Podcast
Questions and Answers
During shoulder flexion goniometry, the patient is positioned in hook lying primarily to:
During shoulder flexion goniometry, the patient is positioned in hook lying primarily to:
- Isolate glenohumeral motion.
- Stabilize the pelvis. (correct)
- Enhance patient comfort.
- Prevent radial nerve compression.
When measuring shoulder flexion with a goniometer, the fulcrum is aligned with the:
When measuring shoulder flexion with a goniometer, the fulcrum is aligned with the:
- Mid-axillary line.
- Lateral aspect of the greater tubercle.
- Lateral epicondyle.
- Acromion process. (correct)
A capsular end feel during shoulder flexion goniometry is primarily due to tension in the:
A capsular end feel during shoulder flexion goniometry is primarily due to tension in the:
- Posterior coracohumeral ligament.
- Middle deltoid muscle.
- Biceps brachii muscle. (correct)
- Anterior joint capsule.
During shoulder extension goniometry, which of the following patient positions is typically recommended?
During shoulder extension goniometry, which of the following patient positions is typically recommended?
If a patient exhibits limited shoulder extension, the end feel that is MOST likely to be encountered is:
If a patient exhibits limited shoulder extension, the end feel that is MOST likely to be encountered is:
In shoulder abduction goniometry, which bony landmark is used as the fulcrum's reference point?
In shoulder abduction goniometry, which bony landmark is used as the fulcrum's reference point?
Which of the following best describes the alignment of the stationary arm during shoulder abduction goniometry?
Which of the following best describes the alignment of the stationary arm during shoulder abduction goniometry?
When performing goniometry for shoulder horizontal abduction, the patient's shoulder should be positioned at:
When performing goniometry for shoulder horizontal abduction, the patient's shoulder should be positioned at:
During shoulder horizontal adduction goniometry, the fulcrum is typically positioned at:
During shoulder horizontal adduction goniometry, the fulcrum is typically positioned at:
Which of the following end feels is expected during normal shoulder horizontal adduction?
Which of the following end feels is expected during normal shoulder horizontal adduction?
During goniometric measurement of combined shoulder external rotation, which forearm position is correct?
During goniometric measurement of combined shoulder external rotation, which forearm position is correct?
Which of the following describes the correct positioning of the stationary arm during shoulder external rotation goniometry?
Which of the following describes the correct positioning of the stationary arm during shoulder external rotation goniometry?
What is the typical end-feel encountered during shoulder external rotation?
What is the typical end-feel encountered during shoulder external rotation?
When performing goniometry to measure glenohumeral (GH) joint motion, what is the MOST critical step to ensure accurate results?
When performing goniometry to measure glenohumeral (GH) joint motion, what is the MOST critical step to ensure accurate results?
What is the approximate range of motion (ROM) typically observed during PROM of glenohumeral joint flexion:
What is the approximate range of motion (ROM) typically observed during PROM of glenohumeral joint flexion:
During PROM GH joint flexion, resistance to further motion indicating the end of GH PROM is assessed primarily by:
During PROM GH joint flexion, resistance to further motion indicating the end of GH PROM is assessed primarily by:
According to Cyriax's capsular patterns, which limitation is MOST restrictive in patients with glenohumeral joint dysfunction?
According to Cyriax's capsular patterns, which limitation is MOST restrictive in patients with glenohumeral joint dysfunction?
A patient needs to reach a high shelf. The GREATEST amount of shoulder flexion required for this activity is approximately:
A patient needs to reach a high shelf. The GREATEST amount of shoulder flexion required for this activity is approximately:
During muscle length testing for the lower/sternal fibers of the pectoralis major, the patient is positioned in hook lying. The examiner places the arm in about 135 degrees of abduction with the elbow extended and the shoulder in external rotation. In a patient with normal length, what should the examiner observe?
During muscle length testing for the lower/sternal fibers of the pectoralis major, the patient is positioned in hook lying. The examiner places the arm in about 135 degrees of abduction with the elbow extended and the shoulder in external rotation. In a patient with normal length, what should the examiner observe?
