Muscle Length and Strength Testing Quiz

Muscle length testing is used to assess for limitations of ROM (shortened muscles) and excessive movement, ultimately, we are assessing ______

Muscle strength testing is used to determine the client’s ability to contract a muscle or muscle groups voluntarily. It tests the nerve motor nerve supply to the muscles and their ability to sustain contraction. A myotome tests a group of muscles that are innervated by a specific spinal nerve. These are tested by performing isometric resisted tests of a general action that the group of muscles share in common. Therapist protocol: Ask the client to sit/stand/lie down depending on the area being tested. Resist range of motion associated with nerve root of concern for 3-5 seconds. Positive: weakness with or without pain. Clinical Impression: Weakness possibly due to nerve root lesion or peripheral nerve injury. Myotome test for upper extremity: Neck flexion - C1-C2, Neck lateral flexion - C3, shoulder elevation - C4, Shoulder abduction - C5, Elbow flexion, wrist extension - C6, Elbow extension, wrist flexion - C7, Thumb extension, ulnar deviation - C8, Hand intrinsics - T1. Myotome test for lower extremity: L2 Hip flexion, L3 Knee extension, L4 Ankle dorsiflexion, L5 Great toe extension, S1 Ankle plantarflexion, eversion and hip extension, S2 Knee extension. A dermatome tests an area of skin innervated by a single nerve ______

Muscle length testing is used to assess for limitations of ______ (shortened muscles) and excessive movement

Muscle strength testing is used to determine the client’s ability to contract a muscle or muscle groups ______

Myotome test for upper extremity: Shoulder ______ - C4

Myotome test for lower extremity: L4 Ankle ______

Therapist Protocol: Instruct client to Sit – cervical dermatomes and thoracic dermatomes Lie in prone/supine – lumbar/sacral dermatomes Ask client to close eyes, and test both dermatomes bilaterally simultaneously.Enquire about sensation – is it even? Altered? Painful? If there is altered sensation, using a reflex hammer show them the difference between a dull sensation and a sharp sensation. Ask client to close their eyes and have them differentiate between the sharp end or the dull end by tapping the affected area with the reflex hammer. Positive – uneven sensation, painful sensation, burning, tingling, numbness, etc...Faculty of Massage Therapy Bryan College Revised: November 2023 MT-CL20-SM-11 Page 78 of 82 Clinical Impression Altered sensation possibly due to nerve root or peripheral nerve injury

Altered sensation possibly due to nerve root or peripheral nerve injury Dermatome test for upper extremity C1 Vertex of skull C2 Temple, forehead, occiput C3 Entire neck, posterior cheek, temporal area, forward under mandible C4 Shoulder area, clavicular area, upper scapular area C5 Deltoid area, anterolateral limb to base of thumb C6 Lateral limb, radial side of hand, thumb anterior and posterior and index finger C7 Posterior limb up to and including index, ring fingers and middle finger anterior and posterior C8 Medial limb up to and including to middle, ring, and little finger anterior and posterior T1 Anteromedial limb to base of little finger T2 Medial upper arm, axilla pectoral and mid scapular areas Dermatome test for lower extremity L1 Back, over trochanter, groin L2 Back, anterior thigh to knee L3 Back, upper buttock, anterior thigh and knee, medial lower leg L4 Medial buttock, lateral thigh, medial leg, dorsum of foot, big toe L5 Buttock, posterior lateral thigh, lateral aspect of leg, dorsum of foot, medial half of sole and first, second and third toes S1 Buttock, posterior thigh and lower leg S2 Buttock, posterior thigh and lower leg S3 Groin, medial thigh to knee S4 Perineum, genitals, lower sacrum Deep tendon reflexes, more properly referred to as muscle stretch reflexes, and an integral part of the neurological examination A stretch reflex is an involuntary reaction of a muscle to being passively stretched by the percussion of a tendon Although the reflex has a sensory and motor component, deep tendon reflex testing primarily assesses the integrity of the motor system This reflex provides information on upper and lower motor neurons In its simplest form, the quick stretch of the muscle-tendon unit stimulates the muscle spindle receptors which, in turn increases the firing of afferents from the spindles These afferents enter the spinal cord segmentally by the dorsal roots and monosynaptically facilitate motor neurons that supply the muscle causing the muscle to contract Protocol: The extremity being tested should be in a relaxed position A quick, precise tap on the tendon with a reflex hammer should elicit the response It is important to use the lightest force possible to bring out the reflex and to be consistent from side to side Grading Scale: In general, the grades are as follows: 1+ = present but depressed 2+ = normal / average 3+ = increased 4+ = clonus Stretch Reflex (Deed Tendon Reflex) Biceps - Nerve Root C5 Brachioradialis - Nerve Root C6 Triceps - Nerve Root C7 Patellar - Nerve Root L4 Achilles - Nerve Root S1 Medial hamstring - Nerve Root L5-S1 Orthopedic assessment works by what would be called “stress and assess” The orthopedic test procedure ad a physical stress to the client’s body If the structure to which the stress is added is healthy, the client will feel no pain These tests are designed to recreate specific symptoms They help us formulate clinical impressions and rule in certain pathologies Orthopedic definition: Relating to the branch of medicine dealing with the correction and deformities of bones or muscles Red Flags A red flag is a finding in a patient’s history/assessment that indicates the need for referral to a physician

