Shoulder ROM Testing and Muscle Evaluation

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Questions and Answers

What is the correct starting position for shoulder ROM testing when limited in flexion and abduction?

Arm positioned above the shoulder flexed at 90 degrees

Arm fully extended upwards while lying prone

Arm hanging freely by the side of the table

Arm supported at its maximal range of elevation over the table (correct)

Which muscle is the primary muscle responsible for scapular adduction and downward rotation?

Levator Scapulae

Pectoralis Minor

Middle Trapezius

Rhomboids Major (correct)

During the alternative rhomboid test, what anatomical position should the patient's head be in?

Tilted back to enhance scapular stability

Turned to the opposite side to exclude levator scapula (correct)

Turned to the same side to engage the levator scapula

Facing forward to allow full range of motion

What should the examiner do if the shoulder extensors are graded at 3 or more during the adduction and downward rotation test?

Stabilize the contralateral thorax Signup and view all the answers

Which substitution may occur during a rhomboid test due to trunk rotation?

Middle Trapezius involvement Signup and view all the answers

What is the primary muscle tested during scapular abduction and upward rotation?

Serratus Anterior Signup and view all the answers

What is the starting position for testing muscle grade when the resistance is applied?

Shoulder flexion at 130° Signup and view all the answers

In the context of muscle testing, what does 'palpation' refer to?

Feeling the edges of the scapula at the inferior angle Signup and view all the answers

Which muscle group acts as an accessory during scapular abduction and upward rotation?

Pectoralis Minor and Upper Trapezius Signup and view all the answers

What grade indication suggests that the muscle can perform movement against gravity without resistance?

Grade 3 Signup and view all the answers

Which scapular movement is characterized by bringing the scapula away from the spine?

Abduction Signup and view all the answers

What is significant about a muscle performing a grade of 1 during testing?

The muscle contracts without any movement. Signup and view all the answers

During a manual muscle test, what instruction is given for the arm position at the start of the test?

Raise your arm forward above your head. Signup and view all the answers

What is the primary goal when stabilizing the contralateral scapular area during scapular adduction?

To prevent trunk rotation Signup and view all the answers

What action should be taken when the posterior deltoid muscle is weak during scapular adduction testing?

Flex the elbow while supporting Signup and view all the answers

In which position should the patient be when evaluating scapular depression and adduction?

Sitting with arms at 145° shoulder abduction Signup and view all the answers

What is the significance of grade 3 in the context of scapular adduction testing?

Scapula maintains adduction position Signup and view all the answers

What is the primary muscle responsible for scapular adduction, aside from the middle trapezius?

Rhomboids Signup and view all the answers

During the scapular adduction assessment, resistance is given in which direction?

Downward toward the floor Signup and view all the answers

Which primary muscle is primarily involved in the movement of scapular depression and adduction?

Lower trapezius Signup and view all the answers

What should a therapist do to prevent trunk rotation during scapular adduction testing?

Stabilize the contralateral scapular area Signup and view all the answers

What is the proper test position for assessing Grade 3 scapula movement in relation to the arm?

Arm forward flexed to about 130° and protracted Signup and view all the answers

In what situation would a clinician test for scapular elevation?

When shoulders are shrugged towards the ears Signup and view all the answers

What muscles are primarily responsible for scapular elevation?

Upper trapezius & Levator scapulae Signup and view all the answers

Which grade of muscle function indicates that the scapula can move through full range of motion without winging?

Grade 3 Signup and view all the answers

What is the primary purpose of palpating the serratus muscle during the assessment?

To assess serratus anterior activation Signup and view all the answers

During scapular retraction testing at grades 5 & 4, what is the required arm position?

Prone with shoulder abducted 90° Signup and view all the answers

What alternate position is used for testing Grade 2 scapular abduction and upward rotation?

Sitting with arm forward flexed below 90° Signup and view all the answers

Which activity increases trapezius activity while decreasing levator activity?

Turning the face to the opposite side Signup and view all the answers

Study Notes

Manual Muscle Testing of Scapular Muscles

This lecture covers describing and applying muscle testing of scapular muscles.
Topics include scapular movement, surface anatomy of scapular muscles, and manual muscle testing of scapular muscles.
Specific movements include scapular abduction & upward rotation, scapular elevation, scapular adduction, scapular depression & adduction, and scapular adduction & downward rotation.

Scapular Movement

Scapular movement is a key aspect of shoulder function, directly correlated with the functioning of scapular muscles.
The movements discussed include elevation, depression, abduction (protraction), adduction (retraction), and rotation (upward and downward).

Surface Anatomy of Scapular Muscles

The lecture identifies key muscles involved in scapular movements.
These include the Levator Scapulae, Trapezius, Rhomboid Minor, and Rhomboid Major.
Precise locations and anatomical relations of these muscles on the scapula are detailed.

Manual Muscle Testing Procedure

A step-by-step procedure for assessing strength is outlined.
Steps in order include starting positions of the patient, order of the test sequence, fixation, resistance, and palpation.
Different grades (1-5) for muscle testing strength are introduced.

Specific Muscle Testing Procedures

A thorough outline of testing procedures for each type of scapular movement is presented.
The lecture provides specific testing positions, instructions to the patient, and grading criteria.
Examples include the various positions for testing Abduction & Upward Rotation of the scapula, utilizing specific anatomical reference points (e.g. inferior angle).
Further detailed specific procedures are provided for Scapular Elevation, Depression & Adduction, and Adduction & Downward Rotation, including grading criteria.

Substitutions and Additional Tests

Substitutions are discussed for each muscle group involved in scapular movements.
These substitutions are muscle groups that might appear to substitute or compensate for some of the primary muscles tested and are important distinctions during assessment of patient strength.
Additional and alternative more accurate tests provide greater detail for assessing strength.

Muscle Origins and Insertions

Anatomical details for the origins and insertions of various muscles, such as serratus anterior, pectoralis minor, upper, middle, and lower trapezius, levator scapulae, rhomboids major and minor, and latissimus dorsi, are referenced throughout the presentations of various movements.

Clinical Applications

The presentation provides practical application and understanding of how scapular muscle movement patterns and testing result in diagnostic insights for professionals to understand patient anatomy, strength, and movement patterns.
Understanding and practicing each movement with its corresponding testing method and grading scale is key to the application of manual muscle testing for clinicians.
Helpful hints are included for specific situations, such as when the posterior deltoid is weak.

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Description

Test your knowledge on shoulder range of motion testing, muscle functions, and anatomical positions relevant to physical therapy. This quiz covers key concepts such as grading muscle strength, palpation, and specific muscles involved in scapular movements. Perfect for students and practitioners in the field of rehabilitation.