Clinical Skills 1 Practical 2

Finger MCP flexion position

Supinated, curl fingers - straighten to sky, stabilize MC, force @ proximal phalanx

Finger MCP flexion muscles tested

Dorsal interossei, palmar interossei, lumbricals

Finger PIP flexion position

Supinated, curl fingers - straighten to sky, stabilize MC & PIP, force @ middle phalanx

Finger PIP flexion muscles tested

Flexor digitorum superficialis

Finger DIP flexion position

Supinated, curl fingers - straighten to sky, stabilize everything, force @ distal phalanx

Finger DIP flexion muscle tested

Flexor digitorum profundus

Finger MCP extension position

Pronated, stabilize wrist, keep IP joints relaxed, force @ proximal phalanx

Finger MCP extension muscles tested

Extensor digitorum, extensor digiti minimi, extensor indicis

Finger abduction position

Fingers apart, try to push together @ middle/distal phalanx

Finger abduction muscles tested

Dorsal interossei (digits 2-4), abductor digiti minimi

Finger adduction position

Fingers together, try to pull apart @ proximal phalanx

Finger adduction muscle tested

Palmar interossei

Thumb CMC/MCP flexion position

Supinated, stabilize MC, force proximal phalanx into extension

Thumb CMC/MCP flexion muscle tested

Flexor pollicis brevis

Thumb IP flexion position

Supinated, stabilize proximal phalanx, force distal phalanx into extension

Thumb IP flexion muscle tested

Flexor pollicis longus

Thumb CMC/MCP extension position

Midpronated, stabilize MC, force proximal phalanx into flexion

Thumb CMC/MCP extension muscle tested

Extensor pollicis brevis

Thumb IP extension position

Midpronated, stabilize across MC, force distal phalanx into flexion

Thumb IP extension muscle tested

Extensor pollicis longus

Thumb abduction position

Supinated, stabilize wrist

Brevis - Push distal aspect of proximal phalanx into adduction
Longus - Push MC into adduction

Thumb abduction muscle tested

Abductor pollicis brevis, abductor pollicis longus

Thumb adduction position

Supinated, pull proximal phalanx to sky

Thumb adduction muscle tested

Adductor pollicis

Opposition of thumb and 5th digit position

Supinated, oppose digits, try to separate @ 1st & 5th MC

Opposition of thumb and 5th digit muscles tested

Opponens pollicis & Opponens digiti minimi

Cervical flexion position

Seated, fingers on temple & occiput, slight force into extension, tell to resist (not push against you)

Cervical extension position

Seated, fingers on temple & occiput, slight force into flexion, tell to resist (not push against you)

Cervical lateral flexion position

Seated, stabilize shoulder, slight force of thenar on temple into lateral flexion, tell to resist (not push against you)

Cervical rotation position

Seated, stabilize C/L occiput, slight force of thenar on temple into rotation, tell to resist (not push against you)

Trunk extension position

Prone, stabilize legs, lift trunk off table

Trunk extension muscle tested

Erector spinae

Pelvis elevation position

Supine, hold leg, tell to hike hip, apply long axis distraction

Pelvis elevation muscles tested

Quadratus lumborum & iliocostalis lumborum

Trunk flexion position

Supine, stabilize legs, sit-up

Trunk flexion muscles tested

Rectus abdominus, internal oblique, external oblique

Trunk rotation position

Supine, stabilize legs, sit-up and rotate

Trunk rotation muscles tested

Internal & external oblique

Lateral trunk flexion position

On side, stabilize legs, pillow between knees, lift shoulder off table

Hip flexion position

Sitting, stabilize back, lift knee of table, force into extension

Hip flexion muscles tested

Iliacus, psoas major

Hip flexion, abduction, ER position

Supine, hip flexed & abducted, knee flexed and ER, force into extension, adduction, & IR

Hip flexion, abduction, ER muscle tested

Sartorius

Hip extension position

Prone, stabilize pelvis, leg off table, force into flexion

Glute max - Knee bent

Hamstrings - Leg/knee straight

Hip extension muscles tested

Gluteus maximus, hamstrings (semitendinosus, semimembranosus, biceps femoris)

Hip abduction position

On side, stabilize pelvis, force into adduction

Glute med - Position in abduction and ER, force into adduction and IR

Glue min - Position in pure abduction, force into adduction

Hip abduction muscles tested

Gluteus medius & minimus

Hip abduction/flexion position

On side, stabilize pelvis, position in abduction and IR, force into adduction & ER

Hip abduction/flexion muscle tested

Tensor fascia latae

Hip adduction position

On side, leg over the other (or hold leg), force into abduction

Hip adduction muscles tested

Adductor longus, brevis, magnus, pectineus, gracilis

Hip external rotation position

Seated with towel under knee, stabilize thigh, ankle out, force ankle in

Hip external rotation muscles tested

Piriformis, gemelli, obturators, quadratus femoris

Hip internal rotation position

Seated, towel under knee, stabilize thigh, ankle in, force ankle out

Hip internal rotation muscles tested

Tensor fascia latae, gluteus medius & minimus

Knee flexion position

Knee flexion muscles tested

Hamstrings (semitendinosus, semimebranosus, biceps femoris)

Knee extension position

Knee extension muscles tested

Quadriceps (rectus femoris, vastus lateralis, medialis, & intermedius)

Popliteus BB scan position

MCP flexion ROM

90-100 degrees

MCP extension ROM

30-45 degrees

MCP abduction ROM

20 degrees

PIP flexion ROM

100-120 degrees

DIP flexion ROM

70-90 degrees

1st CMC flexion ROM

15-25 degrees

1st CMC extension ROM

15-35 degrees

1st CMC abduction ROM

40-50 degrees

Thumb MCP flexion ROM

50-60 degrees

Thumb MCP extension ROM

Minimal degrees

Thumb IP flexion ROM

80 degrees

Thumb IP extension ROM

20-30 degrees

Cervical flexion ROM

45-50 degrees

Cervical extension ROM

70-80 degrees

Cervical side bending ROM

40 degrees

Cervical rotation ROM

60-80 degrees

Thoracolumbar flexion ROM

70-90 degrees

Thoracolumbar extension ROM

35-45 degrees

Thoracolumbar side bending ROM

40-45 degrees

Thoracolumbar rotation ROM

40 degrees

Hip flexion ROM

120 degrees

Hip extension ROM

20 degrees

Hip abduction ROM

45 degrees

Hip adduction ROM

25 degrees

Hip IR ROM

25 degrees

Hip ER ROM

45 degrees

Knee flexion ROM

130-150 degrees

Knee extension ROM

5-10 degrees