WorksheetsBiceps Tendon Special Tests
Total questions: 45
Worksheet time: 23mins
Which movement combination best describes the patient action resisted during Yergason’s test to assess biceps tendon stability?
Shoulder external rotation with elbow extension
Forearm pronation with shoulder flexion
Elbow flexion with shoulder abduction
Forearm supination with elbow flexion
During Speed’s test, where should pain reproduction most specifically indicate biceps tendon pathology?
Lateral arm near deltoid tuberosity
Anterior shoulder at bicipital groove
Posterior deltoid region near scapula
Medial elbow over ulnar nerve
Which starting position is most appropriate before applying resistance in Speed’s test?
Shoulder abducted and elbow flexed
Shoulder internally rotated and forearm neutral
Elbow flexed and forearm pronated
Elbow extended and forearm supinated
Yergason’s test primarily evaluates which clinical issue related to the long head of the biceps?
Partial thickness rotator cuff tear
Acromioclavicular joint sprain
Tendon subluxation from the bicipital groove
Posterior labral detachment
If Speed’s test is negative but Yergason’s test is positive, which interpretation is most defensible?
Acute labral tear requiring urgent imaging
Possible biceps instability without tendinopathy
Definite rotator cuff impingement syndrome
Likely proximal humeral fracture
Which examiner hand placement improves accuracy for detecting snapping during Yergason’s test?
One hand on medial epicondyle, other on olecranon
One hand on distal radius, other on bicipital groove
Both hands on deltoid insertion
Both hands on posterior scapula
Using the diagram, which patient position best isolates the acromioclavicular joint during the Crossover Test?
Resisted elbow flexion in neutral position
Passive external rotation at ninety abduction
Active horizontal adduction across chest
Scapular retraction with cervical sidebending
During the Crossover Test shown, localized pain over the acromioclavicular joint most likely indicates which clinical finding?
Glenohumeral internal impingement
Rotator cuff partial thickness tear
Long head biceps tendinopathy
AC joint sprain or pathology
When performing the illustrated maneuver, what examiner action increases stress on the AC joint to improve test sensitivity?
Press posteriorly on the humeral head
Stabilize the scapula and guide adduction
Apply inferior traction at the wrist
Pronate the forearm and flex the elbow
Which structure is primarily involved in a SLAP tear of the shoulder?
Inferior capsule of the glenohumeral joint
Superior labrum adjacent to biceps anchor
Acromioclavicular ligament complex
Subscapularis tendon mid-substance
In O'Brien's Test, pain that increases with shoulder flexion, adduction, and internal rotation against resistance most suggests involvement of which tissue?
Rotator cuff insertional tendons
Acromioclavicular joint capsule
Deltoid muscle belly fibers
Glenoid labrum superior portion
During O'Brien's Test, which position best reduces labral-related pain to differentiate pathology?
Elbow flexed, forearm supinated
Thumb-up external rotation position
Shoulder extended and abducted
Scapular retraction with neutral wrist
Which finding most increases diagnostic probability for a SLAP tear when performing the Biceps Provocation Test?
Weakness of elbow extension only
Numbness over lateral deltoid region
Pain localized deep within the joint
Pain with shoulder external rotation resisted
Which anatomical relationship explains why biceps-related tests can provoke SLAP tear symptoms?
Long head anchors to superior labrum
Short head inserts on coracoid process
Triceps originates from the glenoid labrum
Brachialis crosses the glenohumeral joint
When interpreting special tests for SLAP lesions, which strategy best demonstrates DoK level reasoning?
Combine multiple tests and patient history
Rely on a single positive test result
Use imaging without physical assessment
Ignore pain location during examination
Which scenario most likely yields a false positive on O'Brien’s Test for a SLAP tear?
Pain over acromioclavicular joint surface
Posterior shoulder dull ache after activity
Deep joint catching with rotation
No symptoms reproduced during testing
Select the motion sequence that correctly sets up O’Brien’s Test.
Shoulder 90° flexion, adduction, internal rotation
Shoulder 20° extension, abduction, external rotation
Elbow 90° flexion, neutral forearm, scapular retraction
Shoulder 45° flexion, neutral rotation, elbow extension
Which clinical reasoning step strengthens confidence in diagnosing a SLAP tear after a positive Biceps Provocation Test?