When assessing muscle length of the upper fibers of the pectoralis major, what signifies normal length?
When assessing muscle length of the upper fibers of the pectoralis major, what signifies normal length?
A lateral epicondyle to table measurement is used during:
A lateral epicondyle to table measurement is used during:
For assessing Teres Major tightness what action needs to be performed prior to initiating?
For assessing Teres Major tightness what action needs to be performed prior to initiating?
When assessing Latissimus Dorsi tightness, the therapist stabilizes the pelvis primarily to:
When assessing Latissimus Dorsi tightness, the therapist stabilizes the pelvis primarily to:
In manual muscle testing (MMT) of the upper trapezius, the primary movement being tested is:
In manual muscle testing (MMT) of the upper trapezius, the primary movement being tested is:
During manual muscle testing of the middle trapezius with the patient prone, the shoulder is positioned in 90 degrees of abduction and lateral rotation. What action should the patient perform againist gravity?
During manual muscle testing of the middle trapezius with the patient prone, the shoulder is positioned in 90 degrees of abduction and lateral rotation. What action should the patient perform againist gravity?
During manual muscle testing for the rhomboids against gravity, what is the MOST appropriate patient position?
During manual muscle testing for the rhomboids against gravity, what is the MOST appropriate patient position?
When performing manual muscle testing of the lower trapezius against gravity, what is the expected direction of resistance?
When performing manual muscle testing of the lower trapezius against gravity, what is the expected direction of resistance?
Which of the following is the MOST common observation during serratus anterior weakness when testing against gravity?
Which of the following is the MOST common observation during serratus anterior weakness when testing against gravity?
When testing the anterior deltoid's strength against gravity, what is the the BEST and most accurate position?
When testing the anterior deltoid's strength against gravity, what is the the BEST and most accurate position?
In manual muscle testing of the middle deltoid against gravity, the MOST appropriate patient position involves the shoulder being:
In manual muscle testing of the middle deltoid against gravity, the MOST appropriate patient position involves the shoulder being:
When performing a manual muscle test on the posterior deltoid, which of the following is true about the glenohumeral joint?
When performing a manual muscle test on the posterior deltoid, which of the following is true about the glenohumeral joint?
To isolate the latissimus dorsi during manual muscle testing against gravity, which combined movements are required?
To isolate the latissimus dorsi during manual muscle testing against gravity, which combined movements are required?
During manual muscle testing of the pectoralis major clavicular fibers against gravity, the patient is supine and...
During manual muscle testing of the pectoralis major clavicular fibers against gravity, the patient is supine and...
In performing a manual muscle test of the supraspinatus against gravity with the patient seated, which combined movements and joint positions would MOST isolate this muscle's function?
In performing a manual muscle test of the supraspinatus against gravity with the patient seated, which combined movements and joint positions would MOST isolate this muscle's function?
When performing MMT testing for the infraspinatus and teres minor, against gravity, what does reduced ability typically test?
When performing MMT testing for the infraspinatus and teres minor, against gravity, what does reduced ability typically test?
When performing MMT testing for the medial rotators of the shoulder against gravity, which specific combined movements and joint positions should patient be placed to best test their muscle function?
When performing MMT testing for the medial rotators of the shoulder against gravity, which specific combined movements and joint positions should patient be placed to best test their muscle function?
A key substitution to watch out for during manual muscle testing of shoulder flexion is:
A key substitution to watch out for during manual muscle testing of shoulder flexion is:
Which BEST describes the documentation when assessment for the sensory integrity?
Which BEST describes the documentation when assessment for the sensory integrity?
During shoulder flexion goniometry, what bony landmark serves as the fulcrum's reference?
During shoulder flexion goniometry, what bony landmark serves as the fulcrum's reference?
When performing shoulder extension goniometry, what is the correct position of the patient's forearm?
When performing shoulder extension goniometry, what is the correct position of the patient's forearm?
During shoulder abduction goniometry, the movable arm of the goniometer should be aligned with which of the following?
