Therapeutic Measurements Exam 2

Cervical Flexion End Feel

Firm- Posterior facet joint, capsule, Posterior Long. Lig., posterior cervical musculature

Cervical Flexion Goniometer Alignment

Fulcrum= External Auditory Meatus

Proximal Arm= Perpendicular to the ground

Distal Arm= Base of the Nares (nose)

Cervical Extension End Feel

Firm- anterior capsule of facet joints and bony structure, ant. long. lig. (ALL), anterior musculature

Cervical Extension Goniometer Alignment

• Fulcrum = External auditory meatus

• Proximal Arm = Perpendicular to the ground

• Distal Arm = Base of the nares (nose)

Cervical Flexion/Extension Double Inclinometer Alignment

• Top of the head

• Spinous process of T1

Cervical Flexion/ Extension with Tape Measure Alignment

• Lower edge of the sternal notch

• Middle of the tip of the chin

Cervical Lateral Flexion End Feel

Firm-intertransverse ligs, lateral annulus fibrosus, contralateral muscles= longus capitis, longus colli, anterior scalene, SCM

Cervical Lateral Flexion Goniometer Alignment

• Fulcrum = C7

• Proximal Arm = Perpendicular to the ground in line with thoracic vertebrae

• Distal Arm = Midline of the head

Cervical Lateral Flexion Tape Measure Alignment

Mastoid process, lateral tip of the acromion process

Cervical Rotation End Feel

Firm-alar lig., facet joint capsule, contralateral-longus capitis, longus colli, anterior scalene

Cervical Rotation Goniometer Alignment

Fulcrum = Center of the cranium

• Proximal Arm = Parallel to an imaginary line between the two acromial processes

• Distal Arm = Tip of the nose

Shoulder Flexion End Feel

Firm

3 multiple choice options

Shoulder Flexion Goniometer Alignment

• Fulcrum: greater tubercle

• Proximal Arm: // to midaxillary line of thorax• Distal Arm: lateral midline of humerus

• lateral epicondyle or olecranon process

Shoulder Extension End Feel

firm

3 multiple choice options

Shoulder Extension Goniometer Alignment

• Fulcrum: greater tubercle

• Proximal Arm: // to midaxillary line of thorax

• Distal Arm: lateral midline of humerus

• lateral epicondyle

Shoulder Abduction End Feel

Firm

3 multiple choice options

Shoulder Abduction Goniometer Alignment

Fulcrum: acromion process

• Proximal Arm: // to midline of sternum

• Distal Arm: anterior midline of humerus• medial epicondyle

Shoulder IR end feel

firm

3 multiple choice options

Shoulder IR Goniometer Alignment

• Fulcrum: olecranon process

• Proximal Arm: perpendicular or // to floor

• Distal Arm: ulna

• Olecranon process and ulnar styloid

Shoulder ER End Feel Feel

Firm

3 multiple choice options

Shoulder ER Goniometer Alignment

• Fulcrum: olecranon process

• Proximal Arm: perpendicular or // to floor

• Distal Arm: ulna• Olecranon process and ulnar styloid

Shoulder Flexion MMT

Ant Deltoid, Rotator Cuff (? supraspinatus in early activation of flexion), Pec Major (clavicular), coracobrachialis

Shoulder Extension

Post Deltoid, Latt Doris, Teres Major, LH Tricep

Shoulder Abduction

Middle Deltoid and Supraspinatus

Horizontal Abduction MMT (yellow)

Post Deltoid

Horizontal Adduction MMT (yellow)

Pec Major

Shoulder ER MMT

Infraspinatus and Teres Minor

Shoulder IR MMT

Subscapularis

Scapular ABD and Upward ROT MMT

Serratus Anterior

Scapular Elevation MMT

Upper Trapz and Lev Scap

Scapular Retraction (Adduction) MMT

Mid Trap and Rhomboids

Scap Depression and Adduction MMT

Mid and Lower Trapz

carrying angle Men

5 degrees

Carrying Angle Women

10-15 degrees

Elbow Flexion Goniometer Alignment

Fulcrum: lateral epicondyle

• Proximal arm: lateral midlineof humerus; Acromion process

• Distal arm: lateral midline of radius;Radial styloid process

Elbow Flexion End Feel

Soft, May be Hard, Or Firm

Elbow Extension End Feel

Hard, Maybe be Firm

Forearm Pronation Stabilization for ROM

distal humerus to prevent medial rotation and abduction of shoulder

2 multiple choice options

Forearm Supination Stabilization for ROM

distal humerus to prevent shoulder adduction and lateral rotation

2 multiple choice options

Forearm Pronation Goniometer Line Up

Fulcrum= lateral and proximal to ulnar styloid process

Proximal arm=parallel to anterior midline of humerus

Distal arm=across dorsal aspect of forearm, just proximal and parallel to the radial and ulnar styloid processes

