Combo with Manual Muscle Tests of the hand and wrist and 4 others

Special Test: Shoulder Posterior Apprehension Test

Indication: Anterior shoulder subluxation or dislocation Method: Place pt supine. Passively ABD shoulder 90, flex elbow 90. Passively rotate shoulder externally Positive results: Pt demonstrates apprehension (guarding, facial expression

Special Test: Shoulder Anterior Apprehension Test

Indication: Anterior shoulder subluxation or dislocation Method: Place pt supine. Passively ABD shoulder 90, flex elbow 90. Passively rotate shoulder externally Positive results: Pt demonstrates apprehension (guarding, facial expression)

Special Test: Wrist & Hand Reverse Phalen's

Indication: CTS Method: Hold dorsal surface of hands together (opposite of prayer hands) for 1 min. Positive result: pain, tingling of palmer surface of thumb, index, middle and lateral half of ring finger (Median distribution).

Special Test: Wrist & Hand Phalen's Test

Indication: CTS Method: Place palmer surface of hands toether (prayer hands) for 1 min. Positive result: pain, tingling of palmer surface of thumb, index, middle and lateral half of ring finger.

Special Test: Wrist & Hand Tinel

Indication: CTS (adjunct to Dx) Method: Pt's forearm in supination. PTA taps wrist over CT. Positive result: pain, tingling of palmer surface of thumb, index, middle and lateral half of ring finger.

Special Test: Wrist & Hand Collateral Ligament Stress test

Indication: Collateral ligament integrity of MCP jt. Method: PTA stabilizes metacarpal, holds prox phalanx, applies varus/valgus movement to MCP jt. Positive result: pain or excessive movement/gapping of MCP jt.

Special Test: Wrist & Hand Finklestein

Indication: Dequervain's thumb / APL-EPB tenosynovitis Method: Pt makes fist while enclosing thumb in flexed fingers. PTA stabilizes forearm while passively or actively moving wrist in ulnar deviation. Positive result: more pain on involved side.

Special Test: Elbow Lateral Epicondylitis (Mill's)

Indication: Lateral Epicondylitis Method: Passive Elbow ext and wrist flex. Positive Result: Pain elicited at or near the lateral epicondyle.

Special Test: Elbow Lateral Epicondylitis (Cruzan's)

Indication: Lateral Epicondylitis Method: Resist Wrist Ext. Positive Result: Sudden pain in origin of muscles being contracted.

Special Test: Elbow Medial Epicondylitis Technique 2

Indication: Medial Epicondylitis Method: Passive Elbow ext and wrist ext Positive Result: Pain over Medial epicondyle.

Special Test: Elbow Medial Epicondylitis Technique 1

Indication: Medial epicondylitis Method: Resist wrist flexion. Positive Result: Pain in Medial Epicondyle.

Special Test: Wrist & Hand Allen

Indication: Radial/ulnar artery integrity Method: Pt to open/close hand several times quickly. Stop cycle w fist. PTA presses on r/u arteries at the wrist. Wrist turns whitish. Pt opens hand, PTA releases arteries separately. Note color return. Positive result: Hand remains whitish/pale

Special Test: Shoulder Kennedy-Hawkins Test

Indication: Subacromial impingement of superspinatus. Method: Passively flex shoulder and elbow to 90. Passively rotate should internally. Positive results: Motion reproduces pain especially at end range of rotation

Special Test: Shoulder Supraspinatus Test

Indication: Tear in supraspinatus tendon Method: Have pt sit with shoulder abd 90, thumbs up then apply resistance. Have pt horizontal adduction shoulder 30 with thumbs down then apply resistance. Repeat at 45 horizontal adduction. Positive Result: Weakness or pain in superior rotator cuff

Special Test: Shoulder Speeds Test

Indication: Test for bicipital tendonitis Method: pt sits or stands with shoulder flexed 60, elbow extended and forearm supinated. SPTA pushes down at distal forearm while pt flexes shoulder. Positive result: Reproduces pain?