During shoulder abduction goniometry, the movable arm of the goniometer should be aligned with which of the following?
What is the typical end feel expected during shoulder horizontal abduction goniometry?
What is the typical end feel expected during shoulder horizontal abduction goniometry?
During shoulder external rotation goniometry, which alignment of the stationary arm is correct?
During shoulder external rotation goniometry, which alignment of the stationary arm is correct?
Which of the following is the MOST important action to prevent during ROM measurement of glenohumeral (GH) joint motion?
Which of the following is the MOST important action to prevent during ROM measurement of glenohumeral (GH) joint motion?
During PROM of GH joint flexion, what observation indicates the end of GH PROM?
During PROM of GH joint flexion, what observation indicates the end of GH PROM?
According to Cyriax's capsular patterns, what is the expected order of glenohumeral joint restriction?
According to Cyriax's capsular patterns, what is the expected order of glenohumeral joint restriction?
What is the approximate shoulder flexion ROM needed to eat and wash the face?
What is the approximate shoulder flexion ROM needed to eat and wash the face?
When assessing muscle length performing a lateral epicondyles-to-table measurement, the measurement determines:
When assessing muscle length performing a lateral epicondyles-to-table measurement, the measurement determines:
When performing the latissimus dorsi muscle length test, what is being assessed to determine muscles length?
When performing the latissimus dorsi muscle length test, what is being assessed to determine muscles length?
What action should the patient perform during manual muscle testing of the middle trapezius, with the shoulder is positioned in 90 degrees of abduction and lateral rotation?
What action should the patient perform during manual muscle testing of the middle trapezius, with the shoulder is positioned in 90 degrees of abduction and lateral rotation?
During manual muscle testing for the rhomboids against gravity, the testing patient is positioned in prone. What is the neck position?
During manual muscle testing for the rhomboids against gravity, the testing patient is positioned in prone. What is the neck position?
When performing manual muscle testing of the lower trapezius, which movement best describes the muscles action?
When performing manual muscle testing of the lower trapezius, which movement best describes the muscles action?
What patient presentation is common during a serratus anterior manual muscle test?
What patient presentation is common during a serratus anterior manual muscle test?
To best isolate the action of the posterior deltoid while MMT testing, the upper extremity should be placed in?
To best isolate the action of the posterior deltoid while MMT testing, the upper extremity should be placed in?
To properly perform MMT on the latissimus dorsi, which bony landmark is best to apply counter pressure to, in order to stabilize the patient.
To properly perform MMT on the latissimus dorsi, which bony landmark is best to apply counter pressure to, in order to stabilize the patient.
When documenting sensory integrity, intact, impaired, and absent are examples of:
When documenting sensory integrity, intact, impaired, and absent are examples of:
According to the dermatome map, which nerve root distribution is localized to the anterior shoulder?
According to the dermatome map, which nerve root distribution is localized to the anterior shoulder?
What is the MOST important instruction/reminder for MMT testing?
What is the MOST important instruction/reminder for MMT testing?
When performing goniometry of shoulder external rotation, which bony landmark is best used as an anatomical reference?
When performing goniometry of shoulder external rotation, which bony landmark is best used as an anatomical reference?
When performing MMT of the lower trapezius, in what position is the arm typically placed?
When performing MMT of the lower trapezius, in what position is the arm typically placed?
When performing muscle length testing for the pectoralis major upper/clavicular fibers. What is the most appropriate description of 'normal length'?
When performing muscle length testing for the pectoralis major upper/clavicular fibers. What is the most appropriate description of 'normal length'?
For Latissimus Dorsi tightness, what is the purpose of flexing the knees?
For Latissimus Dorsi tightness, what is the purpose of flexing the knees?
When performing a MMT for the serratus anterior against gravity, the motion to test is most accurate when evaluating the following:
When performing a MMT for the serratus anterior against gravity, the motion to test is most accurate when evaluating the following:
During manual muscle testing for the supraspinatus, how should the elbow be placed, and pressure be applied?
