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Muscle Tests > Upper Extremity > Flashcards

Upper Extremity Flashcards

1
Q

Upper fibres of trapezius

A

Innervation:
– Motor supply CN11- accessory nerve
– sensor supply- ventral rami of cervical nerves (C2-C4)

Attachment:
– occiput, C1-C7 and lateral clavicle, acromion

– head straight, resist lateral flexion of head above the ear and resist shoulder elevation as well

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2
Q

Trapezius- middle

A

Attachment-
- C2 to T12, Nuchal Line, Superior Angle of the scapula, Distal Clavicle, Acromion

Supine-
- arm extended to the side 90 degrees
- place hand on the posterior forearm of pt
- resist downward movement

Prone-
- arm extended to side 90 degrees
- place hand on anterior forearm
- place other hand on posterior forearm
- resist upward movement gently

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3
Q

Trapezius- lower

A

Supine:
- humerus abducted to 135 degrees with elbow locked
- place band on posterior forearm superior to the wrist
- resist downward motion

Prone:
- humerus abducted 135 degrees with elbow locked
- place one hand on anterior forearm and other on posterior forearm
- resist upward motion, gently

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4
Q

Latissimus dorsi- straight arm

A

Innervation:
– thoracodorsal nerve (C6-C8), from the posterior cord of the brachial plexus

Attachment-
- T7-T12, Thoracolumbar Fascia, Iliac Crest, Last 3-4 ribs, bicipital groove

Supine or prone:
- humerus addicted and medically rotated against body, elbow locked
- place hand on posterior forearm
- resist adduction

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5
Q

Latissimus dorsi- bent elbow

A

Supine or prone:

  • Abducted 90 to side, elbow bent 90 degrees
  • shoulder externally rotated
  • resist adduction to elbow
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6
Q

Levator Scapula

A

Innervation:
– cervical C3, C4 and dorsal scapula C4, C5

Attachment-
- C1-C4, superior angle of the scapula

Supine or prone:
- rotate pt head slightly to side
- resist side ending of neck above ear with 1 hand, and resist shoulder elevation with the other hand

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7
Q

Teres major

A

Innervation:
– lower sub scapular nerve (C5, C6), arises from the posterior cord of the brachial plexus

Movement:
– internal rotation of shoulder
– extension of shoulder

Attachment:
– inferior angle of scapula
– bicipital groove of humerus

Supine:
– chicken wing arm
– back of pts hand underneath their waistline
– resist downwards movement

Prone:
– same but the movement will be upwards

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8
Q

Rhomboids

A

Innervation:
– dorsal scapula (C4, C5)

Attachment-
- C7-T5, medial border of the scapula

Supine:
- humerus abducted 45 degrees, elbow bent 90 degrees
- palm facing in
- resist adduction at elbow

Prone:
- elbow bent and slightly abducted
- resist adduction at elbow

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9
Q

Teres Minor

A

Innervation:
– axillary nerve (C5, C6)

Attachment-
- Upper axillary border of the scapula, Greater tubercle of the humerus

Supine and prone:
- Elbow bent 90 degrees, humerus abducted 45 degrees
- Resist lateral rotation with hand superior to wrist stabilising medial elbow

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10
Q

Infraspinatus

A

Innervation:
– supra scapular nerve (C5, C6), from the upper trunk of the brachial plexus

Attachment-
- Infraspinatus fossa of scapula, Greater tubercle of humerus

Supine and Prone:
- Elbow bent 90 degrees, humerus abducted 90 degrees
- Resist lateral rotation, supporting medial elbow

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11
Q

Supraspinatus

A

Innervation:
– supra scapular nerve (C5, C6) from the upper trunk of the brachial plexus

Attachment-
- Supraspinatus fossa of scapula, Greater tubercle of humerus

Supine:
- Humerus abducted 10-15 degrees and lifted slightly off the table
- Resist abduction

