Biceps Brachi <ul><li>Action </li></ul><ul><ul><li>Flex the elbow, supinate the forearm, flex the shoulder </li></ul></ul>...
Biceps brachii <ul><ul><li>Supine or seated </li></ul></ul><ul><ul><li>Bend the elbow  and  shake hands  with pt </li></ul...
Biceps brachii – distal tendon <ul><ul><li>With elbow flexed, shake hands with pt.  </li></ul></ul><ul><ul><li>As you loca...
Biceps brachii- tendon of long head <ul><ul><li>Locate the  intertubercular groove </li></ul></ul><ul><ul><li>Laterally ro...
Brachialis <ul><li>Action </li></ul><ul><ul><li>Flexion at the elbow joint </li></ul></ul><ul><li>Origin </li></ul><ul><ul...
Brachialis <ul><ul><li>Shake hands with pt. and flex the elbow to 90° </li></ul></ul><ul><ul><li>Ask pt to flex his elbow ...
Brachialis <ul><ul><li>Locate the distal biceps tenden </li></ul></ul><ul><ul><li>Palpate along either side of the tendon ...
Test for biceps brachii  and brachialis <ul><li>Patient:  Supine or sitting </li></ul><ul><li>Fixation:  The examiner plac...
Triceps brachi <ul><li>Long head </li></ul><ul><li>Medial head </li></ul><ul><li>Lateral head </li></ul>
Triceps brachi <ul><li>Action </li></ul><ul><ul><li>All head:  Extend the elbow </li></ul></ul><ul><ul><li>Long head:  Ext...
Triceps brachii <ul><ul><li>Prone </li></ul></ul><ul><ul><li>Bring the arm off the side of the table </li></ul></ul><ul><u...
Triceps brachii – tendon of long head <ul><ul><li>Prone </li></ul></ul><ul><ul><li>Place one hand on the proximal elbow an...
Test for triceps and anconeus <ul><li>Patient:  Prone </li></ul><ul><li>Fixation:  The shoulder is at 90° abduction, neutr...
Corachobrachialis <ul><li>Action </li></ul><ul><ul><li>Flex and adduct the shoulder </li></ul></ul><ul><li>Origin </li></u...
Coracobrachialis <ul><ul><li>Supine and   laterally rotate and abduct the shoulder to 45° </li></ul></ul><ul><ul><li>Locat...
Test for coracobrachialis
Test for coracobrachialis  <ul><li>Patient:  Sitting or supine </li></ul><ul><li>Test:  Shoulder flexion in lateral rotati...
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Shoulder & Arm 6

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  • Shoulder & Arm 6

    1. 1. Biceps Brachi <ul><li>Action </li></ul><ul><ul><li>Flex the elbow, supinate the forearm, flex the shoulder </li></ul></ul><ul><li>Origin </li></ul><ul><ul><li>Short head – Coracoid process of scapula </li></ul></ul><ul><ul><li>Long head – Supraglenoid tubercle of scapula </li></ul></ul><ul><li>Insertion </li></ul><ul><ul><li>Tuberosity of the radius andaponeurosis of the biceps brachii </li></ul></ul><ul><li>Innervation </li></ul><ul><ul><li>Musculocutaneous (C5-6) </li></ul></ul>
    2. 2. Biceps brachii <ul><ul><li>Supine or seated </li></ul></ul><ul><ul><li>Bend the elbow and shake hands with pt </li></ul></ul><ul><ul><li>Ask pt to flex his elbow against your resistance </li></ul></ul><ul><ul><li>Palpate the ant. surface of the arm and locate the hard, round belly of the biceps </li></ul></ul><ul><ul><li>Follow the belly distally to the inner elbow and then follow proximally to where it tucks beneath the ant. fiber of deltoid </li></ul></ul>
    3. 3. Biceps brachii – distal tendon <ul><ul><li>With elbow flexed, shake hands with pt. </li></ul></ul><ul><ul><li>As you locate the biceps’s distal tendon, ask pt to flex his elbow against your resistance </li></ul></ul><ul><ul><li>Slide over to the tendon’s medial aspect and explore for the aponeurosis </li></ul></ul>
    4. 4. Biceps brachii- tendon of long head <ul><ul><li>Locate the intertubercular groove </li></ul></ul><ul><ul><li>Laterally rotating the arm may make it easier to pinpoint the tendon </li></ul></ul><ul><ul><li>Ask pt. to gently flex his elbow against your resistance </li></ul></ul>
    5. 5. Brachialis <ul><li>Action </li></ul><ul><ul><li>Flexion at the elbow joint </li></ul></ul><ul><li>Origin </li></ul><ul><ul><li>Distal half of the anterior surface of the humerus, also the medial and lateral intermuscular septa </li></ul></ul><ul><li>Insertion </li></ul><ul><ul><li>Ulnar tuberosity </li></ul></ul><ul><li>Innervation </li></ul><ul><ul><li>Musculocutaneous (C5-6) and radial nerve (C7) </li></ul></ul>