Assess cervical spine for referred symptoms
Re-test in pronation and note pain changes
Perform resisted wrist flexion for comparison
Confirm pain is superficial over deltoid region
Which statement best reflects evidence-based interpretation of SLAP special tests?
Each test alone has perfect accuracy
Biceps tests rule out rotator cuff tears
Tests have variable sensitivity and specificity
O’Brien’s Test is specific for all shoulder pain
In the shoulder diagram, where does a SLAP tear most commonly occur relative to the biceps tendon?
At the distal biceps tendon insertion on radius
Where the biceps tendon anchors to the labrum
Within the supraspinatus musculotendinous junction
At the acromioclavicular joint articular surface
Which structure deepens the glenoid fossa and serves as the attachment site for the long head of the biceps tendon?
Coracoacromial ligament enclosing the humeral head
Glenoid labrum forming a fibrocartilaginous rim
Deltoid muscle covering the lateral shoulder
Rotator cuff tendons stabilizing the joint
A clinician suspects a SLAP lesion. Which maneuver depicted aligns most with O’Brien’s test positioning?
Arm in extension with forearm supination
Arm at 90° flexion with neutral adduction
Arm at 90° flexion with 10° adduction
Arm at 90° abduction with external rotation
During O’Brien’s test for labral pathology, pain that is greater with pronation than supination suggests what?
Long thoracic nerve palsy involvement
Rotator cuff tendinopathy predominates
Acromioclavicular joint sprain mainly
Superior labral anterior posterior lesion
Which combination of findings is used as a clinical cluster to rule out a SLAP tear?
Positive sulcus sign, positive Yergason’s, positive inferior depression
Posterior apprehension, relocation test, Neer sign
Negative sulcus sign, negative Yergason’s, negative abduction with inferior depression
Positive Speed’s test, positive Hawkins–Kennedy, painful arc
If all three cluster tests are positive as listed, what approximate probability of SLAP tear is indicated?
About 45 percent likelihood
About 65 percent likelihood
About 25 percent likelihood
About 85 percent likelihood
Which statement best describes the role of the biceps tendon anchor in shoulder stability?
It compresses the acromion against the clavicle
It contributes to superior labral tension and joint stability
It limits scapular upward rotation during elevation
It primarily prevents inferior humeral migration
When using the cluster to rule out SLAP lesions, why are negative results across tests clinically useful?
They increase post-test probability of SLAP pathology
They indicate urgent surgical repair is necessary
They reduce likelihood, supporting alternative diagnoses
They confirm rotator cuff tear without imaging
In the diagram, which displacement direction most commonly produces a Bankart lesion involving the anterior-inferior glenoid labrum?
Posterior translation of the humeral head
Inferior translation of the humeral head
Superior translation of the humeral head
Anterior translation of the humeral head
Using the diagram, differentiate the humeral head position in anterior versus posterior dislocation relative to the glenoid.
Anterior dislocation: head moves anterior; posterior dislocation: head moves posterior
Anterior dislocation: head moves superior; posterior dislocation: head moves inferior
Anterior dislocation: head moves medial; posterior dislocation: head moves lateral
Anterior dislocation: head moves inferior; posterior dislocation: head moves superior
Which clinical implication is best supported by the diagram of a Bankart lesion after anterior dislocation?
Loss of posterior capsule tension increasing posterior instability
Detachment of anterior-inferior labrum increasing recurrent anterior instability
Avulsion of rotator cuff tendons increasing superior migration
Fracture of acromion increasing subacromial space narrowing
Identify the special test shown on the left photo that assesses anterior shoulder instability associated with a Bankart lesion.
Posterior jerk test in adduction–internal rotation
Apprehension test in abduction–external rotation
Neer impingement sign in forward flexion
Sulcus sign in neutral position
In the right photo, which maneuver is being performed to further evaluate suspected Bankart pathology after a positive apprehension test?
Relocation test applying posterior glide
Empty can test resisting elevation
Crank test applying axial load
Speed’s test resisting elbow flexion
A patient shows apprehension in abduction–external rotation that resolves when a posterior force is applied, as seen in the photos. What is the most likely interpretation?