Special Test: Shoulder Adson's Maneuver

Indication: Thoracic outlet syndrome Method: Have pt sit. Palpate radial pulse then passively hyper extend and externally rotate arm. Have pt extend and rotate head to test side then inhale deeply and hold. Positive Result: If radial pulse weakens or disappear during valsalva and returns upon exhalation

Special Test: Shoulder Roo's Test

Indication: Thoracic outlet syndrome Method: Have pt stand with both elbows flexed and shoulders abducted 90 and externally rotated. Have pt open and close hands for 3 minutes Positive Result: radicular pain, or heaviness/weakness in shoulder (false positives common)

Special Test: Shoulder Allen's Test

Indication: Thoracic outlet syndrome. Method: Have pt sit with shoulder abd and elbow flexed 90. Palpate radial pulse as pt rotates head away from test side. Positive Result: Radial pulse disappears or weakens as head turns away from test side

Special Test: Wrist & Hand Froment

Indication: Ulnar nerve compromise by eval. thumb adduction. Method: Paper placed in between pt's thumb & index finger. Pt told to grip paper w/o bending thumb. PTA tries to pull it out. Positive result: flexing DIP as substitution to compensate for add. pollicis weakness due to ulnar nerve injury.

Special Test: Wrist & Hand Grip/pinch

Indication: assess functional grip/pinch strength. Method: handheld dynanometer. shoulder adducted to side, elbow flexed @ 90*. Squeeze/pinch handle w max force. Take average of 3 trials. Bilateral. Positive result: compare to norm values, based on gender and age.

Special Test: Shoulder Yergason's Test

Indication: bicipital tendonitis in bicipital groove. Method: pt's elbow stabilized at trunk, flexed 90. Wrist fully pronated. Have pt supinate against resistance. Positive result: Reproduces pain?

Special Test: Wrist & Hand Retinacular Ligament test

Indication: differentiates bt retinacular ligament tightness & restriction in PIP jt capsule causing DIP flexion restriction. Method: Extend MCP and PIP, flex DIP, then flex PIP Positive result: Retinacular tightness: PIP flexion allowing full range of DIP flexion. PIP jt restriction: comp. of DIP flexion when PIP is flexed

Special Test: Wrist & Hand Murphys

Indication: dislocation of lunate carpal bone. Method: Pt makes a fist. PTA looks at metacarpal head relations. Positive result: 3rd metacarpal in line w 2nd & 4th. Third metacarpal head normally extends more distally.

Special Test: Shoulder Clunk Test

Indication: glenoid labral tear. Method: Place pt supine, shoulder in full abducted and external rotated. Grasp distal humerus. Sweep humeral head around labrum Positive Result: A "clunk" or grinding sound or feeling

Special Test: Shoulder Anterior Drawer Test

Indication: hyper/hypo translation of humeral head. Method: Have pt sit with hands on thigh. Stabilize the top of the shoulder with one hand and grip humeral head with fingers anterior and thumb posterior. Moved anteriorly and returning posteriorly. Positive Result: Increased anterior translation of the humeral head in the capsule or pain

Special Test: Shoulder Posterior Drawer Test

Indication: hyper/hypo translation of humeral head. Method: Have pt sit with hands on thigh. Stabilize the top of the shoulder with one hand and grip humeral head with fingers anterior and thumb posterior. Moved posteriorly and returning anteriorly. Positive Result: Increased anterior translation of the humeral head in the capsule or pain

Special Test: Shoulder Apley's Scratch Test

Indication: quick, nonspecific, active functional assessment of shoulder girdle mobility. Method: pt reaches up and behind head to touch top of opposite scapula. Next pt reaches down and behind towards bottom of opposite shoulder blade Positive result: Reproduces pain?

Special Test: Shoulder Drop Arm Test

Indication: rotator cuff tear, especially the superspinatus. Method: Have pt sit or stand and fully abduct shoulder (thumbs up). Have pt lower limb slowly to side. Positive Result: Reproduces pain or limb drops.

Special Test: Shoulder Neer Test

Indication: shoulder impingement involving long head of biceps. Method: Have pt abd? shoulder. Stabilize shoulder blade and passively forces into flexion. Positive Result: Reproduces pain

Special Test: Shoulder Ludington's Test

Indication: suspected rupture of the long head of biceps. Method: Palpate bicep tendon then have pt clasp hands at superior posterior aspect of head with interlaced fingers. Have pt push down towards floor and palpate LH tendon of bicep. Positive Result: absences of bicep contraction

Special Test: Wrist & Hand Brunnel-Littner

Indication: tightness of INTRINSIC hand muscles from MCP capsular restriction - flexion Method: PTA stabilizes the MCP jt in slight ext, flex PIP, flex MCP. Positive result: tight intrinsics or capsular restriction at PIP.

Special Test: Elbow Valgus Stress Test

Indication: to assess stability of medial (ulnar) collateral ligament Method: Positive Result: Pain or gapping is felt by examiner along medial aspect of joint

Special Test: Elbow Varus Stress Test

Indications: to assess stability of lateral (radial) collateral ligament Method: Positive Result: Pain or excessive gapping of lateral aspect of joint.

