Exam 3: Rec/Eval: Tests

tests: nerve, ROM, strength

Nerve root: C1

What is the dermatome?

top of head

Nerve root: C1

What is the myotome?

cervical flexion

Nerve root: C2

What is the dermatome?

Temporal, occipital regions of head

Nerve root: C2

What is the myotome?

cervical flexion (Longus colli, sternocleido-mastoid, rectus capitus)

Nerve root: C3

What is the dermatome?

posterior cheek, neck

Nerve root: C3

What is the myotome?

lateral neck flexion (trapezius, splenus capitis)

Nerve root: C4

What is the dermatome?

superior shoulder, clavical area

Nerve root: C4

What is the myotome?

shoulder shrug (trapezius, levator scapulae)

Nerve root: C5

What is the dermatome?

deltoid patch, lateral upper arm

Nerve root: C5

What is the myotome?

shoulder abduction (deltoid), elbow flexion (biceps)

Nerve root: C5

Where is the reflex?

Biceps (brachioradialis)

Nerve root: C6

What is the dermatome?

lateral forearm, radial side of hand, thumb, and index finger

Nerve root: C6

What is the myotome?

elbow flexion (biceps, supinator), wrist extension

Nerve root: C6

Where is the reflex?

brachioradialis (biceps)

Nerve root: C7

What is the dermatome?

posterior lateral arm and forearm, middle finger

Nerve root: C7

What is the myotome?

elbow extension (triceps), wrist flexion

Nerve root: C7

Where is the reflex?

triceps

Nerve root: C8

What is the dematome?

medial forearm, ulnar border of hand, ring, and little finger

Nerve root: C8

What is the myotome?

ulnar deviation, thumb extension, finger flexion and abduction

Nerve root: T1

What is the dermatome?

medial elbow, arm

Nerve root: T1

What is the myotome?

finger abduction (hand intrinsics)

Shoulder Muscle Testing: Flexion

Athlete position: seated

Stabilizing hand placement: scapula and clavicle

Resistance hand placement: distal humerus

Instruction to athlete: leading with the thumb, raise arm forward (anteriorly)

What is the primary muscle being tested in shoulder flexion

anterior deltoid

Shoulder Muscle Testing: Extension

Athlete position: prone

Stabilizing hand placement: trunk

Resistance hand placement: distal posteromedial aspect of humerus

Instruction to athlete: raise palm toward the ceiling

What is the primary muscle being tested in shoulder extension

latissumus Dorsi and teres major

Shoulder Muscle Testing: abduction

Athlete position: seated

Stabilizing hand placement: superior scapula

Resistance hand placement: distal lateral aspect of humerus

Instruction to athlete: palm down, raise arm out to the side (laterally)

What is the primary muscle being tested in shoulder abduction

middle deltoid and supraspinatus

Shoulder Muscle Testing: adduction

Athlete position: supine

Stabilizing hand placement: scapula

Resistance hand placement: distal aspect of the humerus

Instruction to athlete: palm down, move arm toward the side (medially)

What is the primary muscle being tested in shoulder adduction

pectoralis major, latissimus dorsi, Teres major

ROM- Shoulder and Scapula:

Patient position:

Goniometer axis:

Stabilizing arm:

Movable arm:

Movement:

Normal range:

Special Test- Anterior and Posterior Load Shift Load

Patient position: sitting (or supine) with arm at side

Clinician position: standing at patient’s side facing head

Clinician stabilizing hand position: over top of shoulder to stabilize the clavical and scapula

Clinician test hand position: on proximal arm with thumb and index finger in contact with anterior and posterior humeral head

Movement:

What does the Anterior and Posterior Load Shift Load test for?

glenohumeral instability

What does a positive Anterior and Posterior Load Shift Load test look like?

movement of more than 25% of the humeral head size

Special Test- Apprehension Test

Patient position: supine with shoulder abducted to 90 degrees and lateral rotation; elbow at 90 degrees

Clinician position: standing at patient’s side, facing the head

Clinician stabilizing hand position: supporting the forearm

Clinician test hand position: under psoterior glenohumeral joint

Movement: test hand pull the humeral head forward as the hand on the forearm moves the shoulder into more lateral rotation

What does the Apprehension test for?

anterior instability

What does a positive Apprehension test look like?

patient reports pain, tenses the muscles and reacts to or limits the motion due to a fear or sensation of impending joint dislocation or stress

Special Test- Relocation test

Patient position: supine with arm in the end position for the apprehension test

Clinician position: standing at the patient’s side, facing the head

Clinician stabilizing hand position: supporting the forearm

Clinician test hand position: hand moves from the posterior GH joint to the anterior GH joint

Movement: test hand pushes down on the humeral head to reposition it from the end position of the apprehension test

What does the Relocation test for?

anterior subluxation, dislocation, or instability

What does a positive Relocation test look like?

patient feels immediate relief of pain and apprehension

Special Test- Posterior Drawer Test

Patient position: Supine with the arm relaxed and shoulder over the table edge; arm is passively supported with shoulder in midrange abduction and about 30 degrees flexion

Clinician position: as in anterior drawer test: clinician’s forearm holds patient’s forearm against clinician’s ribs and provides a slight distraction on the GH joint by leaning body backwards

Clinician stabilizing hand position: over

Clinician test hand position:

Movement:

What does the Apprehension test for?

What does a positive Apprehension test look like?

Patient position:

Clinician position:

Clinician stabilizing hand position:

Clinician test hand position:

Movement: