Muscle Length Tests and Manual Muscle Tests

Comprehensive vocabulary flashcards detailing muscle length tests (MLT) and manual muscle tests (MMT) procedures, primary movers, target structures, and normative values from the lecture notes.

Modified Thomas Test

A muscle length test for the Iliopsoas, Rectus Femoris, and Tensor Fascia Lata. Findings include: hip abducted indicates Tensor Fascia Lata tightness, hip flexed indicates Iliopsoas tightness, and knee extended ($>90^\circ$ flexed) indicates Rectus Femoris tightness.

Modified Ober's test

A muscle length test for the Tensor Fascia Lata and Iliotibial band. Maximal tightness is present if the leg cannot be passively adducted to horizontal; moderate tightness if horizontal position is reached; minimal tightness if the leg falls below horizontal but does not completely reach the plinth.

Straight Leg Raise

A muscle length test for the hamstrings (Semitendinosus, Semimembranosus, Biceps femoris) with normative values of $80-90^\circ$ hip flexion.

90-90 Test

A muscle length test for the hamstrings (Semitendinosus, Semimembranosus, Biceps femoris) with normative values of $-20^\circ$ knee extension.

Prone knee bend

A muscle length test for the quadriceps (Rectus femoris, Vastus lateralis, Vastus medialis, Vastus intermedius) with normative values of $120^\circ$ knee flexion OR heel to buttock. Hand is placed on the ischial tuberosity to prevent anterior pelvic tilt and rotation of pelvis in transverse plane.

Gastrocnemius MLT

A muscle length test for the Gastrocnemius (which originates above the knee on the medial/lateral condyles of femur and performs plantar flexion) with normative values of $>10^\circ$, ideally $20^\circ$. The knee is held because the muscle crosses both the knee and ankle.

Soleus MLT

A muscle length test for the Soleus (which originates below the knee on the tibia & fibula and performs plantar flexion) with normative values of $>10^\circ$, ideally $20^\circ$. The knee is bent to bias the movement towards the soleus.

Knee to Wall

A functional muscle length test for Soleus and Gastrocnemius with normative values of $10-20\,\text{cm}$ with knee over second toe. Movement is limited anteriorly by the talocrural joint and posteriorly by the Gastroc/achilles/soleus.

Pectoralis Major (Clavicular) MLT

A muscle length test for the clavicular portion of Pectoralis major (which produces flexion, horizontal adduction, and internal rotation). Tested with the arm in $90^\circ$ abduction ($90^\circ$ elbow flexion), horizontally abducted, and externally rotated, recording distance from lateral epicondyle to/past plinth.

Pectoralis Major (Sternal) MLT

A muscle length test for the sternal portion of Pectoralis major (which produces extension back to anatomical position, horizontal adduction, and internal rotation). Tested with the arm in $90^\circ$ abduction ($135^\circ$ elbow flexion), horizontally abducted, and externally rotated, recording distance from lateral epicondyle to/past plinth.

Latissimus dorsi MLT in crook lying

A muscle length test for Latissimus dorsi involving three movements (shoulder flexion, ER) to record shoulder flexion and watch for loss of lumbar spine position.

Biceps Brachii MLT

A muscle length test for Biceps brachii (which produces elbow flexion, supination, and weak shoulder flexion) consisting of elbow extension, shoulder extension, and pronation to record distance range of shoulder extension or distance from lateral epicondyle.

Triceps Brachii MLT

A muscle length test for Triceps brachii (which produces elbow extension and crosses both the shoulder and elbow), measured by recording the range of shoulder flexion.

Long wrist flexors MLT

A muscle length test for Flexor carpi ulnaris, Flexor carpi radialis, Flexor digitorum superficialis, Flexor digitorum profundus, Flexor digiti minimi, and Palmaris longus. Ensured by extending the fingers first (including thumb), taking wrist into flexion, and measuring wrist extension angle.

Long wrist extensors MLT

A muscle length test for Extensor carpi radialis longus, Extensor carpi radialis brevis, Extensor carpi ulnaris, Extensor digitorum, Extensor indicis, and Extensor digiti minimi. Everything should be fully flexed, measuring wrist flexion angle.

Hip extension MMT

Manual muscle test for Gluteus Maximus (primary mover) and hamstrings (Biceps femoris, Semitendinosus, Semimembranosus). Flexing the knee at $90^\circ$ reduces the contribution of the hamstrings.

Knee flexion MMT Tibial Rotation Targets

During knee flexion MMT, external tibial rotation targets LATERAL hamstrings, whereas internal tibial rotation targets MEDIAL hamstrings.

Tibialis posterior

The muscle responsible for inversion, found in the medial third of the tibia, deep to the soleus.

Peroneus tertius

A muscle that dorsiflexes and everts the foot, which is not being tested during standard eversion MMT (which tests Peroneus longus and Peroneus brevis).

Serratus anterior

The muscle responsible for scapula abduction and upward rotation. It does NOT produce scapular anterior tilt, which is the role of pectoralis minor.

Middle trapezius

The muscle responsible for scapular adduction; originates along spinous processes of vertebrae and inserts on the medial acromial margin.

Supraspinatus

A shoulder abductor that initiates the first $30^\circ$ of shoulder abduction, alongside primary mover Middle Deltoid.

Elbow flexion MMT (hand pronated)

Tests Brachialis (deep to biceps on pronate lateral distal third of humerus) and Brachioradialis (tested further with forearm in mid-pronation).

Flexor carpi radialis MMT

Tests wrist flexion and radial deviation with $90^\circ$ of elbow flexion with a stabilizing hand on a supinated forearm.

Flexor carpi ulnaris MMT

Tests wrist flexion and ulnar deviation with $90^\circ$ of elbow flexion with a stabilizing hand on a supinated forearm.

Extensor carpi ulnaris MMT

Tests wrist extension and ulnar deviation with $90^\circ$ of elbow flexion with a stabilizing hand on a pronated forearm.