Manual Muscle Tests - Hand & Wrist: Palmar Interossei

Palpation: 3 tendons cross MCPs, 1st: ulnar side proximal phalanx of 2nd finger, 2nd: radial side of proximal phalanx of 4th finger, 3rd: radial side of proximal phalanx of 5th finger. Position: Hand rests on palmar surface, wrist and fingers in extended position. Movement: Move 2nd, 4th, and 5th fingers toward 3rd finger from starting position of abduction. Resistance: Applied to side of distal end of proximal phalanx. Stabilization: Hand and fingers not being test are stabilized.

Manual Muscle Test of the Shoulder: Serratus Anterior

Palpation: Along midaxillary line adjacent to inferior angle of scapula AG Position: Supine with shoulder flexed 90 and the elbow joint completely flexed GM Position: Sitting with upper limb resting on table shoulder flexed in 90 and elbow extended Movement: Reach forward or protract shoulder joint so scapula slides forward on thorax Resistance: Applied to elbow pushing scapula down into adduction Stabilization: Contralateral thorax. Substitution:

Manual Muscle Test of the Shoulder: Latissimus Dorsi Muscle

Palpation: Along midaxillary line on the trunk AG Position: Prone, shoulder flexed and MR over edge of table GM Position: Sidelying, upper limb supported in 90 degrees of shoulder flexion and MR and with elbow flexed Movement: extend shoulder, allowing elbow to flex Resistance: Applied to posterior arm proximal to elbow Stabilization: stabilize thorax

Manual Muscle Test of the Shoulder: Mid Trap

Palpation: Along the medial border of the scapula near base of spine AG Position: Prone with elbow flexed over edge of table GM Position: Sitting with upper limb resting on friction free table, shoulder abducted 90, elbow flexed 90 Movement: Bring scapulae back together into adduction Resistance: Applied to the medial border of the scapula, pushing down and out into abduction Stabilization: Contralateral thorax Substitution:

Manual Muscle Test of the Shoulder: Subscapularis

Palpation: Anterior surface of scapula. AG Position: Prone, shoulder abducted and elbow flexed over edge of table. GM Position: Prone, shoulder flexed over edge of table. Movement: MR of shoulder joint to 60 degrees Resistance: Proximal to wrist on anterior surface of forearm. Stabilization: Humerus and thorax with hand and forearm.

Manual Muscle Test of the Shoulder: Posterior Deltoid

Palpation: Below and lateral to spine of scapula, posteriorly crosses shoulder joint. AG Position: Prone, shoulder flexed over edge of table, elbow relaxed. GM Position: Sitting, upper limb supported on table, shoulder and elbow flexed to 90. Movement: Horizontal abduction form 90 degrees to 120 degrees of abduction. Resistance: Applied to posterior arm immediately proximal to elbow. Stabilization: Scapula on same side.

Manual Muscle Tests - Hand & Wrist: Extensor Carpi Ulnaris

Palpation: Between head of ulna and tubercle of 5th metacarpal. AG Position: Sitting, hand on palmar surface and fingers relaxed. GM Position: Sitting, hand resting on ulnar border, fingers relaxed. Movement: Extend and deviate wrist toward ulna. Resistance: Applied to dorsum of hand into flexion and radial deviation. Stabilization: Forearm stabilized.

Manual Muscle Test of the Shoulder: Pectoralis Major

Palpation: Clavicular: inferior to medial clavicle, Sternal: anterior axillary fold. (resist ext and add) AG Position: Supine, with shoulder in neutral rotation, and 90 degrees of abduction, elbow flexed GM Position: Sitting, shoulder in neutral rotation and 90 degrees of abduction, elbow flexed to 90, and upper limb supported. Movement: Sternal: Horizontal adduction and ext from 90 degrees of abduction, moving toward opposite shoulder in diagonal direction. Clavicular: Horizontal adduction with flexion from 90 degrees of abduction, moving toward opposite shoulder in diagonal direction. Resistance: Applied to anteromedial arm proximal to elbow. Stabilization: Contralateral shoulder or ipsilateral trunk

Manual Muscle Tests - Hand & Wrist: Extensor Carpi Radialis Brevis

Palpation: Difficult, depression over capitate bone. AG Position: Sitting, palmar surface of hand resting on table, fingers relaxed. GM Position: Hand resting on ulnar border, fingers relaxed. Movement: Extend wrist. Resistance: Applied to dorsum of hand into flexion. Stabilization: Forearm stabilized.

