Practical Questions Flashcards
ROM: MP Flexion
0-90 degrees
ROM: MP Extension (Hyperextension)
0-45 degrees
ROM: MP Abduction
No normal ROM
ROM: MP Adduction
very little adduction beyond zero; typically not measured
ROM: PIP Flexion
0-100 degrees
ROM: PIP Extension
back to 0 degrees; (some people have -16 degrees of hyperextension, but most people don’t have any)
ROM: DIP Flexion
0-90 degrees
ROM: DIP Extension
back to 0 degrees
ROM: Thumb MP Flexion
0-50 degrees
ROM: Thumb MP Extension
0 degrees
ROM: Thumb IP Flexion
0-80 degrees
ROM: Thumb IP Extension (Hyperextension)
0-20 degrees (hyperextension)
ROM: Hip Flexion
0-120 degrees
ROM: Hip Extension
0-30 degrees
ROM: Knee Flexion
0-135 degrees
ROM: Ankle dorsiflexion
0-20 degrees
ROM: Ankle plantar flexion
0-50 degrees
MMT: MP Flexion Substitutions
Flexor digitorum superficialis, flexor digitorum profundus, flexor digiti minimi brevis, and opponens digiti minimi
MMT: MP Extension Substitutions
Flexion of the wrist will produce IP extension through a tenodesis action
MMT: MP Flexion Primary Movers
Lumbricals (all 4); Dorsal and Palmar Interossei
MMT: MP Extension Primary Movers
extensor digitorum, extensor indices, extensor digiti minimi
MMT: PIP Flexion Primary Movers
flexor digitorum superficialis
MMT: PIP Flexion Substitutions
flexor digitorum profundus if DIP allowed to flex; wrist extension; relaxation of IP extension
MMT: DIP Flexion Primary Movers
flexor digitorum profundus
MMT: DIP Flexion Substitutions
wrist extension; make sure patient actively flexes the DIP joint rather than extending the DIP joint and then relaxing
MMT: MP (digit) Abduction Primary Movers
dorsal interossei and abductor digiti minimi
MMT: MP (digit) Abduction Substitutions
none
MMT: MP (digit) Adduction Primary Movers
palmar interossei
MMT: MP (digit) Adduction Substitutions
Prevent finger flexion b/c middle finger flexors can contribute to adduction
MMT: Thumb MP Flexion Primary Movers
Flexor pollicis brevis
MMT: Thumb MP Flexion Substitutions
Make sure patient keeps their thumb straight; if it is bent, the flexor pollicis longus can substitute
MMT: Thumb IP Flexion Primary Movers
Flexor Pollicis longus
MMT: Thumb IP Flexion Substitutions
Make sure that the patient does not extend and then relax the distal phalanx of the thumb at the beginning of the test, as this will make it look like the pt has actively flexed the IP joint
MMT: Thumb MP Extension Primary Movers
Extensor Pollicis Brevis
MMT: Thumb MP Extension Substitutions
Extension of the IP joint of thumb with carpometacarpal adduction in addition to extension of the MP joint indicates substitution by the extensor pollicis longus
MMT: Thumb IP Extension Primary Movers
extensor pollicis longus
MMT: Thumb IP Extension Substitutions
Muscles of the thenar eminence (abductor pollicis brevis, flexor pollicis brevis, and adductor pollicis) can extend the IP joint by flexing the carpometacarpal joint
MMT: Thumb Abduction Primary Movers
abductor pollicis longus and brevis
MMT: Thumb Abduction Substitutions
APL: extensor pollicis brevis (watch for pull towards dorsal surface of arm)
APB: abductor pollicis longus (watch for plane of motion to be toward radial side of hand, not perpendicular)
MMT: Thumb Adduction Primary Movers
Adductor pollicis: oblique and transverse heads; 1st dorsal interosseus
MMT: Thumb Adduction Substitutions
flexor pollicis longus and flexor pollicis brevis will flex thumb; extensor pollicis longus may try to sub for the thumb adductor - watch for CMC joint to extend
MMT: Opposition Prime Movers
Opponens pollicis and opponens digiti minimi
MMT: Opposition Substitutions
Flexor pollicis longus/brevis can draw the thumb across the palm to the little finger (contact would be with tips of fingers instead of pads); abductor pollicis brevis may substitute, but rotation component will not be present in motion