Prone:
- Arm at side
- Resist first 15 degrees of abduction

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12
Q

Subscapularis

A

Innervation:
– Upper and lower subscapular nerves (C5-C7), from the posterior cord of the brachial plexus

Attachment-
- Subscapular fossa of scapula, Lesser tubercle of humerus

Supine and Prone:
- Humerus abducted between 45 and 90 degrees
- Elbow flexed 90 degrees
- Resist medial rotation of elbow, stabilising lateral elbow

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13
Q

Biceps- long head

A

Innervation:
– musculocutaneous nerve (C5, C6)

Attachment-
- Supraglenoid tubercle of the scapula, Radial Tuberosity

Supine:
- Humerus abducted 45 degrees
- Resist elbow flexion holding superior to wrist

Prone:
- Clients elbow bent 90 degrees
- Grasp forearm superior to elbow, and resist movement of hand to shoulder

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14
Q

Biceps short head

A

Innervation:
– musculocutaneous nerve (C5, C6)

Attachment:
– coracoid process
– radial tuberosity

Action:
– flexion of humerus, flexion of elbow
– supination of forearm
– adduction of humerus

Supine:
– humerus adducted, elbow bent 90 degrees
– resist elbow flexion superior to wrist

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15
Q

Brachialis

A

Innervation:
– musculocutaneous nerve (C5, C6)

Attachment:
– lower half of the anterior shaft of the humerus
– ulnar tuberosity and coronoid process of ulnar

Action:
– flexion of elbow

Supine:
– humerus abducted, elbow bent 90 degrees
– thumb facing pts head (hammer curl)
– resist flexion

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16
Q

Pronator Teres

A

Innervation:
– median nerve (C5, T1)

Attachment-
- Medial epicondyle of humerus, Middle of lateral shaft of radius

  • Clients elbow bent
  • Grasp thumb with one hand, and place back of other hand against back of pt hand
  • Resist pronation
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17
Q

Supinator

A

Innervation:
– Radial nerve (C5-T1)

Attachment-
- Lateral epicondyle of humerus, Lateral surface of proximal third of radius

  • Pt elbow bent
  • One hand behind pt thumb and index finger, other hand on hypothenar eminence
  • Resist supination

This also tests biceps supination action

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18
Q

Longus colli

A

Innervation:
– C2-6

Attachment:
– anterior C1 and C2
– anterior C3 and C4

– Support pts head an inch or 2 off the bed with hand under occiput
– get pt to chin tuck, while you gently try to tip the forehead back, as if to undo the nod.

19
Q

Medial scalene

A

Innervation:
– C4-8

Action:
- neck flexion and SB raises first rib

Attachment:
- C3-C7 and anterior ribs 1-2

20
Q

Deltoid anterior

A

Innervation:
– axillary (C5, 6)

Attachment:
– lateral third of the clavicle
– deltoid tuberosity

Supine:
– elbow bent:
—- humures abducted 90 degrees
—- resist horizontal adduction (across body)
—- with one hand on bicep and other grasping the pt’s hand

elbow straight:
– abduct the humerus slightly
– resist humeral flexion with hand on posterior forearm superior to the wrist

Prone:
– pts elbow bent and shoulder abducted 90 degrees so arm is hanging off the bed
– top hand place above elbow for stability and one underneath to resist the downward motion

21
Q

Deltoid middle

A

Innervation:
– axillary C5, 6

Attachment:
– lateral acromion and deltoid tuberosity

Action:
– abduction of shoulder to 90 degrees

Supine:
– pts elbow bent 90 degrees
– pts shoulder abducted 90 degrees
– hold arm and hand on superior shoulder
– resist further abduction

Prone:
– same as supine
– arm hanging off the bed

22
Q

Posterior deltoid

A

Innervation:
– Axillary (C5, C6)

Attachment:
– lateral acromion and deltoid tuberosity

Action:
– extension, horizontal abduction and lateral rotation of the humerus

Supine:
– shoulder abducted 90 degrees and elbow flexed 90 degrees
– resist backwards motion of the shoulder

