Scapular Abduction & Elevation Assessment

Scapular Abduction & Upward Rotation

• Grade 3: Supine position, stabilize the trunk, patient pushes arm forward "reaching for the ceiling"
• Muscles Involved: Serratus anterior, Pectoralis minor, upper and lower Trapezius
• Grade 4 & 5: Same position as grade 3, resistance applied to the distal humerus.
• Grade 2, 1, and Zero: Sitting position, avoid trunk rotation, patient pushes arm forward.
• Palpation: Mid-axillary adjacent to the inferior angle of the scapula.
• Serratus Anterior Push Up Test: Winging of the scapula indicates weakness.

Scapular (Shoulder) Elevation

• Grade 3: Sitting position, stabilize head, patient pulls shoulders upward.
• Muscles Involved: Trapezius, Levator scapulae, Rhomboids major and minor.
• Grade 4, 5: Same position as grade 3, resistance applied above the shoulder.
• Grade 2, 1, and Zero: Prone position, therapist supports the weight of the upper extremity, stabilize head, patient pulls shoulders towards the ears.
• Trapezius Palpation: Middle point from the inion to the acromion.

Scapular Adduction (Retraction)

• Grade 3: Prone position, stabilize contralateral thorax, patient brings arm up and adducts scapula toward the midline.
• Muscles Involved: Middle Trapezius, Rhomboids major and minor.
• Grade 4, 5: Same position as grade 3, resistance applied to the distal forearm
• Grade 2, 1, and Zero: Sitting position, avoid trunk rotation, patient pulls arm slightly backward and brings scapula back and in.
• Palpation: Medial border of the scapula and the vertebra above the spine of scapula (from T1-T5)

Scapular Depression and Adduction

• Grade 3: Prone position, arm over head 145 degrees shoulder elevation and abduction, forearm neutral with thumb pointing up, patient moves arm from the table as high as possible.
• Muscles Involved: Lower and middle Trapezius, Lattisimus dorsi, Pectoralis minor and major.
• Grade 4, 5: Same position as grade 3, resistance applied to the distal forearm, patient holds arm against resistance without pushing down.
• Other Points: The therapist should give instructions to "hold your arm" instead of "push down" to ensure adequate muscle engagement in the movement.

This quiz covers the assessment techniques and muscle involvement for scapular abduction and elevation in various grades. Learn how to perform these tests and understand the significance of muscle strength evaluations in shoulder function. Ideal for those studying physical therapy or kinesiology.