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Applied Anatomy > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

What do you do if a patient is below an MMT grade 3 for Cervical Extension?

A

For a grade 3 leave them prone and the patient tries to hold the position without resistance.

Grade 2 and below the patient is supine and the therapist put their fingers in the back of the patients head and ask to push into the hands. If they move through small range (grade 2). If they don’t move but you can feel the muscles contracting (grade 1) If they don’t move and you don’t feel muscle contracture (grade 0)

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2
Q

What do you do if a patient is below an MMT grade 3 for Upper Trapezius?

A

Patient is placed in a prone position, one hand supports shoulder, the other palpates upper trap.

Grade 2: Patient completes full ROM in gravity minimized position

Grade 1: Upper trap fibers can be palpated at clavicle or neck

Grade 0: There is no contracture

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3
Q

What do you do if a patient is below an MMT grade 3 for Middle Trapezius?

A

Patient REMAINS in the same position and the Therapist cradles arm while the other hand palpates muscle.

Grade 2: Completes ROM without the weight of the arm.

Grade 1: Muscle contracts with slight movement

Grade 0: No motion or contraction

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4
Q

What do you do if a patient is below an MMT grade 3 for Lower Trapezius?

A

Patient REMAINS in the same position and the Therapist supports patients arm under the elbow

Grade 2: Completes full scap. ROM without weight of arm.

Grade 1: Can feel contraction

Grade 0: No contraction or motion

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5
Q

What do you do if a patient is below an MMT grade 3 for Rhomboids (Scap. Adduction, retraction)?

A

Place patient in a sitting position with the arm behind the back (Like Gerber lift offs), one hand supports the wrist while the other palpates the muscle.

Grade 2: Completes range of scap. motion

Grade 1: Muscle contracts

Grade 0: No movement or contraction

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6
Q

What do you do if a patient is below an MMT grade 3 for Serratus Anterior?

A

Supports the patient at the arm, while the other hand is palpating the serratus anterior.

Grade 2: The patient actively goes through the motion, if it is not smooth abduction and upward rotation its SA weakness.

Grade 1: Patient holds arm in elevated position. There is muscle contraction.

Grade 0: Patient holds arm in elevated position. There is no muscle contraction.

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7
Q

What is the normative range for shoulder flexion?

A

0-180

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8
Q

What is the normative range for shoulder extension?

A

0-60

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9
Q

What is the normative range for shoulder abduction?

A

0-180

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10
Q

What is the normative range for medial rotation?

A

0-70

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11
Q

What is the normative range for lateral rotation?

A

0-90

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12
Q

What is the normative range for cervical flexion?

A

40

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13
Q

What is the normative range for cervical extension?

A

50

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14
Q

What is the normative range for cervical lateral flexion?

A

22

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15
Q

What is the normative range for cervical rotation?

A

70

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16
Q

When the opposing muscle is stretched to a point where it can no longer lengthen and allow further movement, what type of insufficiency?

A

Passive insufficiency

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17
Q

Occurs when the muscle produces simultaneous movement at all the joints it crosses and reaches such a shortened position that it no longer has the ability to develop effective tension, is what type of insufficiency?

A

Active insufficiency

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18
Q

What do you do if a patient is below a MMT grade 3 for shoulder flexion?

A

Put the patient sidelying and cradle test arm with one hand and with the other palpate the anterior surfaces of the deltoid.

Grade 2: Completes full ROM in gravity minimized position.

Grade 1: Feel or see contraction, no motion

Grade 0: No contraction or movement

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19
Q

What do you do if a patient is below an MMT grade 3 for shoulder extension?

A

Grade 2: Patient completes partial ROM

Patient stays in prone position, palpate posterior shoulder and deltoid.

Grade 1: Feel contraction, no movement

Grade 0: No contraction and no movement

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20
Q

What do you do if a patient is below an MMT grade 3 for shoulder abduction?

A

Lay the patient supine and place hand on middle deltoid.