During manual muscle testing for the supraspinatus, how should the elbow be placed, and pressure be applied?
Generally, what is the motion to test when manual muscle testing a shoulder medial rotator?
Generally, what is the motion to test when manual muscle testing a shoulder medial rotator?
When performing horizontal abduction goniometry what is the degree expected for normal motion?
When performing horizontal abduction goniometry what is the degree expected for normal motion?
When completing MMT of middle trapezius across gravity, what can often be observed for weakness?
When completing MMT of middle trapezius across gravity, what can often be observed for weakness?
The MMT testing position for the rhomboids against gravity is prone, with?
The MMT testing position for the rhomboids against gravity is prone, with?
When performing PROM in GH Abduction while stabilizing the scapula, what should occur?
When performing PROM in GH Abduction while stabilizing the scapula, what should occur?
If flexion is limited in a patient's GH joint, what position should the joint be slightly placed in to perform the motion?
If flexion is limited in a patient's GH joint, what position should the joint be slightly placed in to perform the motion?
What is the plane in motion observed during an MMT for the latissimus dorsi?
What is the plane in motion observed during an MMT for the latissimus dorsi?
To properly stabilize when testing the traps and rhomboids, the trunk should have?
To properly stabilize when testing the traps and rhomboids, the trunk should have?
What shoulder motion results from a contraction of the middle deltoid?
What shoulder motion results from a contraction of the middle deltoid?
Which of the following best describes the dermatome responsible for the lateral epicondyle on the humerus?
Which of the following best describes the dermatome responsible for the lateral epicondyle on the humerus?
What is the MOST common observation during serratus anterior weakness when testing seated against a wall?
What is the MOST common observation during serratus anterior weakness when testing seated against a wall?
During MMT, what should the patient avoid when performing horizontal abduction with the upper extremity?
During MMT, what should the patient avoid when performing horizontal abduction with the upper extremity?
Which of the following BEST describes the stabilization technique when performing subscap and teres major, MMT?
Which of the following BEST describes the stabilization technique when performing subscap and teres major, MMT?
If a patient is unable to perform 120 degrees of flexion during a PROM of the GH joint, which structure is most likely to provide a source of restriction?
If a patient is unable to perform 120 degrees of flexion during a PROM of the GH joint, which structure is most likely to provide a source of restriction?
When documenting muscle length measurements, which of the following pieces of information is MOST critical to include for ensuring reproducibility?
When documenting muscle length measurements, which of the following pieces of information is MOST critical to include for ensuring reproducibility?
During goniometry of shoulder external rotation, if resistance is felt and attempts to push further cause spine extension and rotation, what should the therapist do FIRST?
During goniometry of shoulder external rotation, if resistance is felt and attempts to push further cause spine extension and rotation, what should the therapist do FIRST?
A patient exhibits weakness in shoulder flexion against gravity. To ensure the most accurate assessment of anterior deltoid strength across gravity, which modification would be BEST?
A patient exhibits weakness in shoulder flexion against gravity. To ensure the most accurate assessment of anterior deltoid strength across gravity, which modification would be BEST?
When performing muscle length testing of the latissimus dorsi, why is it important to stabilize the pelvis and flex the patient's knees?
When performing muscle length testing of the latissimus dorsi, why is it important to stabilize the pelvis and flex the patient's knees?
Regarding the scapula, which of the following describes the MOST important factor for accurate assessment of muscle strength during manual muscle testing (MMT)?
Regarding the scapula, which of the following describes the MOST important factor for accurate assessment of muscle strength during manual muscle testing (MMT)?
During goniometric measurement of shoulder flexion, where the end of PROM is determined to be at 120 degrees, what accompanying observations would BEST confirm that further attempts would be inappropriate?
During goniometric measurement of shoulder flexion, where the end of PROM is determined to be at 120 degrees, what accompanying observations would BEST confirm that further attempts would be inappropriate?
While performing MMT on a patient's shoulder, you note the patient is contracting the upper trapezius during a shoulder flexion test. How would you BEST modify your test?
