Question 1

What are the four joints that make up the shoulder complex?

Accepted Answer

The shoulder consists of four separate joints: the glenohumeral joint, the acromioclavicular joint, the sternoclavicular joint, and the scapulothoracic joint. The glenohumeral joint is a ball-and-socket joint primarily responsible for shoulder motion and is the most mobile joint in the body. The other three joints work together to enable the full range of shoulder movement and stability.

Question 2

Why are rotator cuff injuries the most common source of shoulder pain?

Accepted Answer

The four rotator cuff muscles—subscapularis, supraspinatus, infraspinatus, and teres minor—stabilize the glenohumeral joint. Injury to these muscles, especially their tendons, causes the most frequent shoulder complaints. Common rotator cuff injuries include tendonitis, tears, and impingement, often resulting from repeated overhead motions like swimming.

Question 3

What should you look for during shoulder inspection?

Accepted Answer

During inspection, examine both anterior and posterior shoulder aspects for swelling, ecchymoses, and scars. Note any asymmetry from muscle atrophy or hypertrophy. Atrophy of the supraspinatus or infraspinatus muscles may indicate inactivity or nerve damage from rotator cuff injury. Always compare the injured shoulder to the opposite side.

Question 4

What does tenderness in the subacromial space indicate during palpation?

Accepted Answer

Tenderness in the subacromial space, located just below the acromion, can indicate rotator cuff tendonitis, impingement, or rotator cuff tear. To assess this area, move your fingers laterally from the pectoralis tendon to the anterior acromion tip, then palpate just below it in the front, side, and back.

Question 5

What is the difference between active and passive range of motion testing?

Accepted Answer

Active range of motion is tested by asking the patient to move the shoulder independently. If the patient cannot perform the motion, it may indicate rotator cuff tear or nerve injury. Passive motion is performed by the examiner moving the patient's arm. Loss of both active and passive motion suggests a mechanical block like adhesive capsulitis or severe impingement.

Question 6

What does a positive Drop Arm test indicate?

Accepted Answer

The Drop Arm test is performed by lifting the patient's arm to 90 degrees abduction and asking them to hold it. A positive test occurs when the patient cannot lift or hold the arm in this position, suggesting a large rotator cuff tear or nerve injury affecting shoulder stability and strength.

Question 7

Why is a neck exam often performed alongside shoulder examination?

Accepted Answer

Shoulder pain can sometimes radiate from the cervical spine rather than originating in the shoulder itself. A neck exam, which includes palpation motion strength impingement neurologic assessment, is usually performed with the shoulder exam to exclude cervical region injuries and accurately identify the true source of pain.

מבחן כתף I - חידון הערכה