To Know for PT Assess

Lateral neck

C3 (Dermatome)

Distal clavicle

C4 (Dermatome)

Lateral upper arm (Deltoid Insertion)

C5 (Dermatome)

Thumb

C6 (Dermatome)

Distal middle finger

C7 (Dermatome)

Medial border of hand; little finger

C8 (Dermatome)

Anteromedial upper arm

T1 (Dermatome)

None (Dermatome)

T2

Anterior in the area of the inguinal ligament

L1 (Dermatome)

Anterior upper thigh

L2 (Dermatome)

Middle to lower anteromedial thigh

L3 (Dermatome)

Medial lower leg just distal to medial malleolus

L4 (Dermatome)

Dorsal aspect of 2nd/3rd distal metatarsal(s)

L5 (Dermatome)

Lateral aspect of foot and ankle

S1 (Dermatome)

Middle of posterior thigh

S2 (Dermatome)

Cervical lateral flexion

C3 (Myotome)

Shoulder elevation

C4 (Myotome)

Shoulder abduction

C5 (Myotome)

Elbow flexion; wrist extension

C6 (Myotome)

Elbow extension; wrist flexion

C7 (Myotome)

Thumb extension; finger flexion

C8 (Myotome)

Finger abduction and adduction

T1 (Myotome)

None (Myotome)

T2

None (Myotome)

L1

Hip flexion

L2 (Myotome)

Knee extension

L3 (Myotome)

Ankle dorsiflexion; ankle inversion

L4 (Myotome)

Great toe extension

L5 (Myotome)

Hip extension; ankle plantar flexion; ankle eversion

S1 (Myotome)

Knee flexion; ankle plantar flexion

S2 (Myotome)

Biceps brachii (DTR)

C5 [C6], distal biceps tendon, elbow flexion

Brachioradialis (DTR)

C6 [C5], 1-2 in proximal to the radial styloid process, elbow flexion (slight forearm pronation or supination possible)

Triceps (DTR)

C7 [C6], just proximal to olecranon process, elbow extension

Patellar (DTR)

L4 [L2, L3], midway between the distal patella and tibial tubercle, knee extension

Achilles (DTR)

S1 [S2], on achilles tendon at the level of the malleoli, ankle plantarflexion

Grade 0 - Arthrokinematic Joint Motion

Ankylosed

Grade 1 - Arthrokinematic Joint Motion

Considerable hypomobility

Grade 2 - Arthrokinematic Joint Motion

Slight hypomobility

Grade 3 - Arthrokinematic Joint Motion

Normal

Grade 4 - Arthrokinematic Joint Motion

Slight hypermobility

Grade 5 - Arthrokinematic Joint Motion

Considerable hypermobility

Grade 6 - Arthrokinematic Joint Motion

Unstable

Description: soft tissue approximation (Normal End-Feels)

Type: soft, Ex: knee flexion

Description: muscular stretch (Normal End-Feels)

Type: firm, Ex: hip flexion with the knee straight

Description: capsular stretch (Normal End-Feels)

Type: firm, Ex: extension of metacarpophalangeal joints of fingers

Description: ligamentous stretch (Normal End-Feels)

Type: firm, Ex: forearm supination

Description: bone contacting bone (Normal End-Feels)

Type: hard, Ex: elbow extension

Description: occurs sooner or later in the ROM than is usual or in a joint that normally has a firm or hard end-feel, feels boggy (Abnormal End-Feels)

Type: soft, Ex: soft tissue edema, synovitis

Description: occurs sooner or later in the ROM than is usual or in a joint that normally has a soft or hard end-feel (Abnormal End-Feels)

Type: firm, Ex: increased muscular tonus, capsular/muscular/ligamentous/fascial shortening

Description: occurs sooner or later in the ROM than is usual or in a joint that normally has a soft or hard end-feel, a bony grating or bony block is felt (Abnormal End-Feels)

Type: hard, Ex: chondromalacia, osteoarthritis, loose bone fragments in joint, myositis ossifications, fracture

Description: no real end-feel because pain prevents reaching end of ROM, no resistance is felt except for the individual’s protective muscle splinting or muscle spasm (Abnormal End-Feels)

Type: empty, Ex: acute joint inflammation, bursitis, abscess, fracture, psychogenic disorder

Greatest loss of lateral rotation, moderate loss of abduction, minimal loss of medial rotation (Capsular Pattern)

Glenohumeral joint

Loss of flexion greater than loss of extension, rotations full and painless except in advanced cases (Capsular Pattern)

Elbow complex (humeroulnar, humeroradial, proximal radioulnar joints)

Equal loss of supination and pronation, only occurring if elbow has marked restrictions of flexion and extension (Capsular Pattern)

Forearm (proximal and distal radioulnar)

Loss of abduction-cyriax, loss of abduction greater than extension-kaltenborn (Capsular Pattern)

Hand, Carpometacarpal joint—digit 1

Equal loss of all motions (Capsular Pattern)

Hand, Carpometacarpal joint—digits 2-5

Equal loss of flexion and extension-cyriax (Capsular Pattern)

Metacarpophalangeal and interphalangeal joints

Restricted in all motions, but loss of flexion greater than loss of other motions (Capsular Pattern)

Hand—Alternative

Greatest loss of medial rotation and flexion; some loss of abduction, slight loss of extension; little or no loss of adduction and lateral rotation (Capsular Pattern)

Hip—Option 1

Greatest loss of medial rotation; followed by less restriction of extension, abduction, flexion, and lateral rotation (Capsular Pattern)

Hip—Option 2

Loss of flexion greater than extension (Capsular Pattern)

Knee (tibiofemoral joint)

Loss of plantarflexion greater than dorsiflexion (Capsular Pattern)

Ankle (talocrural joint)

Loss of inversion/varus (Capsular Pattern)

Subtalar joint

Loss of inversion (adduction and medial rotation); other motions full (Capsular Pattern)

Midtarsal joint

Description: no contraction felt or seen in the muscle (Muscle Grading)

Grade: 0, Category: no movement

Description: tendon becomes prominent or feeble contraction felt in muscle with no visible movement (Muscle Grading)

Grade: 1, Category: no movement

Description: movement through partial range of motion (Muscle Grading)

Grade: 2-, Category: supported in the horizontal plane

Description: movement through complete range of motion for the muscle being tested (Muscle Grading)

Grade: 2, Category: supported in the horizontal plane

Description: holds against slight pressure in test position (Muscle Grading)

Grade: 2+, Category: supported in the horizontal plane

Description: moves through partial range of motion against gravity (Muscle Grading)

Grade: 2+, Category: tests antigravity position

Description: gradual release from test position occurs (Muscle Grading)

Grade: 3-, Category: tests antigravity position

Description: holds test position—no added pressure (Muscle Grading)

Grade: 3, Category: tests antigravity position

Description: holds test position against slight pressure (Muscle Grading)

Grade: 3+, Category: tests antigravity position

Description: holds test position against slight to moderate pressure (Muscle Grading)

Grade: 4-, Category: tests antigravity position

Description: holds test position against moderate pressure (Muscle Grading)

Grade: 4, Category: tests antigravity position

Description: holds test position against moderate to strong pressure (Muscle Grading)

Grade: 4+, Category: tests antigravity position

Description: holds test position against strong pressure (Muscle Grading)

Grade: 5, Category: tests antigravity position