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EXAM AND EVAL > Upper Extremity Goniometry > Flashcards

Upper Extremity Goniometry Flashcards

1
Q

Muscles responsible for shoulder flexion

A

anterior deltoid- palpate over anterior aspect of humerus, coracobrachialis

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2
Q

Muscles responsible for shoulder extension

A

latissimus dorsi - palpate along lateral side of rib cage

teres major- lateral border of scapula

posterior deltoid- apply resistance into flexion and palpate on the posterior aspect of the shoulder

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3
Q

muscles responsible for shoulder abduction

A

middle deltoid- patient adducts AROM–> palpate on the lateral aspect of the shoulder

supraspinatus- initiation of abduction - palpate in supraspinatus fossa
–> can also be palpated as the patient places their hand on the small of their back with an internally rotated arm (palpate on superior surface of greater tubercle (just distal to the AC joint)

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4
Q

muscles responsible for shoulder internal rotation

A

subscapularis

PATIENT POSITION- sitting 1. lean forward and let arm hang 2. instruct patient to abduct their arm to approximately 60 degrees, patient will push down like they were about to go into internal rotation (therapist will resist this motion) 3. MUSCLE BELLY- palpate in the posterior/lateral aspect of the axilla for muscle belly 4. TENDON- palpate tendons just medial to the lesser tubercle during resisted internal rotation

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5
Q

muscles responsible for shoulder external rotation

A

infraspinatus
-palpate below the spine of the scapula

teres minor
-palpate at the axillary border

PATIENT POSITION: sitting 1. slightly abducted and externally rotated at shoulder (apply resistance in opposite direction) 2. palpate infraspinatus below spine of scapula 2. lateral border of scapula–> teres minor MUSCLE BELLY (while you press into adduction and internal rotation) 3. TENDON OF INFRASPINATUS- exaggerated extension of the shoulder and slight adduction –> tendon is just posterior to the greater tubercle (ALSO can palpate tendon with patient prone and leaning forward on elbows)

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6
Q

Landmarks for shoulder flexion goniometry

A

axis: greater tubercle of the humerus, moving arm:- lateral epicondyle of the humerus, stationary arm: midaxillary line

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7
Q

landmarks for shoulder extension goniometry

A

axis: greater tubercle of the humerus, moving arm:- lateral epicondyle of the humerus, stationary arm: midaxillary line

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8
Q

landmarks for shoulder abduction goniometry

A

axis: anterior acromion moving arm: bisecting the condyles of the humerus stationary arm: parallel to sternum

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9
Q

landmarks for shoulder internal rotation goniometry

A

axis: olecranon process moving arm: ulnar styloid process stationary arm: perpendicular to the floor

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10
Q

landmarks for shoulder external rotation goniometry

A

axis: olecranon process moving arm: ulnar styloid process stationary arm: perpendicular to the floor

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11
Q

expected ROM shoulder flexion

A

0-180

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12
Q

expected ROM shoulder extension

A

0-50

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13
Q

expected ROM: shoulder abduction

A

0-180

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14
Q

expected ROM: internal rotation

A

0-70

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15
Q

expected ROM: external rotation

A

0-90

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16
Q

END FEEL: shoulder flexion and extension

A

flexion- firm due to posterior capsule, muscle tension, ligaments

extension- firm due to anterior capsule, muscle tension, or ligaments

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17
Q

END FEEL- shoulder abduction

A

GH abduction- firm due to SC capsule, muscle tension, or ligaments

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18
Q

END FEEL- shoulder internal and external rotation

A

internal rotation- firm; when you feel an anterior pressure at the humeral head; due to posterior joint capsule muscle tension or ligs

external rotation- firm due to anterior joint capsule muscle tension or ligaments

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18
Q

END FEEL- shoulder internal and external rotation

A

internal rotation- firm; when you feel an anterior pressure at the humeral head; due to posterior joint capsule muscle tension or ligs

external rotation- firm due to anterior joint capsule muscle tension or ligaments

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19
Q

patient position/stabilization shoulder flexion goniometry

A

patient- supine

stabilize- ribcage/thorax

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20
Q

patient position/stabilization shoulder extension goniometry

A

patient- prone

stabilize- upper to mid thorax

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21
Q

patient position/stabilization shoulder abduction goniometry

A

patient- supine

stabilization- avoid shoulder elevation, maintain neutral shoulder position, stabilize through ribcage/thorax to limit lateral flexion of the spine

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22
Q

patient position/stabilization shoulder internal rotation goniometry

A

patient- supine with shoulder abducted 90 and elbow flexed 90 (forearm pointing up to the ceiling to start)

stabilization- anterior, proximal humerus

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23
Q

patient position/stabilization shoulder external rotation goniometry

A

patient: supine with shoulder abducted and elbow flexed to 90 degrees, towel under humerus so that humerus is parallel to table
stabilization: anterior, proximal humerus

