2 muscles responsible for wrist flexion and how to differentiate while testing
FCR = over 2nd MC
- flexion and rad dev
FCU = over 4-5th MC
- flexion and uln dev
Wrist flexion substitution
Finger flexors should stay relaxed
Muscles responsible for wrist extension and how to differentiate while testing
ECR - 2-3 MC
- ext and rad dev
ECU - 4-5 MC
- ext and uln dev
Wrist extension palpation
ECRL 2nd MC
ECRB 3rd MC
ECU 5th MC distal to ulnar styloid
Wrist extension substitution
Finger extensors should stay relaxed
Lunbricals/interossei testing position
Forearm supinated - resist MCP flexion and IP extension
Interossei and lumbricals are _______ muscles
Intrinsic
Substitution for lumbricals/interossei
Long finger flexors - IPs should remain extended
FDS testing position
Forearm supinated - hold all fingers extended except finger to be tested (eliminated FDP)
Pt flexes PIP
FDS palpation
Palmar surface of wrist between wrist flexors
FDS subs
FDP
Tenodesis action by extending wrist - results in passive flexion
Relaxing IP ext results in passive flexion
FDP testing position
Forearm supinated, stabilize middle phalanx - pt flexes DIP
Palpation for FDP
Palmar surface of middle phalanx
FDP substitutions
Tenodesis by extending wrist - results in passive flexion
Relaxing IP ext results in passive flexion
Finger extension position
Forearm pronated, pt extends MCP
Finger extension resistance
Applied toward flexion on proximal phalanx
Finger extension sub
Tenodesis action produces passive IP ext
Finger abduction test position/resistance
Forearm pronated, pt spreads fingers
Resistance applied toward adduction at distal phalanx
Below fair for finger abduction
Partial range
Palpation for abduction
1st DI at base of prox phalanx, radial side of index finger
Abd DM - ulnar border of hand
Finger adduction test position/resistance
Pronated, adduction toward middle finger
Resistance ad middle phalanx
Adduction sub
Finger flexion
Thumb MP flexion test position/resistance
Forearm supinated, pt flexes MP with IP extended
Resistance toward extension @ prox phalanx
Thumb MP flexion palpation
Ulnar side of FP longus tendon in thenar eminence
Thumb IP flexion position/resistance
Forearm sup, stabilize MP in extension, pt flexes IP
Resistance @ distal phalanx
Thumb IP palp
Tendon on palmar surface of prox phalanx of thumb
Thumb IP flexion sub
Relaxation of IP ext produces passive flexion
Thumb MP ext position/resistance
Forearm neutral - stabilize MC, pt extends MP
Resistance @ prox phalanx
Thumb MP ext palp
Base of 1st MC lies between tendons of abd pollicus and EPL
Thumb MP sub
EPL - see ext of IP and CMC adduction
Thumb IP ext position/resistance
Forearm neutral - stabilize prox phalanx, pt extends IP
Resistance @ distal phalanx
Thumb IP ext palp
Ulnar side of anatomical snuff box or dorsal surface of prox phalanx
Thumb IP ext sub
Thenar muscles - flex CMC resulting in passive IP extension
Thumb abduction position/resistance
Forearm supinated
APB - pt abducts thumb
APL - pt abducts thumb in plane halfway between abd/ext
Resistance @ proximal phalanx (APB), distal end of 1st MC (APL)
Thumb abduction palp
APB - center of thenar eminence, medial to OP
APL - base of 1st MC on radial side of EPB
Thumb abduction subs
EP brevis subs for APL - abduction moves toward dorsum of hand
Thumb adduction position/resistance
Forearm pronated
Pt adducts thumb to palm
Resistance @ proximal phalanx
Thumb add palp
Web space between thumb and index finger
Thumb add sub
FP longus/brevis - see thumb flexion
EPL - see CMC extension
Opposition position/resistance
Forearm supinated
Pt opposes - resistance spreads out hand
Opposition palp
OP - along radial shaft of 1st MC lateral to APB
ODM - hypothenar eminence radial side of 5th MC
Opposition sub
FPL/B - see finger flexion
APB - no rotation seen