MMT of shoulder and elbow

Question 1

Innervation of serratus anterior

Answer 1

long thoracic C5 - 7

Question 2

recommended position for testing serratus anterior

Answer 2

sitting with shoulder flexed to 130

Question 3

resistance applied to test serratus anterior

Answer 3

patient pushes upward into flexion, therapist pushes downward on arm above elbow

Question 4

below fair grade for serratus anterior

Answer 4

PT takes weight of arm and asks patient to lift arm and scapula

shoulder should maintain abduction and upward rotation

Question 5

Palpation of serratus anterior

Answer 5

hand should be along lower borders of scapula with web space at inferior angle

Question 6

Alternate position for serratus anterior

Answer 6

sitting or supine with shoulder flexed to 100

Question 7

Innervation of traps (upper, middle and lower)

Answer 7

Cranial nerve XI, C3 - 4

Question 8

Action of serratus anterior

Answer 8

scapular abduction and upward rotation

Question 9

innervation of levator scap

Answer 9

L3 - 4 and dorsal scapular nerve C5

Question 10

recommended position for testing upper trap and levato scap

Answer 10

sitting with arms at sides

Question 11

resistance for upper trap and levator scap

Answer 11

patient shrugs shoulders

resistance applied downward toward surface over superior shoulder

Question 12

below fair position for upper trap and levator scap

Answer 12

supine or prone with head in midline

Question 13

palpation for upper trap and levator scap

Answer 13

near insertion near clavicle or near cervical spine

Question 14

substitution of upper trap and levator scap

Answer 14

watch hands pushing down on legs or surfaces

rhomboids substitute with adduction and upward rotation

Question 15

action of upper trap and levator scap

Answer 15

scapular elevation

Question 16

recommended position to test middle trap

Answer 16

Prone, shoulder at 90 degrees abduction and elbow at 90 (arm hands over edge of mat)

OR

shoulder 90 abduction and ER

Question 17

resistance for middle trap

Answer 17

patient lifts elbow toward ceiling

resistance downwards towards floor, proximal to elbow if deltoid is strong, over scapular is deltoid is weak

Question 18

below fair position for middle trap

Answer 18

therapist takes weight of arm

Question 19

palpation point for middle trap

Answer 19

spine of scapular from acromion to vertebral column (T1 - T6)

Question 20

substitutions of middle trap

Answer 20

rhomboids – downward rotation with adduction

Question 21

action of middle trap

Answer 21

scapular adduction

Question 22

recommended position to test lower trap

Answer 22

prone: arm abducted 145 forearm mid-position with thumb pointing to ceiling

Question 23

resistance for lower trap

Answer 23

patient lifts arm towards ceiling

resistance applied downwards towards floor proximal to elbow if shoulder is strong, over scapula is shoulder is weak (push up and out)

Question 24

below fair position for lower trap

Answer 24

therapist takes weight of arm

Question 25

palpation of lower trap

Answer 25

below spine of scapula and across to thoracic vertebrae (T7 - 12)

Question 26

Action of lower trap

Answer 26

scapular depression and adduction

Question 27

innervation of rhomboids

Answer 27

dorsal scapular C5

Question 28

recommended position of rhomboids

Answer 28

prone, shoulder internally rotated, arm adducted with elbow flexed, hand on back

Question 29

resistance of rhomboids

Answer 29

patient lifts hand off back resistance proximal to elbow if shoulder is strong resistance downward and out if shoulder is weak

Question 30

below fair position of rhomboids

Answer 30

therapist takes weight of arm OR short sitting (Gravity minimized)

Question 31

palpation of rhomboids

Answer 31

deep under vertebral border of scapula strong activity - fingers will pop out from palpation point

Question 32

substitution of rhomboids

Answer 32

do not allow elbow to lead = humeral extension middle trap = see add without rotation

Question 33

action of rhomboids

Answer 33

scapular adduction and downward rotation