Manualmusletesting

1. Trace & Zero
• Contraction of Flexor pollicis Brevis may be
determined by pressure over palmar surface of first
metacarpal (medial to Abductor pollicis Brevis) as
patient attempts flexion.

2. Flexion of Interphalangeal Joint of Thumb

3. Normal & Good
• Position:
• Sitting with hand resting palm
upward on table.
• Stabilization:
• Stabilize first phalanx of thumb.
• Desired motion:
• Patient flexes distal phalanx
(motion takes place in plane of
palm).
• Resistance:
• Is given on palmar surface of
distal phalanx of thumb

4. Fair & Poor
• Patient flexes distal phalanx through full ROM
for fair grade and through partial range for
poor grade.

5. Trace & Zero
• The tendon of Flexor pollicis longus may be
found on palmar surface of the first phalanx of
the thumb

6. Extension of Metacarpophalangeal &
Interphalangeal of Thumbs joints
Extensor pollicis Brevis Extensor pollicis longusExtensor pollicis Brevis Extensor pollicis longus

7. Muscles contribute to Extension of Metacarpophalangeal
& Interphalangeal of Thumbs joints
Extensor pollicis BrevisExtensor pollicis Brevis
• Origin:
• Lower third of posterior shaft of radius and adjacent interosseous
membrane
• Insertion:
• Over tendons of radial extensors and brachioradialis to base of
proximal phalanx of thumb
• Action:
• Extension of MP & IP of the thumb
• Nerve supply

8. Muscles contribute to Extension of Metacarpophalangeal
& Interphalangeal of Thumbs joints
Extensor pollicis longusExtensor pollicis longus
• Origin:
• Middle third of posterior ulna (below abductor pollicis longus)
and adjacent interosseous membrane
• Insertion:
• Base of distal phalanx of thumb via Lister's tubercle (dorsal
tubercle of radius).
• Action:
• Extension of MP & IP of the thumb
• Nerve supply

9. Extension of Metacarpophalangeal Joint of
Thumb

10. Normal & Good
• Position:
• Sitting with hand resting on table.
• Stabilization:
• Stabilize first metacarpal.
• Desired motion:
• Patient extends first phalanx of thumb.
• Resistance:
• Is given on dorsal surface of proximal
phalanx.

11. Fair & Poor
• Patient extends first phalanx of thumb through
full ROM for fair and through partial range for
poor

12. Trace & Zero
• Tendon of Extensor pollicis Brevis may be found at
base of metacarpal of thumb

13. Extension of Interphalangeal Joint
of Thumb

14. Normal & Good
• Position:
• Sitting with hand resting on
ulnar border.
• Stabilization:
• Stabilize first phalanx of
thumb.
• Desired motion:
• Patient extends distal phalanx
(motion takes place in plane of
palm).
• Resistance:
• Is given on dorsal surface of
distal phalanx of thumb

15. Fair & Poor
• Patient extends distal phalanx of thumb through full
ROM for fair, and through partial range for poor.

16. Trace & Zero
• Tendon of Extensor pollicis longus may be palpated
on dorsal surface of hand between head of first
metacarpal and base of second. It may also be found
on dorsal surface of first phalanx

17. Thumb Abduction
Abductor pollicis Brevis Abductor pollicis longusAbductor pollicis Brevis Abductor pollicis longus

18. Muscles contribute to Thumb Abduction
Abductor pollicis BrevisAbductor pollicis Brevis
• Origin:
• Tubercle of scaphoid & flexor retinaculum
• Insertion:
• Radial sesamoid of proximal phalanx of thumb &
tendon of extensor pollicis longus
• Action:
• Thumb Abduction
• Nerve supply

19. Muscles contribute to Thumb Abduction
Abductor pollicis longusAbductor pollicis longus
• Origin:
• Upper posterior surface of ulna and middle third of
posterior surface of radius and interosseous membrane
between
• Insertion:
• Over tendons of radial extensors and brachioradialis
to base of 1st metacarpal and trapezium
• Action:
• Thumb Abduction
• Nerve supply

20. Normal & Good
• Position:
• Sitting with hand supported.
• Stabilization:
• Stabilize medial four metacarpals
and wrist.
• Desired motion:
• Patient raises thumb vertically
through range of abduction.
• Resistance:
• Is given on lateral border of first
phalanx of thumb.

21. Note
• If Abductor pollicis longus is stronger than the
Brevis, thumb will deviate toward radial side
of hand.
• If Abductor pollicis Brevis is stronger,
deviation will be toward ulnar side

22. Fair & Poor
• Position:
• Sitting with hand supported.
• Stabilization:
• Stabilize metacarpals and
wrist.
• Desired motion:
• Patient abducts thumb through
full ROM for fair grade and
through partial range for poor
grade

23. Trace & Zero
• The Abductor pollicis Brevis fibers may easily be
found on thenar eminence lateral to the Flexor pollicis
Brevis. The tendon of the Abductor pollicis longus
may be palpated near its insertion

24. Thumb Adduction
Adductor PollicisAdductor Pollicis

25. Muscles contribute to Thumb Adduction
Adductor pollicisAdductor pollicis
• Origin:
• Oblique head: base of 2nd and 3rd metacarpals,
trapezoid and capitate. Transverse head: palmar
border and shaft of 3rd metacarpal
• Insertion:
• Ulnar sesamoid then ulnar side of base of proximal
phalanx and tendon of extensor pollicis longus
• Action:
• Thumb Adduction
• Nerve supply

26. Normal & Good
• Position :
• Sitting with hand supported.
Stabilize medial four
metacarpals.
• Desired motion:
• Patient adducts thumb.
• Resistance:
• Is given on medial border of
first phalanx

27. Fair & Poor
• Position:
• Sitting with hand
supported.
• Stabilization:
• Stabilize metacarpals.
• Desired motion:
• Patient adducts thumb
through full ROM for fair
grade and through partial
range for poor grade.

28. Trace & Zero
• Muscle fibers may be
palpated between first
Interossei dorsales
muscle and first
metacarpal bone.

29. Note
• Flexor pollicis longus and Flexor pollicis Brevis
may help pull thumb toward palm. These muscles
should remain relaxed during test.

30. Opposition of Thumb
Opponens pollicis Opponens digiti minimiOpponens pollicis Opponens digiti minimi