Musculoskeletal Trail: Muscle Testing

A patient that is unable to perform hip abduction against gravity, but can successfully move through the complete range of motion in the position shown, should be assigned a grade of: supine 2 2- 2+ 1

Correct Answer: 2 A manual muscle test grade of 2 (poor) is characterized by the patient completing range of motion with gravity eliminated.

Which manual muscle test grade would be given to a patient that was able to initiate movement in a gravity-eliminated position? 1/5 1+/5 2-/5 2+/5

Correct Answer: 2-/5 A manual muscle test grade of 2-/5, or poor minus indicates that the patient is able to initiate movement in a gravity-eliminated position. A manual muscle test grade of 2+/5 indicates the ability to initiate motion against gravity.

Which manual muscle test grade would be given to a muscle where the joint moves through complete range of motion against gravity and moderate resistance? 2 3 4 5

Correct Answer: 4 A grade of "4" is given when a subject completes range of motion against gravity with moderate resistance. A grade of "4" is synonymous with "Good."

When performing a resistive test of the triceps muscle in supine, the shoulder should be positioned in: 0 degrees of flexion 45 degrees of flexion 90 degrees of flexion 135 degrees of flexion

Correct Answer: 90 degrees of flexion The shoulder should be supported in a position perpendicular to the table (i.e., 90 degrees).

Where should manual resistance be applied when performing a manual muscle test on the latissimus dorsi? against the forearm in the direction of abduction and flexion of the arm, against the forearm in the direction of adduction and extension of the arm, against the forearm in the direction of abduction and extension of the arm, against the forearm in the direction of adduction and flexion of the arm,

Correct Answer: against the forearm in the direction of abduction and flexion of the arm The latissimus dorsi medially rotates, adducts, and extends the glenohumeral joint. It is tested with the patient in prone and the arm extended and medially rotated.

How should manual resistance be applied when performing a manual muscle test on the tensor fasciae latae? against the leg in the direction of extension and abduction against the leg in the direction of extension and adduction against the leg in the direction of extension and lateral rotation against the leg in the direction of extension and medial rotation

Correct Answer: against the leg in the direction of extension and adduction Manual resistance should be placed against the leg in the direction of extension and adduction when testing the tensor fasciae latae. Application of force against the rotation component is not recommended.

When testing the strength of the hip adductors in an adult, the therapist would most likely need to fixate the: contralateral leg in abduction, contralateral leg in adduction, ipsilateral leg in abduction, ipsilateral leg in adduction,

Correct Answer: contralateral leg in abduction Testing the strength of the hip adductors requires the patient to be positioned in sidelying with the test leg resting on the table. The therapist is required to abduct the uppermost leg to 25 degrees and support it so that the patient can attempt to lift the test leg off of the table without interference from the contralateral limb.

What muscle would be strength tested by placing the elbow in maximal flexion and the forearm in maximal supination to minimize activation of the biceps brachii? anterior deltoid coracobrachialis triceps brachii pectoralis minor

Correct Answer: coracobrachialis This coracobrachialis is tested with the elbow in flexion and the forearm in supination. This position is necessary since it dramatically reduces the ability of the biceps brachii to flex the shoulder.

Which of the following would be least appropriate for assessment with a pinch gauge? tip pinch lateral pinch cylinder grip three-point chuck

Correct Answer: cylinder grip A pinch gauge is able to assess all types of pinch techniques, including tip pinch, pad to pad, three-point chuck, and lateral pinch. A cylinder grip is a type of power grasp primarily utilizing force generated from digits 3-5 against the hypothenar eminence. This type of grip would be best assessed using a handheld dynamometer.

When performing resistive isometrics to the elbow flexors, the patient's elbow should be positioned in: elbow extension and forearm supination, elbow extension and forearm pronation, elbow flexion and forearm supination, elbow flexion and forearm pronation

Correct Answer: elbow flexion and forearm supination The biceps brachii is the primary muscle responsible for elbow flexion. Force is applied to the distal forearm in the direction of elbow extension.

Resistance is applied to the palm of the hand into extension and radial deviation in order to test the strength of the: extensor carpi radialis longus flexor carpi radialis extensor carpi ulnaris flexor carpi ulnaris

Correct Answer: flexor carpi ulnaris The flexor carpi ulnaris originates on the common flexor tendon at the medial epicondyle of the humerus and inserts on the pisiform, hook of the hamate, and base of the fifth metacarpal bone. Resistance is applied opposite to the muscle's action.

A dynamometer would be must useful when conducting a formal measurement of: angular velocity force momentum linear movement

Correct Answer: force A dynamometer is a device that measures strength through the use of a load cell or spring-loaded gauge. There are various kinds of dynamometers including handheld, isometric, and isokinetic.

The manual muscle test depicted would most likely be used to assess the: sidelying leg abducted, external rotation gluteus maximus piriformis gluteus medius obturator internus

Correct Answer: gluteus medius The gluteus medius is tested in sidelying since the muscle's primary action is abduction of the hip. The muscle is innervated by the superior gluteal nerve.

A manual muscle test of the gluteus maximus requires the test leg to be positioned in: hip extension and knee flexion hip extension and knee extension hip flexion and knee flexion hip flexion and knee extension

Correct Answer: hip extension and knee flexion A muscle test of the gluteus maximus is performed with the patient in prone with the hip extended and the knee flexed to 90 degrees. Knee flexion is necessary to eliminate the hamstrings from assisting in hip extension.