Prone:
– same as supine but resist upward motion

23
Q

Coracobrachialis

A

Innervation:
– musculocutaneous nerve (C5, C6, C7)

Attachment:
– coracoid process and middle third of medial surface of humeral shaft

Action:
– flexion of humerus
– adduction of humerus

Supine:
– humerus abducted slightly
— arms lifted up slightly
– elbow bent 90 degrees
– place hand on bicep while grasping pts hand
– resist flexion of the shoulder

24
Q

Pectoralis major clavicular fibres

A

Innervation:
– upper fibres:
—- lateral pectoral nerve (C5, C6)
– lower fibres:
—- lateral and medial pectoral nerves (C6-C8, T1)

Attachment:
– medial half of the clavicle and bicipital groove

Supine:
– pt arm straight up with posterior arm facing their opposite shoulder and palm of hand facing you
– resist movement of shoulder across body

Prone:
– pt arm straight out with palm facing the floor
– resist downward movement towards the floor

25
Q

Pectoralis major sternal fibres

A

Attachment:
– sternal cartilage of ribs 1-6 and bicipital groove

Supine:
– client arm straight up with their palm facing practitioner and thumb facing opposite hip
– traction the arm
– resist movement across body

Prone:
– arm abducted 135 degrees
– place hand superior to the wrist
– palm facing practitioner
– resist downward movement

26
Q

Pectoralis minor

A

Innervation:
– medial pectoral nerve with fibres from the communicating branch of the lateral pectoral nerve (C6-C8, T1)

Attachment:
– ribs 3-5 and coracoid process

Action:
– protraction, depression, downward rotation of scapula

supine:
– pt lifts shoulder up
– resist the protraction of the shoulder over the ball and socket

Prone:
– humerus abducted 90 degrees with elbow bent
– place hand under clients fist
– resist downward movement
– tests both pec minor and major

27
Q

Serratus anterior

A

Innervation:
– long thoracic (C5-8)

Attachment:
– outer surface of upper 8 ribs
– anterior surface of vertebral border of scapula

Action:
– protraction and upward rotation of the scapula
– stabilises scapula versus the chest wall

Upper fibres:
– pt supine
– humerus flexed 90 degrees and slightly abducted
– elbow locked
– resist downward movement of the arm (caudal)

Lower fibres:
– pt supine
– humerus flexed 90 degrees and slightly abducted
– elbow locked
– resist upwards movement by holding the wrist

28
Q

Triceps long head

A

Innervation:
– radial nerve (C6-T1)

Attachment:
– infraglenoid tubercle of scapula
– olecranon

Action:
– extension of humerus
– extension of elbow

Supine:
– humerus adducted with palm facing upwards, with elbow locked out
– resist extension

29
Q

Triceps brachii as a whole

A

Attachment:
– long head- infraglenoid tubercle of scapula
– lateral head- posterior humerus
– medial head (deep)- posterior humerus
– all insert at the olecranon

Action:
– extension of elbow

Supine:
– supine or seated, shoulder flexed 90 degrees
– elbow slightly flexed
– push wrist to cause flexion at the elbow and get pt to resist
– stabilise by holding pts elbow

30
Q

Brachioradialis

A

Attachment:
– lateral supracondylar ridge of humerus
– styloid process of radius

Action:
– flexion of elbow in neutral position

Supine:
– arm abducted 45 degrees
– elbow bent 90 degrees
– thumb pointing upwards
– resist flexion (pull arm into extension and get pt to resist)
– stabilise at pts elbow

31
Q

Flexor carpi radialis

A

Attachment:
– medial epicondyle of humerus
– 2nd and 3rd metacarpals

Action:
– flexion and abduction of wrist (radial deviation)

Supine:
– clients wrist flexed 45 degrees
– place your hand on medial wrist in line with the thumb
– resist flexion of the wrist

