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©2013 UpToDate ® Print Email Apley scratch tests These tests provide a simple way to assess shoulder motion. To assess adduction, the patient is asked to reach across her chest and touch the opposite shoulder (photograph A). To assess external rotation and abduction, the patient is asked to reach behind her head and touch the superior medial tip of the opposite scapula (photograph B). A patient with normal function can reach approximately the level of the T4 spinous process. To assess internal rotation and adduction, the patient is asked to reach behind her back and touch the inferior tip of the opposite scapula (photograph C). A patient with normal function can reach approximately the level of the T8 spinous process.