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24
Q

muscles responsible for elbow flexion

A

biceps brachii, brachialis, brachioradialis

25
Q

normative value for elbow flexion ROM

A

0-150

26
Q

landmarks for elbow flexion goniometry

A

axis- lateral epicondyle of the humerus

moving arm - radial styloid process

stationary arm- acromion process

27
Q

patient position/stabilization elbow flexion goniometry:

A

patient- supine with towel under humerus

stabilization- proximal humerus

28
Q

end feel for elbow flexion

A

END FEEL: soft due to approx of bicep and forearm musculature

29
Q

STEPS OF GONIOMETRY PROCEDURE:

A
  1. AROM then PROM assessment
  2. palpate muscles of interest
  3. have patient hold the position (so that you can measure)
  4. measure difference from beginning to end
30
Q

Muscles responsible for elbow extension:

A

triceps brachii

31
Q

normative range for elbow extension

A

0

32
Q

patient position/stabilization elbow extension goniometry

A

patient- supine, towel under humerus but an elbow is hanging off the towel

stabilization: proximal humerus

33
Q

landmarks elbow extension goniometry

A

axis: lateral epicondyle of the humerus
stationary arm: acromion process
moving arm: radial styloid process

34
Q

end feel for elbow extension

A

HARD- hard due to posterior, bony approximation of the olecranon process into the olecranon fossa

35
Q

muscles responsible for pronation of forearm

A

pronator teres, pronator quadratus

36
Q

normative value for forearm pronation

A

80 degrees

37
Q

patient position/stabilization for pronation of the forearm

A

patient- seated with elbow in 90 degrees flexion and neutral rotation of forearm, humerus at thorax

stabilization- at posterior elbow

38
Q

landmarks- forearm pronation

A

axis: dorsal and proximal to the ulnar styloid process

stationary arm: mid line of humerus (perpendicular to the floor)

moving arm: dorsal surface of wrist, proximal and parallel to the ulnar and radial styloid processes

39
Q

forearm pronation end feel

A

END FEEL: firm due to joint capsule, muscle tension, ligaments

40
Q

supination muscles

A

supinator, biceps brachii

41
Q

normative value supination

A

80 degrees

42
Q

patient position/stabilization supination goniometry

A

patient- seated with elbow in 90 degrees flexion and neutral rotation of forearm, humerus at thorax

stabilization- at posterior elbow

43
Q

landmarks for forearm supination goniometry

A

axis: ventral and proximal to ulnar styloid process
stationary arm: midline of humerus
moving arm: ventral surface of the wrist; proximal and parallel to the styloid processes

44
Q

end feel forearm supination

A

END FEEL: firm due to joint capsule, muscle tension, ligaments

45
Q

wrist flexion muscles

A

FCR

FCU

46
Q

wrist flexion normative value

A

0-80 degrees

47
Q

patient position/stabilization wrist flexion goniometry

A

patient- seated, forearm pronated and supported on table, wrist hanging off edge of table

stabilization: distal forearm (radius and ulna on posterior aspect of distal forearm)

48
Q

landmarks for wrist flexion goniometry:

A

axis: lateral to triquetrum
stationary arm: from triquetrum to the olecranon process
moving arm: parallel with the 5th metacarpal

49
Q

end feel for wrist flexion

A

firm due to joint capsule, muscle tension, ligaments

50
Q

muscles for wrist extension

A

ECRL, ECRB

ECU

51
Q

normative value wrist extension

A

70

52
Q

patient position/stabilization wrist extension

A

patient- seated, forearm pronated and supported on table, wrist hanging off edge of table

stabilization: distal forearm (radius and ulna on posterior aspect of distal forearm)

53
Q

landmarks wrist extension

A

axis: lateral to triquetrum
stationary arm: from triquetrum to the olecranon process
moving arm: parallel with the 5th metacarpal

54
Q

Ulnar deviation patient position/stabilization

A

patient- seated with shoulder abducted and elbow flexed to 90, forearm pronated, palm flat on table with forearm supported

stabilization- posterior radius and ulna

55
Q

ulnar deviation normative value

A

0-30

56
Q

ulnar deviation landmarks

A

axis:capitate
stationary arm:bisect the dorsal midline of the forearm
moving arm: dorsal midline of third metacarpal

57
Q

ulnar deviation end feel

A

firm

58
Q

radial deviation patient position/stabilization

A

shoulder abducted, elbow flexed 90, forearm pronated and supported on table, palm flat on table

stabilization: radius and ulna (posterior aspect of forearm)

59
Q

radial deviation normative value

A

0-20

60
Q

radial deviation landmarks

A

axis:capitate
stationary arm:bisect the dorsal midline of the forearm
moving arm: dorsal midline of third metacarpal

61
Q

radial deviation end feel

A

END FEEL: hard due to bony approximation, firm due to joint capsule, muscle tension, ligaments

EXAM AND EVAL (7 decks)

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