Manual Muscle Tests - Hand & Wrist: Extensor Digitorum, Extensor Indicis, Extensor Digiti Minimi

Palpation: Digitorum: dorsal hand along 4 metacarpals, Indicis: dorsal hand over second metacarpal, Digiti Minimi: dorsal hand over fifth metacarpal. Position: Hand rests on palmar surface on table with wrist in neutral. MCPs flexed to 90 off edge of table. Movement: Extension of MCPs with IP joints flexed. Resistance: Applied to distal end of proximal phalanx on dorsal aspect. Stabilization: Stabilize hand and wrist.

Manual Muscle Tests - Hand & Wrist: Adductor Pollicis

Palpation: First web space. Position: Hand rests on table with thumb abducted from the palm in the sagittal plane. Movement: Adduction of first CMC joint. Resistance: Apply resistance to proximal phalanx into abduction. Stabilization: Stabilize palm of hand,

Manual Muscle Tests - Hand & Wrist: Dorsal Interossei, Abductor Digiti Minimi

Palpation: First: on radial side of 2nd metacarpal, second: radial side of proximal phalanx of middle finger, third: ulnar side of proximal phalanx of middle finger, fourth: ulnar side of proximal phalanx of ring finger. Position: Hand rests on palmar surface on table, wrist in neutral and fingers extended. Movement: Move 2nd,4th, and 5th fingers away from 3rd, 3rd moves toward 2nd and 3rd fingers. Resistance: Applied to side of distal end of proximal phalanx of each of the four fingers. Stabilization: Hand and fingers not being tested are stabilized.

Manual Muscle Tests - Hand & Wrist: Palmaris Longus

Palpation: If present tendon at midline of wrist. AG Position: Sitting, dorsal hand resting on table and fingers relaxed. GM Position: Sitting, hand resting on ulnar border and fingers relaxed Movement: Flexion of wrist Resistance: Applied to palm of hand into ext. Stabilization: Forearm is stabilized.

Manual Muscle Test of the Shoulder: Supraspinatus

Palpation: In supraspinous fossa above scapular spine. AG Position: Sitting with shoulder in neutral rotation, elbow flexed. GM Position: Supine with upper limb supported, shoulder in neutral rotation, elbow flexed. Movement: Abduct shoulder within 30 degree range. Resistance: Applied to lateral arm proximal to elbow Stabilization: Opposite shoulder

Manual Muscle Test of the Shoulder: Coracobrachialis

Palpation: In the axilla. Abduct shoulder to bring the belly to a superficial position. AG Position: Shoulder in LR, elbow flexed, forearm pronated. GM Position: Sidelying with shoulder in LR, elbow flexed at 90 and forearm pronated. Movement: Flex shoulder to 90. Resistance: Applied to ant/med arm proximal to elbow, pushing in ext and abduction. Stabilization: opposite shoulder

Manual Muscle Test of the Shoulder: Pec Minor

Palpation: Inferior to coracoid process of scapula toward lateral end of clavicle AG Position: Supine with hand on lumbar GM Position: Sitting with hand resting on the small of back Movement: Tip scapula forward Resistance: Applied to Acromion, pushing into posterior tip of scapula Stabilization: Ipsilateral thorax Substitution:

Manual Muscle Test: Infraspinatus and Teres Minor

Palpation: Infraspinous fossa, inferior to spine of scapula. AG Position: Prone, elbow flexed over edge of table. GM Position: Prone, shoulder flexed over edge of table. Movement: Rotate shoulder laterally 90 degrees. Resistance: Proximal to wrist on extensor surface of forearm. Stabilization: humerus and thorax.

Manual Muscle Test of the Shoulder: Middle Deltoid

Palpation: Lateral and inferior to acromion process. AG Position: Sitting with shoulder in neutral and elbow flexed to 90. GM Position: Supine, upper limb supported and elbow flexed to 90. Movement: abduct shoulder to 90 in frontal plane. Resistance: Applied to lateral arm proximal to elbow. Stabilization: Opposite shoulder.

Manual Muscle Tests - Hand & Wrist: Opponens Pollicis

Palpation: Lateral side of 1st metacarpal. Position: Hand rests on dorsal surface with forearm supinated. Movement: Roll head of first metacarpal toward ulnar side of hand keeping tip of thumb against pad of the tip or base of 5th finger. Resistance: Applied to distal end of first and fifth metacarpals into derotation. Stabilization: First and fifth metacarpals and palm of hand are stabilized.