Grade 2: Completes ROM in this position.

If they cannot complete, slightly flex the elbow and continue to palpate posterior shoulder.

Grade 1: Contraction with no movement

Grade 0: No contraction or movement

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21
Q

How do you grade a patient that can hold the test position against maximal resistance?

A

5

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22
Q

How do you grade a patient that can hold a test position against moderate to strong pressure?

A

4+

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23
Q

How do you grade a patient that can hold a test position against moderate pressure?

A

4

24
Q

How do you grade a patient that can hold a test position against slight moderate to moderate pressure?

A

4-

25
Q

How do you grade a patient that holds against gravity with minimal pressure?

A

3+

26
Q

How do you grade a patient that can hold a test position against gravity with no additional pressure applied?

A

3

27
Q

How do you grade a patient that has gradual release from a test position and is unable to hold against gravity?

A

3-

28
Q

How do you grade a patient that can move through full ROM in gravity minimized position and hold against resistance.

Or can move against partial ROM against gravity.

A

2+

29
Q

How do you grade a patient that can move through full ROM in gravity eliminated position?

A

2

30
Q

How do you grade a patient that can move through partial ROM in gravity eliminated position?

A

2-

31
Q

How do you grade a patient when there is no motion, but the therapist feels or sees contractile activity of muscle?

A

1

32
Q

How do you grade a patient that has no discernable palpable contractile activity?

A

0

33
Q

What do you do if a patient is below an MMT grade 3 for shoulder horizontal adduction (Pec major-Upper Fibers)?

A

Upper fibers:
Place patient in supine position, while therapist supports arm at 90 degrees of abduction with elbows flexed at 90.

Grade 2: Patient adducts shoulder through available ROM with arm supported by therapist.

Grade 1: Palpable contractile activity

Grade 0: No discern palpable contractile activity

34
Q

What do you do if a patient is below a MMT grade 3 for Horizontal shoulder abduction?

A

Patient is in (short) sitting position and therapist supports forearm and palpates over the posterior surface of shoulder. Patient “trys to move their arm back”.

Grade 2: Moves through full ROM

Grade1: No motion but palpable contraction

Grade 0: No discernable palpable contractile activity

35
Q

What do you do if a patient is below an MMT grade 3 for Latissimus dorsi?

A

For grade 0-5 patient stays in same position (Nothing to do if below grade 3)

Alternate test: patient is sitting and arms are on both sides of the table, the therapist is behind patient palpating latissimus dorsi.
–Patient pushes down on hands and lifts butt off the table.

Grade 3, 4 and 5:
If patient can lift buttocks clear off table.

36
Q

What do you do if a patient is below an MMT grade 3 for elbow flexion?

A

(This one is a lot check book for visual and full description)
The patient is short-sitting with arm flexed at 90 and internally rotated and is supported by therapist.
or
Patient is side-lying with arm supported at the elbow in 90 degree flexion

Grade 2: Completes ROM in gravity minimized position (in each muscle group tested.

Grade 1 and 0: Side-lying for all three muscles

Grade 1: Therapist can palpate a contractile response in each of the three muscles.

Grade 0: No discernable palpable contractile activity

37
Q

What do you do if a patient is below an MMT grade 3 for elbow extension?

A

Patient is short sitting, shoulder is abducted to 90 and neutral rotation with the elbow flexed to about 45 degrees to minimize gravity .

For grade 2 support the limb at the elbow.

For grade 1 and 0 support the limb under the forearm and palpate triceps.

Grade 2: Complete ROM with gravity minimized position

Grade 1: Therapist can feel tension in the tricep, contractile activity

Grade 0: No discernable palpable muscle activity.

38
Q

What are the attachments and innervation of the Deltoid?

A

-Lateral one-third of clavicle, acromion, spine of scap.
-Deltoid Tuberosity

Axillary Nerve

39
Q

What are the attachments and innervation of the Trapezius?

A

-External occipital protuberance, ligamentum nuchae, C7-T12
-Lateral one-third of clavicle, acromion, and spine of scap.

