Testing muscle groups of the upper limb

Question 1

How do you test the function of the sternomastoid muscle?

Answer 1

Patient to turn head to right or left against resistance.

Question 2

How do you test the function of the trapezius muscle?

Answer 2

Patient to raise shoulders against resistance.

Question 3

How do you test the function of the pectoralis muscles?

Answer 3

Patient to adduct abducted arm against resistance.

Question 4

How do you test the function of the serratus anterior muscle?

Answer 4

Both arms of patient should be outstretched with palms against a wall.
Press forward strongly.

Question 5

How do you test the function of the deltoid muscle?

Answer 5

Patient to abduct upper arm against resistance.

Question 6

How do you test the function of rotator cuff muscles?

Answer 6

Supraspinatous: abduct arm to 90 degrees
Infraspinatous + Teres minor: patient’s arm with elbow flexed at 90 degrees, passively rotate arm to its max.
Subscapularis: patient to place their hand on lower back, apply light resistance to hand (pressing into lower back) + ask patient to move hand off their back

Question 7

How do you test the function of the flexors and extensors of the forearm at the elbow?

Answer 7

Biceps: hold patient’s arm at elbow, get patient to flex their arm at the elbow, then repeat with resistance (push down in patient’s forearm whilst they try to resist)
Triceps: extend forearm against resistance

Question 8

What nerve supplies the flexor pollicis longus muscle?

Answer 8

Median nerve via anterior interosseous br C8,T1.

Question 9

What nerve supplies the extensor pollicis longus muscle?

Answer 9

Radial nerve via posterior interosseous br C7,8.

Question 10

How do you assess the integrity of the flexor digitorum profundus muscle/tendon?

Answer 10

Hold the PIPJ in extended position while DIPJ is flexed against resistance.

Question 11

What nerve supplies the flexor digitorum profundus muscle?

Answer 11

Ulnar nerve C8,T1 for 4th + 5th digits

Median nerve C8,T1 for 2nd + 3rd digits

Question 12

How do you assess the integrity of the flexor digitorum superficialis muscle/tendon?

Answer 12

Each digit is tested separately.

Hold non-test fingers in full extension while PIPJ of the test finger is flexed against resistance.

Question 13

How do you assess the integrity of the extensors of the wrist?

Answer 13

Extend wrist against resistance.

Question 14

How do you assess the integrity of the extensors of the digits?

Answer 14

Extend fingers against resistance

Question 15

How do you assess the integrity of the dorsal interossei muscles?

Answer 15

Hold adjacent extended + adducted fingers of the patient between your thumb + index finger while the patient attempts to abduct them.

Question 16

What nerve supplies the dorsal and palmar interossei?

Answer 16

Ulnar nerve C8,T1

Question 17

How do you assess the integrity of the palmar interossei muscles?

Answer 17

Patient to hold a slip of paper between adjacent fingers that are extended + adducted.
Patient to close fingers tightly on paper while you attempt to withdraw it.

Question 18

How do you test the function of the biceps brachii muscle?

Answer 18

Patient to flex forearm against resistance.

Question 19

How do you test the function of the triceps muscle?

Answer 19

Patient to extend flexed forearm against resistance.

Question 20

How do you test the function of the brachioradialis muscle?

Answer 20

Patient to flex elbow against resistance with forearm in midprone position.

Question 21

What muscles are tested when the patient flexes their wrist against resistance?

Answer 21

Flexor carpi ulnaris
Flexor carpi radialis
Palmaris longus
(Superficial wrist flexors of forearm)

Question 22

How is pronation tested?

Answer 22

Patient sits with arms at side + elbow bent at 90 degrees with forearm in neutral
Support elbow + grasp forearm at the wrist palmar surface for resistance
Patient attempts to roll arm in pronation direction

Question 23

How is supination tested?

Answer 23

Patient sits with arms a side + elbow bent at 90 degrees with forearm in neutral
Support elbow + grasp forearm at the wrist dorsal surface for resistance
Patient attempts to roll arm in supine direction

Question 24

How would you test the superficial wrist flexors of the forearm?

Answer 24

Patient with forearm supine + wrist in neutral
Stabilise forearm against table with 1 hand + grasp patient’s hand in handshake position with other hand
Apply resistance to palm + ask patient to flex wrist

Question 25

How would you test the thenar muscles?

Answer 25

Patient to touch their thumb to their small finger

Question 26

How would you test the hypothenar muscles?

Answer 26

Patient to bring their little finger away from the others