Yergason's test

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Yergason's test
Medical diagnostics
Purpose examination of the shoulder

Yergason's test is a special test used for orthopedic examination of the shoulder and upper arm region, specifically the biceps tendon. [1]

Contents

Purpose

It identifies the presence of a pathology involving the biceps tendon or glenoid labrum as. The specific positive findings to the test include: pain in the bicipital groove indicating biceps tendinitis, [2] [3] subluxation of the long head of the biceps brachii muscle, [3] and presence of a SLAP tear. [4]

Pathology study and diagnosis of disease

Pathology is concerned mainly with the causal study of disease.

Glenoid labrum

The glenoid labrum is a fibrocartilaginous structure rim attached around the margin of the glenoid cavity in the shoulder blade. The shoulder joint is considered a ball and socket joint. However, in bony terms the 'socket' is quite shallow and small, covering at most only a third of the 'ball'. The socket is deepened by the glenoid labrum.

Procedure

Palpating the biceps tendon as it passes through the bicipital groove to identify any lesions, abnormal bumps, or abnormal movement (i.e. biceps tendon) in the involved area. [4]

Tendon type of tissue that connects muscle to bone

A tendon or sinew is a tough band of fibrous connective tissue that usually connects muscle to bone and is capable of withstanding tension.

A lesion is any damage or abnormal change in the tissue of an organism, usually caused by disease or trauma. Lesion is derived from the Latin laesio "injury". Lesions may occur in plants as well as animals.

Mechanism

To perform the test, the examiner must stand on the affected side of the patient. The patient needs to be in a seated position with the elbow flexed to 90°, forearm pronated (palm facing the ground), and the arm stabilized against the thorax. [2] [3] [4] The examiner places the stabilizing hand on the proximal portion of the humerus near the bicipital groove, and the resistance hand on the distal forearm and wrist. [1] [2]

The patient is instructed to actively supinate the forearm, externally rotate the humerus, and flex the elbow against the resistance of the examiner. [1] [2] Referred pain by the patient results in one of positive findings.

Humerus long bone of the upper arm

The humerus is a long bone in the arm that runs from the shoulder to the elbow. It connects the scapula and the two bones of the lower arm, the radius and ulna, and consists of three sections. The humeral upper extremity consists of a rounded head, a narrow neck, and two short processes. The body is cylindrical in its upper portion, and more prismatic below. The lower extremity consists of 2 epicondyles, 2 processes, and 3 fossae. As well as its true anatomical neck, the constriction below the greater and lesser tubercles of the humerus is referred to as its surgical neck due to its tendency to fracture, thus often becoming the focus of surgeons.

Results

Biceps tendinitis or subluxation of the biceps tendon can normally be addressed by palpating the long head of the biceps tendon in the bicipital groove. [2] The patient will exhibit a pain response, snapping or both in the bicipital groove. Pain with no associated popping might indicate bicipital tendinopathy. A snapping indicates a tear or laxity of the transverse humeral ligament, which would prevent the ligament from securing the tendon in the groove. Pain at the superior glenohumeral joint is indicative of a SLAP tear. [4]

Adverse effects

This is a difficult test to perform for an accurate diagnosis. [2] False positive findings can be the result of a rotator cuff tear, while pain in the superior glenohumeral region is a weak predictor of a SLAP tear. [4]

See also

Here are a list of anatomical terms with their associated links that are used in this article.

Related Research Articles

Rotator cuff

In anatomy, the rotator cuff is a group of muscles and their tendons that act to stabilize the shoulder. Of the seven scapulohumeral muscles, four make up the rotator cuff. The four muscles are the supraspinatus muscle, the infraspinatus muscle, teres minor muscle, and the subscapularis muscle.

Biceps muscle of the arm

The biceps, also biceps brachii, is a large muscle that lies on the front of the upper arm between the shoulder and the elbow. Both heads of the muscle arise on the scapula and join to form a single muscle belly which is attached to the upper forearm. While the biceps crosses both the shoulder and elbow joints, its main function is at the elbow where it flexes the forearm and supinates the forearm. Both these movements are used when opening a bottle with a corkscrew: first biceps unscrews the cork (supination), then it pulls the cork out (flexion).

Brachioradialis

The brachioradialis is a muscle of the forearm that flexes the forearm at the elbow. It is also capable of both pronation and supination, depending on the position of the forearm. It is attached to the distal styloid process of the radius by way of the brachioradialis tendon, and to the lateral supracondylar ridge of the humerus.