32
Q

Extensor carpi radialis brevis

A

Attachment:
– lateral epicondyle
– third metacarpal

Action:
– extension of the wrist

Supine:
– clients wrist extended 45 degrees
– place hand on medial wrist in line with thumb
– resist extension

33
Q

Flexor carpi ulnaris

A

Attachment:
– humeral and ulnar head, make up the cubital tunnel, can be affected by golfers elbow

Action:
– flexion of wrist
– ulnar deviation

Supine:
– clients wrist flexed 45 degrees
– resist on medial wrist in like with little finger
– resist flexion

34
Q

Extensor carpi ulnaris

A

Attachment:
– lateral epicondyle
– fifth metatarsal

Action:
– extension of wrist
– ulnar deviation

Supine:
– clients wrist extended 45 degrees
– place hand over wrist in line with little finger
– resist extension

35
Q

Flexor digitorum superficialis

A
  • humeroulnar head- medial epicondyle
  • radial head- anterior border of the radius
  • Attaches onto the middle phalanges of the 4 fingers (PIP)

Action:
– flexion of PIP joints

Supine:
– clients wrist flexed 45 degrees
– place fingers across each PIP joint from 2-5
– resist flexion of PIP joints

36
Q

Flexor digitorum profundus

A

Attachment:
– ulna
– interosseous membrane
– base of distal phalanges of four fingers

Action:
– flexion of DIP’s

Supine:
– Clients wrist flexed 45 degrees
– place fingers over DIP joints 2-5
– resist flexion off DIP’s

37
Q

Extensor digitorum

A

Attachment:
– lateral epicondyle
– extensor expansion of the 4 fingers

Action:
– extension of MCP joints

Supine:
– clients wrist extended 45 degrees
– place fingers across back of fingers 2-5
– resist extension of the MCP’s

38
Q

Flexor pollicis longus

A

Attachment:
– anterior radius
– interosseous membrane
– DIP of thumb

Action:
– flexion of DIP of thumb

Supine:
– clients elbow bent 90 degrees
– fingers curled into palm apart from thumb
– place index finger onto thumb
– resist flexion of the thumb

39
Q

Extensor pollicis longus

A

Attachment:
– posterior ulna
– interosseous membrane
– Distal phalanx of thumb

Action:
– extension of distal phalanx of thumb

Supine:
– elbow bent 90 degrees
– fingers curled into palm apart from thumb
– index finger on the posterior thumb
– resist extension

40
Q

Flexor pollicis brevis

A

Attachment:
– flexor retinaculum and carpal bones
– PIP of thumb

Action:
– flexion of pip of thumb

Supine:
– elbow flexed
– fingers curled into palm of hand other than thumb
– thumb curled slightly, place finger on the tip
– resist further flexion

41
Q

Extensor pollicis brevis

A

Attachment:
– posterior radius
– interosseous membrane
– PIP of thumb

Action:
– extension of PIP of thumb

Supine:
– elbow bent
– fingers curled into palm of hand apart from thumb
– thumb already bent, place index finger behind it
– resist extension

42
Q

Adductor pollicis

A

Attachment:
– capitate, 2nd and 3rd metacarpals
– PIP of thumb

Action:
– adduction of the first metacarpal of the thumb at CM joint (carpometacarpal)

Supine:
– place clients thumb against their index finger
– pull thumb away from index finger, they have to stop you

43
Q

Adductor pollicis longus

A

Attachment:
– posterior radius and ulna
– interosseous membrane
– base of 1st metacarpal

Action:
– abduct the thumb
– extends the thumb
– assists with wrist abduction

Supine:
– place clients thumb against their index finger and then move slightly apart
– place index finger on the posterior of their thumb
– resist abduction

44
Q

Thumb to finger opposition

A

Opponens pollicis and opponens digiti minimi are involved

Get pt to put thumb and little finger together, see if they can hold it there while you slowly try to pull them away from each other

Muscle Tests (3 decks)

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