Scapula MMT

Question 1

How many degrees of abduction and flexion comes from scapular rotation?

Answer 1

60°

-First 30° is from GH. From 30° to 90° the scapula provides 30°. From 90° to 180° the scapula provides another 30°.

Question 2

TESTING SCAPULAR UPWARD ROTATION AND ABDUCTION: ________________

• The serratus anterior can never be graded higher than the grade given to what?
• Difference between a grade 3-5 test vs a grade 0-2?

Answer 2

• Serratus Anterior
• Shoulder flexion
• In a grade 3-5 the patient is told to raise their arm to 130°. The PT applies force to the arm just above the elbow in a downward direction. There is no gravity minimized test, so a grade 2 would mean the patient couldn’t get their arm into the 130° position with coordinated movement. Grade 1 and 0 would be done with palpations.

Question 3

TESTING SCAPULAR ELEVATION:__________________

• This is the only test that can be done __________ and __________.
• Difference between a grade 3-5 test vs a grade 0-2?
• In the 0-2 test we dont want the patients head to be _______ because there will be more trap activity and less levator.

Answer 3

• Trapezius and Levator Scapula
• bilaterally and simultaneously
• In a grade 3-5 test, the patient will raise their shoulders and the PT will apply resistance in a downward direction. In a grade 0-2 test, the patient will be lying prone to allow for easier palpation.
• turned

Question 4

TESTING SCAPULAR ADDUCTION: ______________

• When substitution by the rhomboids occurs, the scapula will adduct and ____________. If there is substitution by the posterior delt, there will be no ______________.
• Difference between a grade 3-5 test vs a grade 0-2?
• If the patients posterior deltoid demonstrates a grade less than 2, the PT can utilize an alternate resistance with a shorter _______.

Answer 4

• Middle Trapezius and Rhomboids Major
• rotate downward, scapular adduction
• In a grade 3-5 test, the patient will be lying in prone at the end of the table. The PT will instruct the patient to raise their arm to 90° then go through their ROM. The PT will then apply resistance proximal to the elbow. In a grade 0-2 test, the examiner will support the weight of the arm and instruct the patient to go through the ROM while palpating for contractility.
• lever arm

Question 5

TESTING SCAPULAR DEPRESSION AND ADDUCTION:_____________

• Difference between a grade 3-5 test vs a grade 0-2?
• If a patient cant get the arm overhead at this angle, the arm over the ____ of the table is acceptable.

Answer 5

• Lower Trapezius
• In a grade 3-5 test, the patient will be lying prone with their arm at about 145° of abduction and their thumb pointing up. The PT will then apply pressure proximal to the elbow straight down. In a grade 2 test, the patient will be able to go through the ROM without the weight of the arm. In a grade 0 and 1 test, the PT will palpate for contractility.
• side

Question 6

SCAPULAR ADDUCTION AND DOWNWARD ROTATION:______________

• Inability to lift the hand off the small of the back is diagnostic for a __________ muscle tear.
• Resistance in this test is applied in an “_______ and ________” direction when the shoulder extensors are a grade 3 or higher!
• Difference between a grade 3-5 test vs a grade 0-2?
• Fibers of the ________ can substitue for the adduction but not the downward rotation.

Answer 6

• Rhomboids
• outward and downward
• In a grade 3-5 test, the patient is lying prone with their hand behind their back. The PT then applies resistance outward and downward. An alternate test also involves the PT cupping the flexed elbow and applying resistance out and up with one hand while the other applies resistance in the direction of shoulder depression. In a grade 0-2 test, the PT will cradle the patients arm while the patient tries to lift their hand off their back.
• Middle Trapezius

Question 7

SCAPULAR DEPRESSION, SHOULDER EXTENSION:_______________

-Difference between a grade 3-5 test vs a grade 0-2?

Answer 7

• Lattisimus Dorsi
• In a grade 3-5 test, the patient is in prone with their head turned towards the testing side. The patient depresses their shoulder while the PT applies resistance in the opposite direction.