SCI- MOTOR EXAM GUIDE Flashcards
C5 responsible for
Elbow Flexors | Biceps Brachii, Brachialis
C5 GRADE 3 - Patient Position:
The shoulder is in neutral rotation,
neutral flexion/extension, and adducted. The elbow is fully
extended, with the forearm in full supination. The wrist is in
neutral flexion/extension.
C5 GRADE 3 - Examiner Position:
Support the wrist.
C5 GRADE 3 - Instructions to Patient:
“Bend your elbow and try to reach your
hand to your nose.”
C5 GRADE 3 - Action:
The patient attempts to move through the full range of
motion in elbow flexion.
C5 GRADE 4/5 - Patient Position:
The shoulder is in neutral rotation, neutral
flexion/extension, and adducted. The elbow is flexed to 90° and
the forearm is fully supinated.
C5 GRADE 4/5 - Examiner Position:
Place a stabilizing hand on the anterior
shoulder. Grasp the volar aspect of the wrist and exert a pulling
force in the direction of elbow extension.
C5 GRADE 4/5 - Instructions to Patient:
“Hold your arm. Don’t let me move it.”
C5 GRADE 4/5 - Action:
The patient resists the examiner’s pull and attempts to
maintain the elbow flexed at 90°.
C5 GRADE 2 - Patient Position:
The shoulder is in internal rotation and
adducted with the forearm positioned above the abdomen, just
below the umbilicus. The elbow is in 30° of flexion. The forearm
and wrist are in neutral pronation/supination. Sufficient flexion of
the shoulder must be permitted to allow the forearm to
comfortably move over the abdomen.
C5 GRADE 2 - Examiner Position
Support the arm.
C5 GRADE 2 - Instructions to the Patient
“Bend your elbow and try to bring your
hand to your nose.”
C5 GRADE 2 - Action
The patient attempts to move the elbow through a full
range of motion in elbow flexion.
Fix side C5 GRADE 0/1 - Patient Position:
The patient is in the grade 2 position with the shoulder in
internal rotation and adducted. The palm and ventral forearm are
positioned above the abdomen. The elbow is in 30° of flexion.
The forearm and wrist are in neutral pronation/supination.
Sufficient flexion of the shoulder must be permitted to allow the
forearm to comfortably move over the abdomen.
C5 GRADE 0/1 - Examiner Position
One hand supports the forearm while the
other hand palpates the biceps tendon in the cubital fossa. The
belly of the biceps brachii muscle may also be palpated or
observed for movement.
C5 GRADE 0/1 - Instructions to the Patient
“Bend your elbow and try to bring your
hand to your nose.”
C5 GRADE 0/1 - Action
The patient attempts to move the elbow through a full range of motion in elbow flexion.
C6 responsible for
Wrist Extensors | Extensor Carpi Radialis Longus, Extensor Carpi Radialis Brevis
C 6 grade 3 Patient Position Examiner Position Instructions to Pt Action
Patient Position: The shoulder is in neutral rotation, neutral flexion/extension, and adducted. The elbow is fully extended, the forearm is fully pronated, and the wrist flexed.
Examiner Position: One hand supports the distal forearm to allow the wrist to be pre-positioned in sufficient flexion for testing.
Instructions to Patient: “Bend your wrist upwards. Lift your fingers toward the ceiling.”
Action: The patient attempts to extend the wrist through a full range of motion.
C 6 grade 4 and 5 Patient Position Examiner Position Instructions to Pt Action
Patient Position: Same as grade 3, except the wrist is fully extended.
Examiner Position: Grasp the distal forearm to stabilize the wrist. Apply pressure across the metacarpals in a downward direction toward flexion and ulnar deviation. The force applied should be angled toward the ulnar side of the wrist rather than directly downward, since it is the radial wrist extensors that are being tested.
Instructions to Patient: “Hold your wrist up. Don’t let me push it down.”
Action: The patient resists the examiner’s push and attempts to maintain the wrist in the fully extended position.
C 6 grade 0, 1 &2 Patient Position Examiner Position Instructions to Pt Action
Patient Position: Position the patient with the arm resting on the exam table. The shoulder is in neutral flexion/extension, neutral rotation, and adducted. The elbow is fully extended. The forearm is in neutral pronation-supination and the wrist fully flexed The patient may also be positioned with the shoulder in slight flexion, internal rotation, and adducted, with the patient’s arm above the abdomen. The elbow is flexed to 90° and the forearm is in full supination. The wrist is flexed.
Examiner Position: Support the forearm and ask the patient to bend the wrist backwards into extension. For trace function, palpate the radial wrist extensors just proximal to the wrist, on the radial aspect of the distal forearm. Observe the muscle belly for movement.
Instructions to Patient: “Bend your wrist backwards.”
Action: The patient attempts to extend the wrist though a full range of motion in wrist extension.
C7 responsible for
Elbow Extensors | Triceps
C7 grade 3 Patient Position Examiner Position Instructions to Pt Action
Patient Position: The shoulder is in neutral rotation, adducted, and 90°of flexion. The elbow is fully flexed with the palm of the hand resting by the ear.
Examiner Position: Support the upper arm.
Instructions to Patient: “Straighten your arm.”
Action: The patient attempts to move through the full range of elbow extension.
