Elbow/wrist ROM and MMT

Question 1

Elbow flexion
-axis
-stationary arm
-moving arm
AAOS

Answer 1

Testing position:
- supine,
- shoulder in neutral (towel under distal humerus)
- forearm supinated

GONI
- axis: lateral epicondyle of the humerus
- stationary arm: acromian/mid line of humerus
- Moving arm: lateral midline of radius/radial styloid process
- AAOS: 150*

Question 2

elbow Extension:
-axis
-stationary arm
-moving arm
AAOS

Answer 2

Testing position:
- supine,
- shoulder in neutral (towel under distal humerus)
- forearm supinated

GONI

• axis: lateral epicondyle of the humerus
• stationary arm: acromian/mid line of humerus
• Moving arm: lateral midline of radius/radial styloid process
• AAOS: 0 (some have hyperextension)

Question 3

Pronation: (ROM)
-testing position
-stabilization

Answer 3

testing position:
-seated
-shoulder neutral next to trunk
-elbow 90*
-thumb pointing to the ceiling

Stabilization:
-distal end of the humerus to prevent medial rotation and abduction of the shoulder

Question 4

Pronation:
-axis
-stationary arm
-moving arm
AAOS

Answer 4

testing position:
- seated
- shoulder neutral next to trunk
- elbow 90*
- thumb pointing to the ceiling

Goni

• axis: lateral and proximal to ulnar styloid process
• stationary arm: parallel to anterior midline of the humerus
• moving arm: dorsal surface of forearm just proximal to styloid processes
• AAOS: 80

Question 5

Supination:
-testing position
-stabilization

ROM

Answer 5

testing position:

• seated
• shoulder neutral next to trunk
• elbow 90*
• thumb pointing to the ceiling

Stabilization:
distal end of humerus to prevent lateral rotation and adduction of the shoulder

Question 6

Supination
-axis
-stationary arm
-moving arm
AAOS

Answer 6

testing position:

• seated
• shoulder neutral next to trunk
• elbow 90*
• thumb pointing to the ceiling

Goni

• axis: medial and proximal to ulnar styloid
• stationary arm: parallel to anterior midline of humerus
• moving arm: ventral surface of forearm just proximal to styloid process
• AAOS: 80

Question 7

Biceps brachii
1. review anatomy:
2. position:
3. movement:
4. resistance:

Answer 7

1. review anatomy:
2. position:
   - AG: sitting UE in anatomical position forearm supinated
   - GM: sitting UE supported with shoulder in 90* abduction and neural rotation elbow extended forearm supinated
3. movement: elbow flexion
4. resistance: proximal to the wrist

Question 8

Brachioradialis/brachialis
1. review anatomy:
2. position:
3. movement:
4. resistance:

Answer 8

1. review anatomy:
2. position:
   - AG: sitting UE in anatomical position forearm pronated
   - GM: sitting UE supported with shoulder in 90* abduction and neural rotation elbow extended forearm pronated
3. movement: flex the elbow
4. resistance: proximal to wrist
   palpate to tell the difference

Question 9

Triceps brachii: (anconeus)
1. review anatomy:
2. position:
3. movement:
4. resistance:

Answer 9

1. review anatomy:
2. position:
   - AG: supine shoulder flexed 90* elbow fully flexed
   - GM: sitting UE supported in 90* flexion and IR, Elbow flexed, forearm neutral
3. movement: elbow extension
4. resistance: proximal to wrist

Question 10

Supinator
1. review anatomy:
2. position:
3. movement:
4. resistance:

Answer 10

1. review anatomy:
2. position:
   -AG: sitting arm at side elbow flexed to 90*
   -GM: prone, shoulder in 90* abduction, elbow flexed to 90* forearm perpendicular to table
3. movement: supinated
4. resistance: proximal to wrist

Question 11

Pronator teres and quadratus
1. review anatomy:
2. position:
3. movement:
4. resistance:

Answer 11

1. review anatomy:
2. position:
   -AG: sitting, arm at side, elbow flexed to 90*
   -GM: sitting shoulder and elbow flexed to 90*, forearm perpendicular to table
3. movement: pronation
4. resistance: proximal to wrist

Question 12

Flexor carpi radialis
1. review anatomy:
2. position:
3. movement:
4. resistance:

Answer 12

1. review anatomy:
2. position:
   -AG: Dorsal hand on table fibers slightly flexed
   -GM: ulnar border of hand on table fingers slightly flexed
3. movement: wrist flexion with radial deviation
4. resistance: palm of hand

Question 13

Flexor capri ulnaris
1. review anatomy:
2. position:
3. movement:
4. resistance:

Answer 13

1. review anatomy:
2. position:
   -AG: dorsal hand on table, fingers slightly flexed
   -GM: sitting ulnar border of hand not resting on table, fingers slightly flexed
3. movement: wrist flexion with ulnar deviation
4. resistance: palm of hand

Question 14

Palmaris longus
1. review anatomy:
2. position:
3. movement:
4. resistance:

Answer 14

1. review anatomy:
2. position:
   -AG: dorsal hand on table, fingers relaxed
   -GM: ulnar border of hand on table, fingers relaxed
3. movement: wrist flexion
4. resistance: palm of hand

Question 15

Extensor carpi radialis longus and brevis
1. review anatomy:
2. position:
3. movement:
4. resistance:

Answer 15

1. review anatomy:
2. position:
   -AG: palm of hand on table, fingers relaxed in flexion
   -GM: ulnar border on table fingers relaxed
3. movement: Wrist extension with radial deviation
4. resistance: dorsum of hand

Question 16

Extensor carpi ulnaris
1. review anatomy:
2. position:
3. movement:
4. resistance:

Answer 16

1. review anatomy:
2. position:
   -AG: Palm of hand on table fingers relaxed in flexion
   -GM: ulnar border on table, fingers relaxed
3. movement: wrist extension with ulnar deviation
4. resistance: dorsum of hand