MSK upper extremity

RROM

resistance range of motion

c spine flexion muscles

SCM, scalene, prevertebral

c spine extension muscle

splenius capitis and cervicis, small intrinsic neck muscles

c spine rotation muscles

SCM, small intrinsic neck muscles

c spine lateral bending muscles

scalenes, small intrinsic neck muscles

spurling’s test

assess nerve root for cervical radiculopathy

shoulder abduction relief test

assess nerve root for cervical radiculopathy

positive spurling’s test

pain in shoulder that radiates down ipsilateral arm

positive shoulder abduction relief test

decrease or disappearance of radicular symptoms with maneuver

cervical radiculopathy causes

herniated disc, bony prominence, nerve impingement

spurling’s test steps

tell pt to rotate and extend neck to unaffected then affected side

stand behind pt and lightly compress downward on head in both positions

shoulder abduction relief test steps

tell pt to raise affected arm overhead and put on top of head for 30+ sec or until sx change

C5 location

deltoid

C6 location

lateral arm, wrist, hand, and thumb/half of pointer finger

C7 location

half of ring and pointer finger; middle finger

C8 location

half of ring finger; pinkie

peace sign against resistance nerve

ulnar nerve

thumbs up nerve

radial nerve

fist sign nerve

median nerve

ok sign nerve

median nerve

C5 test

resisted shoulder abduction

C6 test

resisted elbow flexion and wrist extension

C7 test

resisted elbow extension

C8 test

grip strength

wrist drop injury

radial nerve

claw hand injury

ulnar nerve

“ape” hand injury

median nerve

scapulohumeral muscle group

supraspinatus, infraspinatus, teres minor, subscapularis

axioscapular muscle group

trapezius, rhomboids, serratus anterior, levator scapulae

axiohumeral muscle group

pectoralis major, minor, and latissimus dorsi

popeye deformity

scapular winging

clavicle dislocation

shoulder dislocation

pectoral muscle tear

shoulder dislocation

scapular winging

scapular winging

bicep tendon location

bicipital groove between greater and lesser tubercle of humerus

glenohumeral joint tests

apprehension/relocation test, sulcus sign

apprehension/relocation test positive

apprehension during external rotation and pain relieved when posterior pressure is applied

positive apprehension/relocation test meaning

anterior glenohumeral instability

sulcus sign positive

depression occurs just below acromion

positive sulcus sign meaning

inferior glenohumeral instability

AC joint tests

cross body adduction

cross body adduction positive

pain with adduction

positive cross body adduction meaning

AC joint damage or subacromial impingement

labrum test

obrien’s test

obrien test positive

pain when humerus is internally rotated but relieved in external rotation or clicking during maneuver

positive obrien test meaning

SLAP tear

SLAP tear

superior labrum anterior-posterior tear

apprehension test

pt lays supine with shoulder 90° abduction and maximally externally rotated while pushing up from scapula

relocation test

if apprehension test is positive apply posterior force

sulcus sign

apply traction to arm inferiorly and observe for depression

cross body adduction test

passively flex shoulder to 90° then horizontally adduct

obrien’s test

flex shoulder to 90° and horizontally adduct 20-30° with thumb down then tell pt to resist you pressing down on their arm then do with thumb up

neer’s test positive

pain in subacromial arch

positive neer’s test meaning

impingement of soft tissue structures

hawkins kennedy test positive

pain in subacromial arch

positive hawkins kennedy test meaning

impingement of rotator cuff

drop arm test positive

inability to control adduction

positive drop arm test meaning

rotator cuff tear (supraspinatus)

empty can test positive

inability to hold against resistance

positive empty can test meaning

supraspinatus weakness/tear

speed’s test positive

pain in bicep region

positive speed’s test meaning

bicep tendon irritation or SLAP tear

neer test

with your hand on scapula and pt’s thumb turned down, passively fully flex arm above head

hawkins kennedy test

passively flex shoulder and elbow to 90° and internally rotate

drop arm test

tell pt to raise arms above head and slowly drop to sides

empty can test

put thumbs facing down and shoulder at 90° and tell pt to resist against pushing arms down

speed’s test

put arms straight out palms up and tell pt to resist pushing down

elbow bursitis

proximal bicep tendon rupture

distal bicep tendon rupture

elbow dislocation

tinel’s sign positive

parestheisa extending distally

positive tinel’s sign meaning

cubital tunnel syndrome or ulnar nerve entrapment

valgus test positive

opening of joint or pain with applied pressure

positive valgus test meaning

medial elbow instability

varus test positive

opening of joint or pain with applied pressure

positive varus test meaning

lateral elbow instability

cozen’s test positive

reproduction of pain along lateral epicondyle

positive cozen’s test meaning

lateral epicondylitis

tinel’s sign

tap 4-6x on ulnar nerve proximal to cubital tunnel

valgus stress test

flex elbow 20-30° with one hand on outside of elbow and other hand applies outward force

milking maneuver

abduct shoulder and flex elbow to 90° and pull thumb

cozen’s test

palpate lateral epicondyle and tell pt to extend wrist against resistance

dinner fork deformity, colles fracture

garden spade deformity, smith’s fracture

ganglion cyst

Dupuytren’s contracture

volkmann ischemic contracture

trigger finger, stenosing tenosynovitis

mallet finger

boutonniere deformity

swan neck deformity

trigger finger/stenosing tenosynovitis CP

catching of flexor tendon through stenotic sheath

mallet finger CP

disruption of terminal slip of extensor tendon at DIP joint often d/t hitting finger on end of ball

boutonniere deformity CP

PIP flexion and DIP hyperextension d/t tear in central slip of extensor tendon at PIP joint

swan neck deformity CP

DIP flexion and PIP hyperextension from abnormal stress at volar plate of PIP joint