MUSCLES OF SHOULDER GIRDLE & SCAPULA Test – The patient flexes his elbow, holds the elbow to his side and then attempts to turn the fore arm backwards against resistance Peripheral Nerve – Suprascapular Mains Segmental Supply – C5 INFRA SPINATUS Test – Ask the patient to abducted from 30º to 60º the arm against examiner resistance Peripheral Nerve – Circumflex Main Segmental Supply - C5 DELTOID Test – The patient tries to initiate abduction of the arm from the side against resistance Peripheral Nerve – Suprascapular Main Segmental Supply – C5 SUPRA SPINATUS
If seratous anterior is weak, scapular medial borden will become prominent – winging of scapula Test Push the wall by his hands keeping elbow extended Main Seg supply C5C6C7 P. Nerve – N. to serratus anterior SERRATUS ANTERIOR Test-2 Strech the arm out infront & than to clasp the hands together while examiner endeavour to hold them apart Test-1 Placing the hand on hip and pressing in wards Main Seg supply C5C6C7 P. Nerve – Lat. & medial pectoral N. PECTORALIS MAJOR
Test-2 Resist the patient’s attempt to adduct the arm when abducted to above 90º Test-1 While palpating the muscle, ask the patient to cough Main Seg supply C7 P. Nerve –Nerve to L. Dorsi LATISSIMUS DORSI
Upper part-ask the patient to shrug his shoulders while you try to press them from behind.
Lower part – ask the patient to approximate his shoulder blades.
MUSCLES OF ELBOW JOINT Test – Pt. attempts to extend the elbow against resistance Peripheral Nerve – Radial Mains Segmental Supply – C7 TRICEPS Test – Pt. pronates the forearm and draws the thumb towards the nose against resistance Peripheral Nerve – Radial Main Segmental Supply - C5C6 BRACHIORADIALIS Test – Pt. flexes his elbow against resistance, the forearm being supinated Peripheral N. – Musculo cutaneous Main Segmental Supply – C5 BICEPS
MUSCLES OF FOREARM & WRIST JOINT Peripheral Nerve - Ulnar Mains Segmental Supply – C8 FLEXOR CARPI ULNARIS Test – Examiner resist the patient attempt to flex the wrist towards the radial side Peripheral Nerve – Median Mains Segmental Supply – C6C7 FLEXOR CARPI RADIALS Test – Examiner attempt to flex the patients extended fingers at metacarpophalangeal joints Peripheral Nerve – Radial Main Segmental Supply -C7 EXTENSOR DIGITORUM Test – Pt. holds the fingers partialy extended and dorsiflexes the wrist towards the radial side against resistance Peripheral N. – Radial Main Segmental Supply – C6C7 EXTENSOR CARPI RADIALIS LONGUS
MUSCLES OF THUMB Test – Patients attempt to extend the thumb while the examiner attempts to flex it at the interphalangeal joint Peripheral Nerve – Radial Mains Segmental Supply – C8 EXTENSOR POLLICIS LONGUS Test – Pt. attempts to extend the thumb while the examiner attempts to flex it at MCP joint Peripheral Nerve – Radial Main Segmental Supply - C8 EXTENSOR POLLICIS BREVIS Test – Pt. attempts to maintain his thumb in abduction against the examiner resistance Peripheral N. – Radial Main Segmental Supply – C8 ABDUCTOR POLLICIS LONGUS
Test – Patient attempt to flex the distal phalanx of the thumb against the patient resistance (Hold the proximal phalanx) Peripheral Nerve – Median Mains Segmental Supply – C8 FLEXOR POLLICIS LONGUS Test – Ask the patient to abduct the thumb in a plane at right angle to the palmar aspect of index finger against the resistance of examiner thumb Peripheral Nerve – Median Main Segmental Supply - T1 ABDUCTOR POLLICIS BREVIS Test – Pt. attempts to touch the little finger with the thumb Peripheral N. – Median Main Segmental Supply – T1 OPPONENS POLLICIS
The patient attempts to hold a piece of paper between the thumb and the palmar aspect of forefinger.
MUSCLES OF HAND & FINGERS Pt. Tries to Adduct the fore finger against resistance Pt. Tries to abduct the fore finger against resistance Peripheral nerve ulnar Main Seg supply T1 IST DORSAL INTEROSSI & IST PALMAR INTROSSI B. Interossi – Pt. attemps to keep the fingers abducted against resistance A. Lumbricals – Pt. Tries to flex the extended fingers at the MCP Joints Median – Lumbical I & II Ulnar – lumbrical III & IV & interossi Main Seg supply C8 T1 LUMBRICAL & INTEROSSI
thank you Test – Back of hand is placed on the table & little finger abducted against resistance (sign of ulnar N. lesion) P. N. – Ulnar Mains Segmental Supply – T1 ABDUCTOR DIGITI MINIMI Test – Pt. Flexes the terminal phalanx of the fingers against resistance, the middle phalanx being supported P. N. – Median Ist & IInd Ulnar IIIrd & IVth Main Segmental Supply - C8 FLEXOR DIGITORUM PROFUNDUS Test – Pt. flexes the finger at the proximal inter phalangel joint against resistance (examiners fingers placed on middle phalanx) Peripheral N. – Median Main Segmental Supply – C8 FLEXOR DIGITORUM SUBLIMIS
place your hands on the outer thighs and asking the patient to move their legs apart. This tests the gluteus maximus and gluteus minimus. Abduction of the hip is mediated by the L4, L5 and S1 nerve roots.
hold the knee from the side and applying resistance under the ankle and instructing the patient to pull the lower leg towards their buttock as hard as possible. This tests the hamstrings. L5 and S1 nerve roots via the sciatic nerve.
place one hand under the knee and the other on top of the lower leg to provide resistance. Ask the patient to "kick out" or extend the lower leg at the knee.This tests the quadriceps muscle. L3 and L4 nerve roots via the femoral nerve.
Hold the top of the ankle and have the patient pull their foot up towards their face as hard as possible.This tests the muscles in the anterior compartment of the lower leg. L4 and L5 nerve roots via the peroneal nerve
Holding the bottom of the foot, ask the patient to "press down on the gas pedal" as hard as possible. This tests the gastrocnemius and soleus muscles S1 and S2 nerve roots via the tibial nerve.