Manual Muscle Tests - Hand & Wrist: Flexor Digiti Minimi

Palpation: Laterally along shaft of 5th metacarpal. Position: Hand rests on its dorsal surface, forearm supinated. Movement: Flexion of fifth MCP with IP joints remaining extended. Resistance: Applied to palmar surface of proximal phalanx. Stabilization: Fifth metacarpal and the palm are stabilized.

Manual Muscle Tests - Hand & Wrist: Flexor Pollicis Longus, Flexor Pollicis Brevis

Palpation: Longus tendon: palmar surface of proximal phalanx of thumb. Brevis belly: ulnar side of 1st metacarpal. Position: Hand resting on dorsal surface on table. Wrist in neutral, thumb adducted. Movement: Flexion of MCP and IPs in frontal plane. Resistance: Applied to proximal phalanx for brevis, and distal phalanx for longus. Stabilization:First metacarpal is stabilized for brevis, and proximal phalanx for longus.

Manual Muscle Tests - Hand & Wrist: Extensor Pollicus Longus, Extensor Pollicis Brevis

Palpation: Longus: dorsal aspect at base of first MCP toward distal phalanx, Brevis: lateral aspect of base of first MCP toward proximal phalanx. Position: Hand rests with ulnar border on table. With Brevis, MCP is flexed and abducted. With Longus, MCP is abducted and IP flexed. Movement: Extension of MCP and IP individually. Resistance: Brevis: Dorsal surface of proximal phalanx, Longus: Dorsal surface of distal phalanx. Stabilization: First metacarpal is stabilized for brevis, and proximal phalanx for longus.

Manual Muscle Test: Abductor Pollicis Longus, Abductor Pollicis Brevis

Palpation: Longus: proximal to 1st CMC, Brevis: anterior surface of 1st metacarpal. Position: Hand rests on ulnar border, forearm in supination with wrist in neutral and thumb adducted Movement: Longus: thumb abducts in plane of palm in frontal plane. Brevis: thumb abducts at right angle from palm in sagittal plane. Resistance: Longus: Applied into adduction to distal end of 1st metacarpal, Brevis: on proximal phalanx. Stabilization: Palm of the hand is stabilized.

Manual Muscle Test: Lower Trap

Palpation: Medial to base of spine and medial border of scapula AG Position: Prone with shoulder abducted to 130 GM Position: Same Movement: Lift upper limb off table Resistance: Applied to lateral angle of scapula in a forward and outward direction Stabilization: Thorax on opposite side Substitution:

Manual Muscle Tests - Hand & Wrist: Lumbricals

Palpation: Not palpated, "1" or "T" grade cannot be given. Position: Hand rests on palmar surface with proximal, middle, distal phalanges over edge of table. Movement: Extension of proximal and DIP joints. Flexion of MCP with proximal and DIPs maintained in extension. Resistance: Applied to dorsal surface of middle and distal phalanges. Palmar surface of proximal phalanx Stabilization: Under proximal phalanx of finger. Other hand stabilizes wrist and MCP joint in neutral.

Manual Muscle Tests of the Elbow: Triceps Brachii, Anconeus

Palpation: Posterior arm AG Position: Supine, shoulder flexed to 90, elbow flexed GM Position: Sitting, shoulder flexed to 90, elbow flexed and forearm neutral supported by table Movement: Extend elbow from 145 degrees of flexion Resistance: Applied proximal to wrist on posterior forearm Stabilization: arm is stabilized

Manual Muscle Tests - Hand & Wrist: Extensor Carpi Radialis Longus

Palpation: Posterior forearm, proximal to second metacarpal AG Position: Hand rests on palmar surface on the table, fingers relaxed. GM Position: Hand rests on ulnar border on table with fingers relaxed. Movement: Extend wrist with radial deviation. Resistance: Applied to dorsum of hand into flexion and ulnar deviation. Stabilization: Forearm is stabilized.

Manual Muscle Tests - Hand & Wrist: Opponens Digiti Minimi

Palpation: Shaft of fifth metacarpal. Position: Hand rests on dorsal surface with forearm supinated. Movement: Roll fifth metacarpal toward opposite hand trying to touch the pad of the thumb. Resistance: Applied to distal end of fifth metacarpal into derotation. Stabilization: Palm of hand.