    6. 6. Brachialis <ul><ul><li>Shake hands with pt. and flex the elbow to 90° </li></ul></ul><ul><ul><li>Ask pt to flex his elbow against your resistance </li></ul></ul><ul><ul><li>With arm relaxed, slide laterally half an inch off the distal biceps. The edge of the brachialis can be detected </li></ul></ul>
    7. 7. Brachialis <ul><ul><li>Locate the distal biceps tenden </li></ul></ul><ul><ul><li>Palpate along either side of the tendon for portions of the deeper brachialis </li></ul></ul>
    8. 8. Test for biceps brachii and brachialis <ul><li>Patient: Supine or sitting </li></ul><ul><li>Fixation: The examiner places one hand under the elbow to cushion it form table pressure </li></ul><ul><li>Test: Elbow flexion slightly less than or at a right angle, with the forearm in supination </li></ul><ul><li>Pressure: Against the lower forearm, in the direction of extension </li></ul>
    9. 9. Triceps brachi <ul><li>Long head </li></ul><ul><li>Medial head </li></ul><ul><li>Lateral head </li></ul>
    10. 10. Triceps brachi <ul><li>Action </li></ul><ul><ul><li>All head: Extend the elbow </li></ul></ul><ul><ul><li>Long head: Extend and adduct the shoulder </li></ul></ul><ul><li>Origin </li></ul><ul><ul><li>Long head: Infraglenoid tubercle of the scapular </li></ul></ul><ul><ul><li>Lateral head: Posterior surface of proximal half of the humerus </li></ul></ul><ul><ul><li>Medial head: Posterior surface of distal half of the humerus </li></ul></ul><ul><li>Insertion </li></ul><ul><ul><li>Olecranon process of the ulna </li></ul></ul><ul><li>Innervation </li></ul><ul><ul><li>Radial (C6-8) </li></ul></ul>
    11. 11. Triceps brachii <ul><ul><li>Prone </li></ul></ul><ul><ul><li>Bring the arm off the side of the table </li></ul></ul><ul><ul><li>Locate the olecranon process to outline the distal tendon of the triceps </li></ul></ul><ul><ul><li>Ask pt. to extend his elbow as you apply resistance </li></ul></ul><ul><ul><li>Slide proximally and onto the broad triceps tendon </li></ul></ul>
    12. 12. Triceps brachii – tendon of long head <ul><ul><li>Prone </li></ul></ul><ul><ul><li>Place one hand on the proximal elbow and ask pt. to extend against your resistance </li></ul></ul><ul><ul><li>Locate its belly and follow the muscle proximally </li></ul></ul><ul><ul><li>Note how it disappears underneath the post. deltoid toward the infraglenoid tubercle </li></ul></ul><ul><ul><li>With the arm relaxed , press through the post. deltoid and strum across its tendon to the infraglenoid tubercle </li></ul></ul>
    13. 13. Test for triceps and anconeus <ul><li>Patient: Prone </li></ul><ul><li>Fixation: The shoulder is at 90° abduction, neutral with regard to rotation, and with the arm supported between the shoulder and the elbow by the table. </li></ul><ul><li>Test: Extension of the elbow joint (to slightly less than full extension) </li></ul><ul><li>Pressure: Against the forearm, in the direction of flexion. </li></ul>
    14. 14. Corachobrachialis <ul><li>Action </li></ul><ul><ul><li>Flex and adduct the shoulder </li></ul></ul><ul><li>Origin </li></ul><ul><ul><li>Coracoid process of the scapula </li></ul></ul><ul><li>Insertion </li></ul><ul><ul><li>Medial surface of mid-humeral shaft </li></ul></ul><ul><li>Innervation </li></ul><ul><ul><li>Musculocutaneous </li></ul></ul>
    15. 15. Coracobrachialis <ul><ul><li>Supine and laterally rotate and abduct the shoulder to 45° </li></ul></ul><ul><ul><li>Locate the fibers of the pectoralis major </li></ul></ul><ul><ul><li>Lay one hand along the medial side of the arm and move your fingerpads into the armpit </li></ul></ul><ul><ul><li>Ask pt horizontally adduct gently against your resistance </li></ul></ul><ul><ul><li>Isolate the solid edge of the pectoralis major then slide off the fibers posteriorly (into the axilla) and explore the belly of coracobrachialis </li></ul></ul>
    16. 16. Test for coracobrachialis
    17. 17. Test for coracobrachialis <ul><li>Patient: Sitting or supine </li></ul><ul><li>Test: Shoulder flexion in lateral rotation, with the elbow completely flexed and the forearm supinated. </li></ul><ul><li>Pressure: Against the anteromedial surface of the lower 1/3 of the humerus, in the direction of extension and slight abduction </li></ul>
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