While performing MMT on a patient's shoulder, you note the patient is contracting the upper trapezius during a shoulder flexion test. How would you BEST modify your test?
A therapist is performing goniometry on a patient for shoulder abduction. During the movement, the patient begins to laterally flex their trunk. What is the MOST appropriate action for the therapist to take?
A therapist is performing goniometry on a patient for shoulder abduction. During the movement, the patient begins to laterally flex their trunk. What is the MOST appropriate action for the therapist to take?
A physical therapist is planning to perform manual muscle testing on a patient with suspected scapular instability. What principle needs to be considered FIRST?
A physical therapist is planning to perform manual muscle testing on a patient with suspected scapular instability. What principle needs to be considered FIRST?
Flashcards
Shoulder Anatomy
Shoulder Anatomy
Review bones, joints, ligaments, and musculature of the shoulder.
MMT Positions
MMT Positions
Manual muscle test positions for shoulder musculature against and across gravity.
ROM & MMT Discussion
ROM & MMT Discussion
Discuss when ROM and manual muscle testing are appropriate/inappropriate.
Shoulder Extension end of motion
Shoulder Extension end of motion
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Shoulder abduction fulcrum point
Shoulder abduction fulcrum point
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Shoulder Abduction end feel
Shoulder Abduction end feel
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External rotation end of motion and compensation
External rotation end of motion and compensation
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Pectoralis major length
Pectoralis major length
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Shortness testing
Shortness testing
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MMT grade 3/5
MMT grade 3/5
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Rhomboids MMT position
Rhomboids MMT position
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Resistance test towards a stable arm
Resistance test towards a stable arm
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Serratus Anterior MMT Position
Serratus Anterior MMT Position
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Shoulder dermatomes
Shoulder dermatomes
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What you will hear about humerus during therapy!
What you will hear about humerus during therapy!
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Study Notes
- The information below is study notes on the therapeutic measurements and testing of the shoulder.
Objectives
- Review bones, joints, ligaments, and musculature of the shoulder, including nearby areas.
- Learn range of motion measurements of the shoulder using goniometry.
- Learn manual muscle test positions for shoulder musculature against and across gravity.
- Review dermatomes on and near the shoulder.
- Discuss when range of motion and manual muscle testing is appropriate or inappropriate.
- Document the objective section of a note regarding goniometry and strength testing.
- Review normal and abnormal end feels as well as discuss capsular patterns.
Shoulder Girdle
- Presents a musculoskeletal overview of the shoulder girdle.
- Considers the bones and bony landmarks.
- Considers the Joints, ligaments, and Muscles of the Shoulder Girdle.
- Scapular bony landmarks should be reviewed.
- Humerus bony landmarks should also be reviewed.
- Joints of the shoulder girdle should be reviewed
- Includes the Glenohumeral (GH).
- Includes the Sternoclavicular (SC).
- Includes the Acromioclavicular (AC).
- Includes the Scapulothoracic(ST) - More of a 'functional' joint rather than anatomical.
- Ligaments of the AC and GH joints should be reviewed.
- Ligaments of the SC joints should be reviewed.
- Capsules, bursae, and cartilage should be reviewed.
- Motions of the Scapula are important to review.
- Motions of the GH joint are important to review.
Goniometry of the Shoulder
- Discusses the procedure for measuring shoulder range of motion.
- Shoulder Flexion should be at zero to 180 degrees.
- To ensure pelvic stabilization during shoulder flexion goniometry, position the patient in hook lying.
- The patient should be shoulder and forearm neutral with the elbow extended, although slight rotation is permitted for optimal flexion.
- Have patient stand and stabilize the thorax.
- Place the goniometer fulcrum on the lateral aspect of the greater tubercle.
- The stationary arm is parallel to the mid axillary line.
- The movable arm is on the lateral midline of the humerus, referencing the lateral epicondyle.
- Resistance felt and further motion resulting in spine or rib movement signals the end of motion.
