vibration sense Proprioception Tactile Localization Discriminative sensations

question

Light touch

answer

compare bilaterally Start distally Work proximally if abnormal or absent

question

Pain

answer

sharp or dull? Compare sensations

question

Vibration sense

answer

tap tuning fork place vibrating instrument onto DIP \"Do you feel buzz? Tell me when it stops?\"

question

Propioception

answer

Move toe up and down. Pt closes eyes and tell you the position of their toe

question

B12 deficiency (subacute combined degeneration

answer

Degeneration of the posterior columns of the spinal cord due to B12 deficiency Profound sensory ataxia and gait instability Sometimes have mental status changes

question

Discriminative senses

answer

Two point discrimination: touch finger pad in two places, alternate double stimulus irregularly. Normal <5mm Test Point localization: briefly touch a point on the patient's skin with their eyes close. Have them open their eyes and touch the place that you previously touched.

question

Stereognosis

answer

Place an object in their hand and have them name what it is

question

Graphesthesia

answer

Draw a number in their hand

question

Coma

answer

potential life threatening even affecting the two hemispheres, the brainstem or both

question

Brain death exam

answer

Oculocephalic reflex: \"doll's eyes\" Cold caloric stimulation

question

MSK Common or concerning symptoms

answer

Low back pain Neck pain Monoarticular or polyarticular joint pain Inflammatory or infectious joint pain Joint pain with systemic features such as fever, chills, rash, anorexia, weight loss, weakness Joint pain with symptoms from other organ systems

question

MSK terminology

answer

Articular: joint related Nonarticular: around the joint

question

Synovial joints

answer

freely movable E.g. Knee, shoulders

question

Cartilaginous joints

answer

slightly movable e.g. vertebral bodies

question

Fibrous joints

answer

immovable e.g. skull structures

question

Important MSK questions in addition to OLDCARTS for HPI

answer

1. point to the pain 2. is pain localized, diffuse, acute, chronic? 3. Mechanism of injury: When did it occur? Did you hear a click or pop when it happened? 4. Is there any swelling or dislocation? 5. Has it improved with therapeutics or rest? 6. FEVER or CHILLS? red flag!

question

Inspect joints for:

answer

symmetry, edema, ecchymosis, erythema, deformity, abnormal position, broken skin or rashes

question

Inspect muscle tone for:

answer

atropy, tremory, fasciculations

question

Palpation

answer

unaffected joint first area surrounding site of pain, working towards the site Check for tenderness, derm changes, warmth, nodules, muscle atrophy, crepitus, crunching, adenopathy. Watch their face to assess for tenderness.

question

Active ROM

answer

the patient moves their joint or limb Note any limits, apprehension in movement, differentiate b/w true strength and ROM limitations vs. limitations in ROM or strength due to pain Look for joint instability Look for increased mobility

question

Passive ROM

answer

Provider assisted movement gently test the limits of noted AROM Look for joint instability Look for increased mobility

question

ROM terminology

answer

Flexion Extension Abduction Adduction External rotation Internal rotation deviation pronation supination inversion eversion

question

Neck Pain Common Conditions

answer

Neck spasm, cervical disc problems, thoracic outlet syndrome, torticollis, herpes zoster, osteoarthritis or spinal stenosis, spondylolisthesis, ankylosing spondylitis, infection, malignancy

question

Red flag during MSK history

answer

Age greater than 50, fever, weight loss, numbness

question

Neck Pain - muscle spasms

answer

either traumatic or nontraumatic neck pain, limited ROM

question

Neck pain - cervical disk injury

answer

traumatic injury, worse with tilt to affected side, numbness or tingling to the affected dermatones, may not have pain or radicular pain

question

Neck Pain physical exam

answer

- Inspection with gown or shirt removed Check stance, gait, posture, expressions, pain behavior - Comprehensive general physical exam: 1. neuro evaluation: cranial nerve testing, upper limb sensation, reflexes 2. Palpation of vertebral and paravertebral areas 3. ROM

question

Active ROM Cervical Spine

answer

Extension Flexion: check nucchal rigidity. Pain cannot place chin to chest while other ROM is intact. Lateral bending Rotation

question

Brudzinskis sign

answer

when head comes up, the knees also come up

question

Kernig's sign

answer

When knees come up, the head comes up

question

Low Back Pain common conditions

answer

Back strain Acute disc herniation Osteoarthritis or spinal stenosis Spondylolistehesis Ankylosing spondylitis Infection Malignancy

question

Back Strain ROS

answer

low back, buttock, posterior thigh, aching pain, spasm, increased with activity or bending, limited motion due to pain

question

Acute disc herniation ROS

answer

low back to lower leg pain, sharp, shooting or burning pain, paresthesia in leg, pain better with standing, increased with bending or sitting

question

Osteoarthritis ROS

answer

low back to lower leg, often bilateral, ache, shooting pain, \"pins and needles\" sensation, increased with walking, especially up an incline, decreased with sitting

question

Shoulder pain common conditions

answer

Rotator cuff injury cervical disk disease

question

Rotator cuff injury ROS

answer

history of trauma, pain accompanied by weakness

question

Impingement

answer

More chronic and positional Bursitis Tendonitis

question

Cervical disk disease

answer

pain radiating below elbow decreased cervical range of motion

question

Shoulder pain physical exam Inspection

answer

Posture sitting or standing expressions, behavior symmetry muscle atrophy edema derm discoloration

question

Shoulder pain physical exam palpation

answer

sternum, clavicle, neck vertebrae, shoulder joint, and elbow

question

Shoulder pain physical exam AROM

answer

lateral raise (abduction and adduction) Flexion and extension Internal and external rotation (Apley Scratch test) Circumduct

question

Shoulder pain physical exam PROM

answer

hand on shoulder to be examined Grasp humerus and move through ROM

question

shoulder pain physical exam strength testing

answer

Neers and Hawkins tests

question

Assessment of rotator cuff

answer

Test all 4 muscles: supraspinatus with \"empty can\" test, Teres Minor and Infraspinatus with \"no wings\" test, and subscapularis with \"lift off\" test Drop Arm test for supraspinatus tears

question

Humeral Head displacement

answer

Use apprehension test

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