Sports Med - Upper Quarter Screen

Movements/motions of upper quarter screen

Cervical spine: Rotation

TMJ: Elevation, depression, protraction, retraction, side-to-side

Shoulder: Flexion, abduction, adduction, horiontal adduction, internal and external rotation

Elbow: Flexion, extension

Wrist: Flexion, extension

Fingers: Flexion, extension, abduction, adduction

Dermatomes

C5: Anterolateral aspect of shoulder

C6: Lateral border of forearm (radius)

C7: Palmar tip of 3rd phalanx

C8: Ulnar border of hand

T1: Medial aspect of proximal forearm, elbow, and distal arm

Myotomes

C1: Cervical rotation (left, right)

C2-4: Scapular elevation (shrugging shoulders)

C5: Shoulder abduction

C6: Elbow flexion

C7: Elbow extension and wrist flexion

C8: MP joint flexion and thumb extension

T1: Finger abduction

*Add resistance

Reflexes (3)

C5: Biceps brachii (elbow)

C6: Triceps

C7: Brachioradialis

Upper motor neuron lesion (UMNL) tests

Wrist clonus: Have patient relax their hand, do repetitive and forceful wrist extension

• Positive sign: Involuntary wrist flexion

Hoffman’s: Have patient relax their hand, do stabilize proximal interphalangeal joint of middle finger then flick fingernail of middle finger

• Positive sign: Involuntary adduction of thumb and index fingers, other fingers flex

Steps

1. Postural assessment

2. Active motion

   1. Cervical spine, TMJ, shoulder, elbow, wrist, fingers

   2. Passive over pressure at end range if symptom free

3. Dermatomal assessment

4. Myotomal assessment

5. Muscle stretch reflexes

6. Upper motor neuron lesion (UMNL) tests