Spinal accessory nerve (CN XI)

40
Q

What are the attachments and innervation of the Latissimus Dorsi?

A

-Thoracolumbar fascia, last 3-4 ribs, inferior angle of scap., iliac crest

-Floor of Intertubercular sulcus

Thoracodorsal Nerve

41
Q

What are the attachments and innervation of the Teres Major?

A

-Inferior angle and lower one-third of lateral border of scap.

-Medial lip of intertubercular sulcus of humerus

Lower Subscapular Nerve

42
Q

What are the attachments and innervation of the Suprasinatus?

A

-Supraspinous fossa
-Greater tubercle of humerus

Suprascapular Nerve

43
Q

What are the attachments and innervation of the Infraspinatus?

A

-Infraspinous fossa
-Greater tubercle of humerus

Suprascapular Nerve

44
Q

What are the attachments and innervation of the Teres Minor?

A

-Upper two-thirds (Middle part) of the lateral border
-Greater tubercle of humerus

Axillary Nerve

45
Q

What are the attachments and innervation of the Subscapularis?

A

-Subscapular foss
-Lesser tubercle of humerus

Upper Subscapular and Lower Subscapular Nerve

46
Q

What are the attachments and innervation of the Rhomboid Major?

A

-Spinous process of T2-T5
-Medial border of the scap, and inferior angle of scap

Dorsal Scapular Nerve

47
Q

What are the attachments and innervations of the Rhomboid Minor?

A

-Spinous process of C7-T1

-Smooth triagngular area at medial end of scapular spine.
(Upper part of medial border of the scap.)

Dorsal Scapular Nerve

48
Q

What is the Goni placement for Shoulder Flexion and position of patient?

A

Patient is Supine, knees bent

Axis: Lateral aspect of acromion

Moving Arm: Lateral midline of humerus toward lateral epicondyle

Stationary Arm: Lateral midline of thorax

49
Q

What is the Goni placement for Shoulder Extension and position of patient?

A

Patient is prone

Axis: Lateral aspect of acromion

Moving Arm: Lateral midline of humerus toward lateral epicondyle

Stationary Arm: Lateral midline of thorax

50
Q

What is the Goni placement for shoulder Abduction and position of patient?

A

Patient is supine, knees bent

Axis: Anterior aspect of acromion

Moving Arm: Anterior midline of humerus toward medial epicondyle

Stationary Arm: Parallel to sternum

51
Q

What is the Goni placement for Shoulder Lateral Rotation and position of the patient?

A

Patient is supine, knees bent , elbow on towel.

Axis: Olecranon process

Moving Arm: Ulnar border of forearm toward ulnar styloid process

Stationary Arm: Perpendicular to floor

51
Q

What is the Goni position for Shoulder Medial Rotation and position of the patient?

A

Patient is supine, knees bent, elbow on towel

Axis: Olecranon process

Moving Arm: Ulnar border of forearm toward ulnar styloid process

Stationary Arm: Perpendicular to floor

51
Q

What is the Goni position for Cervical Flexion and position of the patient?

A

Patient is sitting

Axis: Earlobe

Moving Arm: Base of the nose

Stationary Arm: Perpendicular to ceiling

52
Q

What is the Goni position for Cervical Extension and position of the patient?

A

Patient is sitting

Axis: Earlobe

Moving Arm: Base of the nose

Stationary Arm: Perpendicular to Ceiling

53
Q

What is the Goni placement for Cervical Rotation and position of patient?

A

Patient is sittiing

Axis: Top of patients head

Moving Arm: Nose

Stationary Arm: Imaginary line connecting two acromion processes

54
Q

What is the Goni placement for Cervical Side Flexion and position of patient?

A

Patient is sitting

Axis: C7 spinous process

Moving Arm: Midline of skull

Stationary Arm: Thoracic spinous processes (Perpendicular to floor)

Applied Anatomy (2 decks)

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