Forearm Pronation End Feel

Hard, Firm

Forearm Supination Goniometer Line Up

Fulcrum= medial and proximal to ulnar styloid process•

Proximal arm=parallel to anterior midline of humerus

Distal arm= across ventral aspect of forearm, just proximal and parallel to radial and ulnar styloid processes

Forearm Supination End Feel

Firm

Wrist Flexion Stabilization

stabilize radius and Ulna to prevent supin/pronation or elbow motion; pressure on 3rd metacarpal; avoid radial/ulnar deviation fingers should remain extended; don't let hypothenar eminence fool u

Wrist Flexion Goniometer Alignment

Fulcrum=triquetrum

Proximal arm= lateral midline of ulna (olecranon and ulnar styloid process)

Distal arm= lateral midline of 5th metacarpal

patient in sitting, hand off table

wrist flexion end feel

firm

wrist extension Stabilization

radius and ulna to prevent supination/pronation or elbow motion; pressure should be on palmar surface of metacarpals evenly; Avoid radial or ulnar deviation; Fingers should be allowed to flex• Don't let the hypothenar eminence fool you!

wrist extension goniometer line up

Fulcrum= triquetrum

Proximal arm= lateral midline of ulna (olecranon and ulnar styloid process)

Distal arm= lateral midline of 5th metacarpal

Wrist Extension End Feel

Firm, May be Hard

2 multiple choice options

Wrist Radial Deviation (ABD) stabilization

To prevent elbow flexion past 90 degrees, forearm pronation/supination; Avoid flex/ext of wrist and rotating the hand

Wrist Radial Deviation Goniometer Line Up

Fulcrum=dorsal aspect of wrist over capitate

Proximal arm=dorsal midline of forearm (lateral epicondyle of humerus)

Distal arm= dorsal midline of 3rd metacarpal; don't let the fingers fool you

Wrist Radial Deviation (ABD) end feel

hard, May be firm

3 multiple choice options

Wrist Ulnar Deviation (ADD) stabilization

To prevent pronation/supination, elbow extension; Avoid flex/ext of wrist and rotating hand

Wrist Ulnar Deviation (ADD) Goniometer Line Up

Fulcrum= dorsal aspect of wrist over capitate

Proximal arm= dorsal midline of forearm (lateral epicondyle of humerus)• Distal arm= dorsal midline of 3rd metacarpal; don't let the fingers fool you

Wrist Ulnar Deviation (ADD) End Feel

firm

3 multiple choice options

Thumb Opposition Stabilization

5th metacarpal to prevent fifth CMC joint motion

Thumb Opposition End Motion

contact between tip of thumb and base of 5th digit(allowing thumb MCP and IP flexion)

Thumb Opposition Testing What?

ABDuction, flexion, and adduction

Thumb Opposition Measurement

shortest distance between tip of thumb and center of proximal digital crease of 5th finger

Thumb Opposition End Feel

soft or firm

3 multiple choice options

Thumb MCP Flexion and Extension Stabilization

1st metacarpal to prevent wrist motion and CMC flexion

Thumb MCP Flex/Ext Goniometer Line Up

Fulcrum: dorsal aspect of MCP joint

Proximal arm: dorsal midline of 1stmetacarpal

Distal arm: dorsal midline of proximal phalanx

Thumb MCP Flexion End Feel

hard or firm

3 multiple choice options

Thumb MCP Extension End Feel

firm

Thumb IP Flexion/Extension Stabilization

proximal phalanx to prevent MCP flex/ext

Thumb IP Flex/Ext Goniometer Line Up

Fulcrum: dorsal surface IP joint

Proximal arm: dorsal midline of proximal phalanx

Distal arm: dorsal midline of distal phalanx

Thumb IP Flex End Feel

usually firm, may be hard

3 multiple choice options

Thumb IP Ext End Feel

firm

3 multiple choice options

FINGER MCP flexion/extension stabilization

stabilize metacarpal to prevent wrist motion, allow other fingers to flex/extend at MCP joints; avoid extreme flexion or extension of PIPs and DIPs

Finger MCP Flex/Ext Goniometer Line Up

Fulcrum: dorsal aspect of MCP joint

Proximal arm: dorsal midline of metacarpal

Distal arm: dorsal midline of proximal phalanx

Alternative Finger MCP Extension Goniometer Line Up

PALMAR ASPECT

Fulcrum= palmar aspect of MCP

Proximal arm= palmar midline of

metacarpal

Distal arm= palmar midline of proximal phalanx

Finger MCP flexion End Feel

hard or firm

3 multiple choice options

Finger MCP Extension End Feel

Firm

3 multiple choice options

Biceps Brachii MMT forearm position

forearm in Supination

2 multiple choice options

Brachialis MMT forearm postion

forearm in pronation

3 multiple choice options

Brachioradialis MMT positions

forearm in middle of supination and pronation (thumbs up)

3 multiple choice options