A stretch reflex is an involuntary reaction of a muscle to being passively stretched by the percussion of a ______. Although the reflex has a sensory and motor component, deep tendon reflex testing primarily assesses the integrity of the motor system This reflex provides information on upper and lower motor ______. In its simplest form, the quick stretch of the muscle-tendon unit stimulates the muscle spindle receptors which, in turn increases the firing of afferents from the spindles These afferents enter the spinal cord segmentally by the dorsal roots and monosynaptically facilitate motor neurons that supply the muscle causing the muscle to contract Protocol: The extremity being tested should be in a relaxed position A quick, precise tap on the tendon with a reflex hammer should elicit the response It is important to use the lightest force possible to bring out the reflex and to be consistent from side to side Grading Scale: In general, the grades are as follows: 1+ = present but depressed 2+ = normal / average 3+ = increased 4+ = clonus Stretch Reflex (Deed Tendon Reflex) Biceps - Nerve Root C5 Brachioradialis - Nerve Root C6 Triceps - Nerve Root C7 Patellar - Nerve Root L4 Achilles - Nerve Root S1 Medial hamstring - Nerve Root L5-S1

Muscle length testing is used to assess for limitations of ROM (shortened muscles) and excessive movement, ultimately, we are assessing ______

Muscle length testing is used to assess for limitations of ______ (shortened muscles) and excessive movement

Muscle strength testing is used to determine the client’s ability to contract a muscle or muscle groups ______

Myotome test for upper extremity: Shoulder ______ - C4

Myotome test for lower extremity: L4 Ankle ______

A dermatome tests an area of skin innervated by a single nerve ______

The therapist protocol instructs the client to lie in prone/supine to assess the lumbar/sacral ______

A stretch reflex is an involuntary reaction of a muscle to being passively stretched by the percussion of a ______

Deep tendon reflex testing primarily assesses the integrity of the ______ system

The quick stretch of the muscle-tendon unit stimulates the muscle spindle receptors which increases the firing of afferents from the ______

Orthopedic assessment works by 'stress and assess', adding physical stress to the client’s body to recreate specific ______

The orthopedic test procedure aims to help formulate clinical impressions and rule in certain ______

A red flag in a patient’s history/assessment indicates the need for referral to a ______

Myotome test for upper extremity: Shoulder ______ - C4

Myotome test for lower extremity: L4 Ankle ______

Myotome test for upper extremity: Elbow flexion, wrist extension - ______

Myotome test for upper extremity: Elbow flexion, wrist extension - ______

The therapist protocol instructs the client to lie in prone/supine to assess the lumbar/sacral ______

Myotome test for lower extremity: L4 Ankle ______

A dermatome tests an area of skin innervated by a single nerve ______

A stretch reflex is an involuntary reaction of a muscle to being passively stretched by the percussion of a ______

Orthopedic assessment works by 'stress and assess', adding physical stress to the client’s body to recreate specific ______

The therapist protocol instructs the client to lie in prone/supine to assess the lumbar/sacral ______

A red flag in a patient’s history/assessment indicates the need for referral to a ______

Orthopedic assessment works by 'stress and assess', adding physical stress to the client’s body to recreate specific ______

The orthopedic test procedure aims to help formulate clinical impressions and rule in certain ______

The quick stretch of the muscle-tendon unit stimulates the muscle spindle receptors which increases the firing of afferents from the ______

A dermatome tests an area of skin innervated by a single nerve ______

Muscle length testing is used to assess for limitations of ______ (shortened muscles) and excessive movement

Deep tendon reflex testing primarily assesses the integrity of the ______ system

Muscle strength testing is used to determine the client’s ability to contract a muscle or muscle groups ______

Myotome test for upper extremity: Shoulder ______ - C4

Myotome test for upper extremity: Elbow extension, wrist flexion - ______

Dermatome test for upper extremity: C5 Deltoid area, anterolateral limb to base of ______

Stretch Reflex (Deep Tendon Reflex) Biceps - Nerve Root ______

Muscle strength testing is used to determine the client’s ability to contract a muscle or muscle groups ______

A dermatome tests an area of skin innervated by a single nerve ______

Myotome test for lower extremity: S2 Knee ______

Myotome test for upper extremity: Elbow extension, wrist flexion - ______

Dermatome test for upper extremity: C5 Deltoid area, anterolateral limb to base of ______

A dermatome tests an area of skin innervated by a single nerve ______

The orthopedic test procedure aims to help formulate clinical impressions and rule in certain ______

Myotome test for lower extremity: L4 Ankle ______

Deep tendon reflex testing primarily assesses the integrity of the ______ system

Myotome test for upper extremity: Elbow extension, wrist flexion - ______

Myotome test for lower extremity: L4 Ankle ______

A red flag in a patient’s history/assessment indicates the need for referral to a ______

Myotome test for upper extremity: Elbow extension, wrist flexion - ______

Muscle length testing is used to assess for limitations of ______ (shortened muscles) and excessive movement

Myotome test for upper extremity: Shoulder ______ - C4

Myotome test for upper extremity: Elbow flexion, wrist extension - ______

Myotome test for lower extremity: L4 Ankle ______

Dermatome test for upper extremity: C5 Deltoid area, anterolateral limb to base of ______

Myotome test for upper extremity: Shoulder ______ - C4

The therapist protocol instructs the client to lie in prone/supine to assess the lumbar/sacral ______

A stretch reflex is an involuntary reaction of a muscle to being passively stretched by the percussion of a ______