The lift-off test is used to test the subscapularis muscle, an internal rotator of the shoulder, in isolation. The patient is asked to place the dorsum of the hand on the small of the back, which causes an internal rotation of the shoulder joint. The patient is now asked to lift the dorsum of the hand off of the back to increase the internal rotation, which should be possible if there is pathology of the subscapularis muscle. The patient is asked to repeat this maneuver against resistance. . The
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A thorough examination of the lungs involves inspection, percussion, palpitation, and auscultation. The examination usually begins with the back, with percussion and auscultation starting lateral to the upper spine and then moving down, alternating between the left and the right side for comparison. The right middle lobe is best assessed from the front. Abnormalities on one side of the lung, e.g., dullness to percussion, increased tactile fremitus, or dry crackles, should always be compared to t
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