- Shoulder flexion end feel is capsular/firm due to tension in the posterior coracohumeral ligament, posterior joint capsule, posterior deltoid, teres minor/major, and infraspinatus muscles.
- Shoulder extension should be at zero to 60 degrees.
- For shoulder extension goniometry, the patient should be prone, shoulder neutral, elbow slightly flexed, and forearm neutral.
- Therapist standing, stabilizing trunk to prevent trunk rotation.
- Position the goniometer fulcrum of fulcrum of goniometer to the lateral aspect of the greater tubercle.
- Stationary arm should be parallel to the mid axillary line.
- Movable arm: lateral midline of the humerus (lateral epicondyle).
- Resistance felt and further motion results in spine flexion or rotation signals the end of motion.
- End feel: capsular/firm; tension in SC capsule and ligaments and in serratus anterior muscle.
- Shoulder abduction should be at zero to 180 degrees.
- The patient is hook lying (pelvis stabilized); ER shoulder, no flexion/extension, elbow extended.
- The therapist should stand and stabilize the thorax to prevent lateral spine flexion.
- Position the goniometer fulcrum close to the anterior part of the acromial process.
- Ensure the stationary arm is parallel to the midline of the sternum.
- The movable arm is on the anterior midline of the humerus referencing the medial epicondyle.
- Resistance felt and further motion causing lateral spine flexion signals of the end of motion.
- End feel: capsular/firm; tension in costoclavicular ligament and sternoclavicular capsule and ligaments, and latissimus dorsi, sternocostal fibers of pectoralis major, and rhomboid major and minor muscles.
- Shoulder adduction is not usually measured because it is the return to zero from full abduction. Shoulder horizontal abduction should be at 45 degrees (Magee).
- The patient should be seated with the shoulder at 90 degrees of abduction and the elbow flexed to 90 degrees.
- The therapist stand behind the patient, prevents thoracic extension and rotation, and allows the arm to move backward.
- Position the goniometer fulcrum on the acromial process.
- Ensure the stationary arm runs between the acromial processes.
- The movable arm should be on the Midline of the humerus.
- Resistance to movement and further motion attempts cause extension and rotation of the spine signals the end of motion.
- the end feel is capsular and firm, with tension in the costoclavicular ligament, sternoclavicular capsule and ligaments, sternocostal fibers of pectoralis major, and pec minor.
- Shoulder horizontal adduction, should be 130 degrees (magee).
- Patients should be sitting with shoulder abducted to 90 degrees and elbow flexed to 90 deg.
- Therapist should stand behind the patient, prevent thoracic flexion and rotation and allow the arm to move forward and across the body.
- Align the fulcrum in the acromial process.
- Move the stationary arm to line between acromial processes.
- Move the moveable arm to midline of humerus.
- Stop when resistance is encountered.
- End feel is soft tissue approximation.
- complex External/lateral rotation Should be zero to 90 degrees.
- The patient is to be placed supine, with a towel used under the humerus to ensure alignment of the humerus.
- Abduct the patient to 90 deg, neutral forearm, 90 deg elbow flexion.
- Keep the therapist standing , stabilize humeral head to maintain 90 abduction and prevent extension and rotation of the spine
- Position goniometer in olecranon process.
- The stationary arm should be perpendicular to the floor.
- Keep the movable arm on ulnar styloid.
- stop When resistance is feel and attempts to overcome cause extension and rotation of the spine
- End feel capsular/firm; tension in SC capsule and ligaments and in latissimus dorsi, sternocostal fibers of pectoralis major, pectoralis minor, and serratus anterior muscles.
- SPTА must provide stabilization to anterior humeral head to prevent humeral head from popping forward during the exam (typical compensation when ER end range is achieved)
- Shoulder internal rotation should be at zero to 70 deg
- This is measured with the patience supine, and towel under humerus and forearm natural, and 90 deg abduction
- Keep the therapist stabilize humeral head and maintain 90 deg abduction
- Place goniometer in olecranon process.
- keep the Stationary arm perpendicular to the floor..
- The movable arm should be the ulnar styloid.