Anterior instability due to labral detachment consistent with Bankart lesion
Posterior instability due to reverse Bankart lesion
Primary rotator cuff tendinopathy without instability
Functional pain inhibition unrelated to labrum pathology
In the left diagram, the shoulder is abducted and externally rotated with a posterior hand applying pressure. Which clinical sign indicates a positive Apprehension Test in this position?
Clicking during passive horizontal adduction toward midline
Relief with gentle anterior translation of humeral head
Pain localized to lateral deltoid with resisted extension
Increased range without discomfort in abduction
Subject expresses fear of dislocation with external rotation
When performing the Apprehension Test shown, which maneuver best reduces the patient’s apprehension without changing position?
Apply a posteriorly directed force to proximal humerus
Increase external rotation past end range quickly
Add axial distraction through the humerus downward
Press upward on distal forearm to increase torque
Internally rotate while maintaining full abduction
In the right photo, the examiner supports the forearm with the shoulder at 90° abduction. What structure is stressed to detect anterior instability as external rotation increases?
Supraspinatus musculotendinous junction
Posterior labrum against glenoid rim
Inferior glenohumeral ligament complex
Long head biceps tendon intra-articular
Acromioclavicular joint capsule
In panel A of the Jerk Test illustration, the arm is flexed to 90° with internal rotation while a posterior force is applied. Which finding most supports posterior instability?
Sharp clunk during horizontal adduction repositioning
Visible anterior subluxation during abduction
Smooth translation without symptoms or sounds
Pain only with resisted external rotation testing
Numbness limited to lateral forearm region
Compare the Apprehension Test and Jerk Test as depicted. Which statement accurately differentiates their mechanics?
Apprehension uses axial compression with internal rotation
Jerk uses abduction at 90° with supination torque
Apprehension uses external rotation; Jerk uses adduction
Both primarily stress posterior labrum under external rotation
Both apply anterior translation with shoulder extension
You suspect posterior instability after a rugby tackle. Using the Jerk Test setup shown, which sequence maximizes diagnostic yield?
Flex to 90°, internally rotate, load posteriorly, adduct
Abduct to 120°, apply anterior glide, then distract
Adduct to neutral first, then load anteriorly with ER
Extend fully, supinate forearm, externally rotate strongly
Place patient supine, apply inferior traction with ER
In the illustrated maneuver on the left image, the examiner elevates the patient’s arm while stabilizing the scapula. What structure is most likely stressed when pain occurs near 90° of forward flexion in this position?
Inferior glenohumeral ligament complex
Supraspinatus tendon under acromion
Long head biceps tendon groove
Posterior labrum near 6–9 o’clock
You plan to use Job’s Empty Can Test to evaluate supraspinatus integrity. Which arm position best represents the test setup before resistance is applied?
45° abduction, scapular retraction, thumbs up
Full flexion, forearm supinated, shoulder neutral
Neutral abduction, external rotation, elbows flexed
90° abduction, 30° horizontal adduction, thumbs down
During the Empty Can Test, the patient reports pain without weakness when the examiner applies downward pressure. What is the most defensible interpretation?
Neurologic deficit of axillary nerve
Subacromial impingement without tear
Full-thickness supraspinatus rupture
Acromioclavicular joint instability
Which examiner hand placement optimizes safety when passively elevating the arm to screen for impingement, as depicted in the left panel?
Fingertips pressing directly on the acromion
Thumb traction applied to the patient’s hand
Both hands grasping the distal forearm tightly
One hand supporting elbow, other controlling wrist
A patient cannot maintain arm position during the Empty Can Test even with minimal resistance. Which clinical action best follows from this finding?
Advise return to full overhead sport activity
Rule out all rotator cuff pathology immediately
Begin aggressive pectoral stretching routine
Order imaging to evaluate supraspinatus tear
When comparing Empty Can to Full Can positioning for supraspinatus assessment, which statement reflects the reasoning for preferring Empty Can to provoke impingement signs?
Scapular protraction enhances labral contact
Elbow flexion unloads deltoid contribution
External rotation increases humeral retroversion
Internal rotation narrows subacromial space
