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Spot Diagnosis : Physical Exam...trying to revive a fading art

Discussion in 'Spot Diagnosis' started by neo_star, Mar 18, 2013.

  1. neo_star

    neo_star Moderator

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    what is the examiner trying to test ?

    Pls. put ur answer as a comment ( preferably in ur own words ). Grammar doesn't matter ( v r a family ) (-:
     

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  2. Emergency medicine Mike

    Emergency medicine Mike Bronze Member

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  3. apparat

    apparat Well-Known Member

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    Testing subscapularis
     

  4. neo_star

    neo_star Moderator

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    Answer: Sub scapularis lift-off test ( aka Gerber test ), for testing subscpularis weaakness and tendenitis.

    Discussion

    lift off.JPG

    Patient: Stands or lies prone, the arm is internally rotated and elbow is moderately flexed, with the dorsum of the hand touching the mid-lumbar spine.
    Examiner: Instruct patient to lift the hand away from the back.

    Positive test: Inability to lift the dorsum of the hand off the back against gravity or minimal resistance from examiner, or restriction is noted compared with contralateral side.


    ▪ Subscapularis tendinitis: anterior shoulder pain increased
    ▪ Subscapularis tear: weakness for this procedure


    Note:
    1. The test may be attempted when standing.
    2. Patient mayattempt to substitute triceps/elbow extension if subscapularis,latissimus dorsi, or rhomboid is weak.

    3. there are other tests that test internal rotation, but recruit other int. rotators (ex. pec major, lat dorsii ) more than in this test. This test isolates subscapularis the most.
     

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