- End of motion resistance is felt and attempts to overcome cause flexion and rotation of the spine
- End feel is capsular, tension in sternoclavicular ligaments and capsule, costoclavicular ligament, and rhomboids and trapezius muscles
- SPTA must provide stabilization to anterior humeral head to prevent popping forward during exam
- To measure pure GH motion and not scapular movements, stabilize the scapula.
- The measured result will be passive as ROM without scapular movement is impossible.
- The goniometer placements are the same as for these ranges when comparing the process to shoulder complex measuring.
- PROM GH (Passive Range of Motion Glenohumeral) Joint Flexion uses certain positions, movement, and stabilizing actions.
- The patient can be on hook-lying
- Stabilize the scapula and prevent upwards tilting.
- The Shoulder is flexed with exception of rotation to maximize flexion.
- The end of GH PROM is when resistance is felt and attempts to overcome resistance rotates it upward, tilted posterior or elevated.
- Normal and feel due to tenson.
- Normal PROM range of 120 degrees.
- Goniometry for GH Abduction follows certain criteria.
- Start with the patient supine, with the shoulder in External Rotation with the hand facing the patient (elbow extended)
- Stabilizing the scapula prevent upward rotation and elevating the scapula upward.
- Move into an abducted position and be sure to maintain a static External Rotation/neutral flexion.
- The end goal is finding the point of resistance and feeling for the capsule. There should be approxanitamly 20 degrees
Principles of ROM
- Examples of capsular patterns data from cyriax j textbook of orthopaedic medicine, diagnosis of soft tissue lesions, 1982 included
- Limitation is the motion to be at at a restricted rate
- Glenohumeral- ER >abduction > IR
- No true of the sternoclavicular pattern, but has a loss of HOR. Add and pain can occur at range
- There are no acromioclavicular true pattern, but loss pf Hor ADD pain can occur at range
Therapeutic Measurement and Testing of the Shoulder Complex.
- Greatest amount of the sholder flexion is a 120 amount
- If 80 degree of sholder flexion is required to wash th face
- Abduction range should be from 100-120 with 40-80 of externa
- As assessments are conducted, results should be tied back
Muscle Length
- Common muscles for muscle length measurement inclue - Pectoralis major upper and lower fibers and the latissimus dorsi and teres major
Pectoralis Major
- To determine the lenth of the pectoralis major, use the position of book lying with low back flat while table.
- For the lower aspect angle/ arm 135 abduction with arm extensions sholder in er
- Normal range is if the arm drops in an even motion with low back flat on table
- short messier with a measuring
Pectoralis Major (upper/clavicular)
- Position is hook lying with low back flat on horizontal abduction.
- Tests examiner puts arm horizontally extended shoulder on ER
- For normal range is full horizontal abduction with arm trunk has no rotation and messier of with a ruler /tap
Teres Major muscle
- Test (subjects raises the arm) arms move overhead with hands close lower one one with er till is is stabilized
Muscle documentation should include
- Test documentation specific body muscles if its standard position
- patient response
Manual muscle remaniders
If a joint crosses being tested then PT needs test for potential integearity if not
- Eace and our if patient
- pressure on person or of muscle
- if anatomy review is necessary
Therauptic measuremebt of Documentation.
Goniometry Goniomtry
- senses testing, to assess what kind of form
- wher the test being performaed
- note of what they say
Notes about rhomboid.
- Posterior deltoid mmt have high % of mvc
- Clinical any options to use or more impot that pt has correct and stablizd
- Mmt should watch out because there are substitute
- Test will be in in middle position or ir er to test shoulder or flex. If is low. Er will er should flex
- During flexion, make sure upper trap not contract or elevate
- If flexion make sure upper trap do not contract
- Assessing horizontal abduction keep elbow flexed to avoid substitute
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Description
Explore therapeutic measurements and testing of the shoulder, including bones, joints, and muscles. Learn ROM measurements using goniometry and manual muscle testing. Review dermatomes and documentation while considering appropriate and inappropriate testing scenarios.