Shoulder problem

Shoulder problems including pain, are one of the more common reasons for physician visits for musculoskeletal symptoms. The shoulder is the most movable joint in the body. However, it is an unstable joint because of the range of motion allowed. This instability increases the likelihood of joint injury, often leading to a degenerative process in which tissues break down and no longer function well.

Shoulder part of the body

The human shoulder is made up of three bones: the clavicle (collarbone), the scapula, and the humerus as well as associated muscles, ligaments and tendons. The articulations between the bones of the shoulder make up the shoulder joints. The shoulder joint, also known as the glenohumeral joint, is the major joint of the shoulder, but can more broadly include the acromioclavicular joint. In human anatomy, the shoulder joint comprises the part of the body where the humerus attaches to the scapula, and the head sits in the glenoid cavity. The shoulder is the group of structures in the region of the joint.

Musculocutaneous nerve

The musculocutaneous nerve arises from the lateral cord of the brachial plexus, opposite the lower border of the pectoralis major, its fibers being derived from C5, C6 and C7.

Cubital fossa

The cubital fossa or elbow pit is the triangular area on the anterior view of the elbow of a human or other hominid animal. It lies anteriorly to the elbow when in standard anatomical position.

Shoulder joint

The shoulder joint is structurally classified as a synovial ball and socket joint and functionally as a diarthrosis and multiaxial joint. It involves articulation between the glenoid cavity of the scapula and the head of the humerus.

Subscapularis muscle Large triangle muscle of the shoulder

The subscapularis is a large triangular muscle which fills the subscapular fossa and inserts into the lesser tubercle of the humerus and the front of the capsule of the shoulder-joint.

The pronator teres is a muscle that, along with the pronator quadratus, serves to pronate the forearm. It has two attachments, to the medial humeral supracondylar ridge and the ulnar head, and inserts near the middle of the radius.

SLAP tear

A SLAP tear or SLAP lesion is an injury to the glenoid labrum. SLAP is an acronym for "superior labral tear from anterior to posterior".

Glenoid cavity part of the shoulder

The glenoid cavity or glenoid fossa of scapula is a part of the shoulder. It is a shallow, pyriform articular surface, which is located on the lateral angle of the scapula. It is directed laterally and forward and articulates with the head of the humerus; it is broader below than above and its vertical diameter is the longest.

Glenohumeral ligaments

In human anatomy, the glenohumeral ligaments (GHL) are three ligaments on the anterior side of the glenohumeral joint. Reinforcing the anterior glenohumeral joint capsule, the superior, middle, and inferior glenohumeral ligaments play different roles in the stability of the head of the humerus depending on arm position and degree of rotation.

Shoulder surgery is a means of treating injured shoulders. Many surgeries have been developed to repair the muscles, connective tissue, or damaged joints that can arise from traumatic or overuse injuries to the shoulder.

Humeroradial joint anatomical structure

The humeroradial joint is the joint between the head of the radius and the capitulum of the humerus, is a limited ball-and-socket joint, hinge type of synovial joint.

Jobe's test, also known as the relocation test and empty can test, is an orthopedic examination used to test stability of the shoulder.

A Shoulder examination is a portion of a physical examination used to identify potential pathology involving the shoulder. It should be conducted with both shoulders exposed to assess for asymmetry and muscle wasting.

The Hawkins–Kennedy Test is a test used in the evaluation of orthopedic shoulder injury. It was first described in the 1980s by American Drs. R. Hawkins and J. Kennedy, and a positive test is most likely indicative of damage to the tendon of the supraspinatus muscle.

References

  1. 1 2 3 Thomas W. Woodward, Thomas M. Best. "The Painful Shoulder: Part 1. Clinical Evaluation." American Family Physicians. Ed. William E. Schekler. 1 May 2000. 9 March 2011. <http://www.aafp.org/afp/20000515/3079.html>.
  2. 1 2 3 4 5 6 Jeff G. Konin et al. Special Tests for Orthopedic Examination: Third Edition. Thorofare, NJ. SLACK Incorporated, 2006.
  3. 1 2 3 W. Ben Kibler, Aaron D. Sciascia, Peter Hester, David Dome, and Cale Jacobs. "Critical Utility of Traditional and New Tests in the Diagnosis of New Bicep Tendon Injuries in Superior Labrum Anterior and Posterior Lesions in the Shoulder." Am J Sports Med. 37 (2009): 1840-1847.
  4. 1 2 3 4 5 6 Chad Starkey, Sara D. Brown, and Jeff Ryan. Orthopedic and Athletic Injury Examination Handbook: Edition 2. Philadelphia: F.A. Davis Company, 2010.