Which muscle would be tested by the therapist applying manual resistance against the forearm with pressure applied in the direction of medial rotation of the humerus? infraspinatus supraspinatus latissimus dorsi teres major

Correct Answer: infraspinatus The infraspinatus functions as a lateral rotator of the humerus and is one of the four muscles that constitute the rotator cuff.

Where should a therapist stabilize when performing a manual muscle test of the tibialis anterior? ipsilateral femur contralateral femur ipsilateral tibia contralateral tibia

Correct Answer: ipsilateral tibia When performing a manual muscle test, it is important to stabilize to prevent compensations from other muscles or joints. When testing the tibialis anterior, the therapist should stabilize the tibia below the posterior knee to prevent substitutions from other muscles of the foot and ankle.

Which muscle would be tested in prone with the shoulder in the greatest amount of abduction? rhomboids upper trapezius middle trapezius lower trapezius

Correct Answer: lower trapezius The lower trapezius requires the arm to be placed diagonally overhead, in line with the lower fibers of the trapezius. This amount of abduction is significantly greater than any of the other presented options.

What muscle would be strength tested in supine by applying pressure against the anterior aspect of the shoulder, downward toward the table? posterior deltoid pectoralis major pectoralis minor upper trapezius

Correct Answer: pectoralis minor The pectoralis minor muscle originates on ribs three to five and inserts on the coracoid process of the scapula. The muscle is tested by positioning the patient in supine. Pressure is applied against the anterior aspect of the shoulder, downward toward the table.

When performing resistive testing of the biceps femoris in prone, resistance should be applied on the: anterior leg immediately distal to the ankle, posterior leg immediately distal to the ankle, anterior leg immediately proximal to the ankle, posterior leg immediately proximal to the ankle

Correct Answer: posterior leg immediately proximal to the ankle The biceps femoris originates from the ischial tuberosity and inserts into the fibular head and lateral tibia. It is responsible for producing hip extension and knee flexion.

When testing the biceps brachii muscle strength, where should the therapist apply resistance? proximal to the humerus in the direction of shoulder flexion, distal to the humerus in the direction of shoulder extension, proximal to the wrist in the direction of elbow extension, distal to the wrist in the direction of elbow flexion,

Correct Answer: proximal to the wrist in the direction of elbow extension The biceps brachii acts to flex the elbow joint, supinate the forearm, and assists with shoulder flexion. When testing the biceps brachii muscle strength, resistance is applied proximal to the wrist in the direction of elbow extension.

Which position is most appropriate to perform a manual muscle test of the quadriceps if the patient is unable to lift their leg against gravity? sidelying sitting prone supine with hips and knees flexed

Correct Answer: sidelying To minimize the effects of gravity, the movement should be performed in the position that best eliminates or reduces the gravitational force on the muscle being tested. Sidelying would be considered a gravity eliminated position when testing the quadriceps.

Which of the following is the gravity eliminated position used to test shoulder flexion? supine seated at the end of a treatment table prone sidelying on the unaffected side

Correct Answer: sidelying on the unaffected side A sidelying position allows the patient to actively flex the shoulder without the resistance of gravity. Muscles contributing to shoulder flexion include the anterior deltoid, coracobrachialis, pectoralis major, and biceps brachii.

Resisted muscle testing performed on a muscle with a minor lesion would most likely be classified as: strong and painful weak and painless strong and painless weak and painful

Correct Answer: strong and painful When a minor lesion is tested using resisted muscle testing, the results typically produce a response classified as strong and painful. This type of response would most commonly be associated with conditions such as a muscle strain or tendonitis.

What muscle would be strength tested in prone with the arm laying on the small of the back? teres major serratus anterior infraspinatus teres minor

Correct Answer: teres major The teres major acts to adduct, extend, and medially rotate the shoulder. The muscle is innervated by the lower subscapular nerve.

A patient who exhibits a palpable muscle contraction but no visible joint movement during manual muscle testing would receive what grade? trace poor minus poor poor plus

Correct Answer: trace A patient who exhibits a palpable muscle contraction but no visible joint movement during manual muscle testing would receive a grade of trace (1/5). Manual muscle testing is typically performed in mid range and includes the examiner stabilizing the joint proximal to the muscle being tested and providing manual resistance distally.

What are the two phases of movement that should occur in sequence during the analysis of trunk raising from a supine position? trunk curl phase and hip flexion phase trunk curl phase and neck flexion phase hip flexion phase and pelvic tilt phase hip flexion phase and vertebral flexion phase

Correct Answer: trunk curl phase and hip flexion phase Kendall's trunk raising progression consists of a trunk curl phase and a hip flexion phase. The trunk curl phase occurs as the abdominals curl the spine with the upper back rounding and the lower back flattening. The hip flexion phase occurs as the trunk and pelvis are lifted off the table as a result of hip flexion.

During resisted testing, a complete grade 3 rupture of a muscle or tendon would most likely be classified as: strong and painful weak and painless weak and painful strong and painless

Correct Answer: weak and painless A grade 3 rupture of a muscle or tendon will present with an obvious deformity with no joint movement or pain upon muscle contraction. This type of injury typically requires surgical repair.

lateral pinch

Prehensile pattern used to grasp a small item with the thumb opposed to the radial side of the index finger e.g., placing a key in a lock

A cylinder grip is a type of

power grasp primarily utilizing force generated from digits 3-5 against the hypothenar eminence.