Manual Muscle Test of the Shoulder: Upper Trapezius and Levator Scapulae

Palpation: Superior and posterior surface of the shoulders AG Position: Subject sits with the arms relaxed GM Position: Subject is supine; examiner supports upper limbs and shoulders Movement: Elevate shoulder(s) towards ear Resistance: Applied superiorly on acromion in inferior direction Stabilization: Apply resistance to both shoulders simultaneously or unilaterally to posterior lateral aspect of head Substitution: Serratus anterior abduction

Manual Muscle Tests - Hand & Wrist: Flexor Carpi Ulnaris Muscle

Palpation: Tendon proximal to pisiform at wrist AG Position: Sitting, forearm supinated and resting on table, fingers in slight flexion GM Position: Sitting with ulnar border of hand not resting on table. Fingers relaxed. Movement: Flexion of wrist and ulnar deviation Resistance: Applied to palm of hand into ext and radial deviation. Stabilization: forearm stabilized

Manual Muscle Tests - Hand & Wrist: Flexor Digitorum Profundus

Palpation: Where it crosses palmar surface of each middle phalanx of medial four digits. Position: Hand rests on table on dorsal surface. Wrist and MCPs in neutral. Movement: Flexion of DIPs. Resistance: Applied to palmar surface of distal phalanx. Stabilization: Middle phalanx and PIP joint.

Manual Muscle Tests - Hand & Wrist: Flexor Digitorum Superficialis

Palpation: Where it crosses palmar surface of proximal phalanx. Position: Hand rests on table on dorsal surface. Wrist and MCPs in neutral. Movement: Flexion of PIP without flexion of DIP. Resistance: Applied to palmar surface of middle phalanx. Stabilization: Proximal phalanx and palm of hand are stabilized, tips of fingers relaxed.

Manual Muscle Test: Rhomboid

Palpation: With pts hand on lumbar palpate beneath and along medial border of scapula AG Position: Prone with hand resting on lumber spine GM Position: Sitting with hand resting on lumbar spine Movement: Lift hand of back Resistance: Applied to vertebral border of scapula, pushing into abduction and upward rotation Stabilization: Thorax on opposite side Substitution:

Manual Muscle Tests of the Elbow: Biceps brachii

Palpation: anterior arm AG Position: Sitting, forearm supinated, elbow flexed GM Position: Sitting, arm supported in 90 degrees abd, forearm supinated Movement: flex elbow to 90 degrees with forearm in supination Resistance: proximal wrist on anterior forearm Stabilization: arm is stabilized at shoulder (or around triceps)

Manual Muscle Test of the Shoulder: Anterior Deltoid

Palpation: inferior to lateral third of clavicle. AG position: Sitting with shoulder in neutral or internal rotation and elbow flexed. GM Position: Sidelying, shoulder in neutral, elbow flexed. (she said we can do it in sitting) Movement: Flex shoulder to 90 degrees, adduct shoulder horizontally to 90 degrees. Resistance: Applied proximal to elbow, pushing into ext and horizontal abduction. Stabilization: opposite shoulder

Manual Muscle Test of the Shoulder: Teres Major

Palpation: lateral to inferior angle of scapula AG Position: Prone, with shoulder MR and hand resting on lower back GM Position: Teres major is not tested in GM. It will contract only against resistance. Movement: Adduct and extend the shoulder. Resistance: Applied proximal to the elbow joint, pushing shoulder into abduction. Stabilization: Stabilize upper trunk.

Manual Muscle Tests of the Elbow: Pronator Teres, Pronator Quadratus

Palpation: medial epicondyle to midway lateral forearm AG Position: Sitting, arm against trunk and elbow flexed to 90 GM Position: Prone, shoulder supported and abducted to 90, elbow flexed, forearm hanging down Movement: From full supination to neutral Resistance: Applied proximal to wrist into supination Stabilization: Stabilize arm, keeping elbow close to trunk

Manual Muscle Tests of the Elbow: Supinator

Palpation: over and inferior to lateral epicondyle AG Position: Sitting, arm at side, elbow flexed to 90 GM Position: Prone, shoulder supported and abducted to 90, elbow flexed, forearm hanging down Movement: from full pronation to neutral forearm position Resistance: proximal to wrist into pronation Stabilization: arm stabilized with elbow close to trunk

Manual Muscle Tests - Hand & Wrist: Flexor Carpi Radialis Muscle

Palpation: tendon lateral to midline of wrist AG Position: sitting, forearm supinated and resting on table, fingers in slight flexion GM Position: ulnar border of hand on table, fingers relaxed Movement: Flexion of the wrist with radial deviation Resistance: Applied to palm of hand into ext and ulnar deviation Stabilization: Forearm is stabilized.