Upper Body

Question 1

Upper Traps

Answer 1

O: EOP, medial 1/3 sup nuchal line, nuchal ligament and SP of C7
I: lat 1/3 clavicle and acromion process of scapula
A: Elevates, Retracts, upwardly rotates the scapula @ ScC
RMA: Extends, Contralateral rotation, lat Flexion of head and neck @ spinal joints
N: Spinal accessory nerve
MMT : Pt sitting, ask them to do lat Flexion, rotate away and slightly extended from test side, can add shoulder elevation.
Examiner force 75% opposite lat Flexion 25% on shoulder

Question 2

Middle traps

Answer 2

O: SP of T1-T5
I: Acromion and spine of scapula
A: Retraction
N: spinal accessory nerve (CN XI) C3, C4
MMT: pt prone with should abducted 90 degrees and Externally rotated
Examiner force: toward the floor for horizontal add (at arm)
Stabilize Contralateral scapula

Question 3

Lower traps

Answer 3

O: The tubercle at the root of the spine of the scapula
I: SP T6-12
A: Depression and Retraction of the scapula @ ScC joint
N: Spinal accessory nerve CN XI C3, C4
MMT: pt prone, shoulder abducted 120 degrees and externally rotated (thumb up)
Examiner force: towards the floor (horiz add) stabilize the Contralateral scapula

Question 4

Rhomboids

Answer 4

O: SP of C7-T5
I: medial border of scapula from the root of the spine to the inferior angle of the scapula
A: Retraction, elevation and Downward rotation of the scapula @ ScC joint
N: Dorsal scapula nerve C4-C5
MMT: Pt prone with shoulders abducted to 90 degrees, scapulas fully retracted ask pt to maintain position
Examiner force: apply mild resistive force over pt’s medial scapulas, pushing into protraction, stabilize opposite shoulder

Question 5

Levator scapula

Answer 5

O: TP’s of C1-C4
I:Medial border of the scapula from the superior angle to the root of the spine
A: Elevates the scapula at ScC joint
RMA: Extends and Laterally flexes the neck @ spinal joints
N: Dorsal scapular nerve
MMT: Pt seated with head laterally flexed, rotated and slightly extended towards same side
Examiner force 75% toward opposite lateral Flexion & 25% pressure on scapula
Stabilize ipsilateral shoulder

Question 6

Serratus Anterior

Answer 6

O: Ribs 1-9 (anterolaterally)
I: Anterior surface of the entire medial border of the scapula
A: Protracts and Upwardly rotates the scapula at the @ ScC joint
MMT:
A: client seated ask them to do a punching motion
B: with arm flexed at an oblique angle
Therapists Pressure is applied against the dorsal surface of the arm btwn the shoulder and elbow downward in extension. And slight pressure against the lateral border of scapula to downward rotation
C: do the motion with resistance

Question 7

Pectoralis minor

Answer 7

O: Ribs 3-5
I: coracoid process
A: protraction, downward rotation and depression of the scapula @ ScC joint
RMA: elevates the ribs 3-5 @ sternocostal and costospinal joints
N: medial and lateral pectoral nerves
MMT: pt supine, ask client to raise the shoulder off of the table, then they should resist pressure against the anterior aspect of the shoulder downward towards the table

Question 8

Deltoid

Answer 8

O: lateral 1/3 of clavicle, acromion process and spine of scapula
I: deltoid Tuberosity of the humerus
A: Ant: Flexion, medial rotation, horizontal Flexion
All fibres: abduction
Posterior: extension, lateral rotation and horizontal extension
RMA: Downwards rotation of scapula @ GHJ and scapulocostal joint
MMT: Anterior - arm at 90 and arm in slight medial rotation.
Therapist provides resistance to adduction and slight lat rotation
Medial - therapist pressure towards add & no rotation
Lateral- therapist pressure towards add and slight internal rotation