Practical Questions

Question 1

ROM: MP Flexion

Answer 1

0-90 degrees

Question 2

ROM: MP Extension (Hyperextension)

Answer 2

0-45 degrees

Question 3

ROM: MP Abduction

Answer 3

No normal ROM

Question 4

ROM: MP Adduction

Answer 4

very little adduction beyond zero; typically not measured

Question 5

ROM: PIP Flexion

Answer 5

0-100 degrees

Question 6

ROM: PIP Extension

Answer 6

back to 0 degrees; (some people have -16 degrees of hyperextension, but most people don’t have any)

Question 7

ROM: DIP Flexion

Answer 7

0-90 degrees

Question 8

ROM: DIP Extension

Answer 8

back to 0 degrees

Question 9

ROM: Thumb MP Flexion

Answer 9

0-50 degrees

Question 10

ROM: Thumb MP Extension

Answer 10

0 degrees

Question 11

ROM: Thumb IP Flexion

Answer 11

0-80 degrees

Question 12

ROM: Thumb IP Extension (Hyperextension)

Answer 12

0-20 degrees (hyperextension)

Question 13

ROM: Hip Flexion

Answer 13

0-120 degrees

Question 14

ROM: Hip Extension

Answer 14

0-30 degrees

Question 15

ROM: Knee Flexion

Answer 15

0-135 degrees

Question 16

ROM: Ankle dorsiflexion

Answer 16

0-20 degrees

Question 17

ROM: Ankle plantar flexion

Answer 17

0-50 degrees

Question 18

MMT: MP Flexion Substitutions

Answer 18

Flexor digitorum superficialis, flexor digitorum profundus, flexor digiti minimi brevis, and opponens digiti minimi

Question 19

MMT: MP Extension Substitutions

Answer 19

Flexion of the wrist will produce IP extension through a tenodesis action

Question 20

MMT: MP Flexion Primary Movers

Answer 20

Lumbricals (all 4); Dorsal and Palmar Interossei

Question 21

MMT: MP Extension Primary Movers

Answer 21

extensor digitorum, extensor indices, extensor digiti minimi

Question 22

MMT: PIP Flexion Primary Movers

Answer 22

flexor digitorum superficialis

Question 23

MMT: PIP Flexion Substitutions

Answer 23

flexor digitorum profundus if DIP allowed to flex; wrist extension; relaxation of IP extension

Question 24

MMT: DIP Flexion Primary Movers

Answer 24

flexor digitorum profundus

Question 25

MMT: DIP Flexion Substitutions

Answer 25

wrist extension; make sure patient actively flexes the DIP joint rather than extending the DIP joint and then relaxing

Question 26

MMT: MP (digit) Abduction Primary Movers

Answer 26

dorsal interossei and abductor digiti minimi

Question 27

MMT: MP (digit) Abduction Substitutions

Answer 27

none

Question 28

MMT: MP (digit) Adduction Primary Movers

Answer 28

palmar interossei

Question 29

MMT: MP (digit) Adduction Substitutions

Answer 29

Prevent finger flexion b/c middle finger flexors can contribute to adduction

Question 30

MMT: Thumb MP Flexion Primary Movers

Answer 30

Flexor pollicis brevis

Question 31

MMT: Thumb MP Flexion Substitutions

Answer 31

Make sure patient keeps their thumb straight; if it is bent, the flexor pollicis longus can substitute

Question 32

MMT: Thumb IP Flexion Primary Movers

Answer 32

Flexor Pollicis longus

Question 33

MMT: Thumb IP Flexion Substitutions

Answer 33

Make sure that the patient does not extend and then relax the distal phalanx of the thumb at the beginning of the test, as this will make it look like the pt has actively flexed the IP joint

Question 34

MMT: Thumb MP Extension Primary Movers

Answer 34

Extensor Pollicis Brevis

Question 35

MMT: Thumb MP Extension Substitutions

Answer 35

Extension of the IP joint of thumb with carpometacarpal adduction in addition to extension of the MP joint indicates substitution by the extensor pollicis longus

Question 36

MMT: Thumb IP Extension Primary Movers

Answer 36

extensor pollicis longus

Question 37

MMT: Thumb IP Extension Substitutions

Answer 37

Muscles of the thenar eminence (abductor pollicis brevis, flexor pollicis brevis, and adductor pollicis) can extend the IP joint by flexing the carpometacarpal joint

Question 38

MMT: Thumb Abduction Primary Movers

Answer 38

abductor pollicis longus and brevis

Question 39

MMT: Thumb Abduction Substitutions

Answer 39

APL: extensor pollicis brevis (watch for pull towards dorsal surface of arm) APB: abductor pollicis longus (watch for plane of motion to be toward radial side of hand, not perpendicular)

Question 40

MMT: Thumb Adduction Primary Movers

Answer 40

Adductor pollicis: oblique and transverse heads; 1st dorsal interosseus

Question 41

MMT: Thumb Adduction Substitutions

Answer 41

flexor pollicis longus and flexor pollicis brevis will flex thumb; extensor pollicis longus may try to sub for the thumb adductor - watch for CMC joint to extend

Question 42

MMT: Opposition Prime Movers

Answer 42

Opponens pollicis and opponens digiti minimi

Question 43

MMT: Opposition Substitutions

Answer 43

Flexor pollicis longus/brevis can draw the thumb across the palm to the little finger (contact would be with tips of fingers instead of pads); abductor pollicis brevis may substitute, but rotation component will not be present in motion