Upper Extremity Muscle Tests
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| Flexor Carpi Ulnaris | Medial epicondyle of humerus | Anterior side of pisiform, hook of hamate and base of metacarpal #5 | Flexes and ulnar deviates (adducts) hand/wrist | Sit or supine;forearm slightly flexed and fully supinated
Test/Mvmt:Flexion of wrist toward ulnar side (fingers should remain relaxed
Pressure: Against hypothenar eminence, in direction of wrist extension toward radial side
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| Supinator | Lateral epicondyle of humerus (and radial collateral ligament…) and proximal ulna | Lateral (and anterior and posterior) surface of proximal ~1/3 of radius | Supinates forearm | Sit or stand; arm extended 30˚, forearm fully extended and supinated
Fixation Hold arm and forearm in extension (straight arm pointing down and back)
Test/Mvmt: Hold position against pressure
Pressure: At distal forearm, in direction of pronation
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| Abductor Pollicis Longus | Middle 1/3 of posterior radius and ulna | Lateral side of base of metacarpal #1 | Abducts and extends CMC joint of thumb | Subject: Sit or supine; forearm neutral
Fixation: Stabilize medial wrist/hand
Test/Mvmt: Abduction and slight extension of metacarpal #1
Pressure: Against lateral surface of distal end of metacarpal #1, in direction of adduction and flexion
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| Extensor Pollicis Brevis | Distal 1/3 of posterior radius (and interosseus membrane) | Postero-lateral base of proximal phalanx of thumb Distal tendon is radial/lateral border of snuffbox | Extends thumb at MCP joint; extend and abduct at CMC joint | Subject: Sit or supine; forearm neutral Fixation: Stabilize medial wrist/hand Test/Mvmt: Extension of MCP joint of thumb Pressure: Against dorsal surface of proximal phalanx, in direction of flexion
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| Extensor Pollicis Longus | Middle 1/3 of posterior ulna (and interosseus membrane) | Posterior surface of base of distal phalanx of thumb Distal tendon is ulnar/medial border of snuffbox | Extend thumb at CMC, MCP and IP joints | Subject: Sit or supine; forearm neutral Fixation: Stabilize medial wrist/hand Test/Mvmt: Extension of IP joint of thumb Pressure: Against dorsal surface of distal phalanx, in direction of flexion
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| Coracobrachialis | Coracoid process (apex of) of scapula | ~Middle of medial humerus (opposite and ~inferior to deltoid tuberosity) | Adducts and flexes arm at shoulder joint | Subject: Sit or supine; forearm ~fully flexed and supinated; arm flexed ~45˚Fixation: None Test/Mvmt: Hold position against pressure Pressure: Against lower humerus on anterior/medial side; direction of extension
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| Biceps Brachii | Long Head: Supraglenoid tubercle of scapula (tendon thru bicipital groove)Short Head: Coracoid process of scapula (with coracobrachialis and pectoralis minor) | Radial tuberosity of radius | Flexes arm at shoulder; flexes forearm at elbow (and supinates forearm at radioulnar joint) | Subject: Sit or supine; arm at side or slightly flexed; forearm supinated and flexed ~90˚Fixation: Cup elbow with one hand or rest on table Test/Mvmt: Hold position against pressure Pressure: Against lower forearm, in direction of forearm extension
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| Brachialis | Distal ~1/2 of anterior surface of humerus | Tuberosity and coronoid process of ulna | Flexes forearm | As for biceps brachii, except subject’s forearm is pronated
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| Triceps Brachii | Long Head: Infraglenoid tubercle of scapula | Lateral Head: Proximal ~half of lateral and posterior humerus Medial Head: Distal ~2/3 of medial and posterior humerus | Posterior surface of olecranon process of ulna | Extend forearm at elbow joint
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| Anconeus | Lateral epicondyle of humerus | Lateral side of olecranon process and proximal ¼ of posterior ulna | Extend forearm at elbow joint | Place a finger on olecranon process and another on lateral epicondyle. Place palpating finger halfway between and 1cm (1/2 inch) distally. Subject extends forearm against resistance
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| Pronator Teres | Humeral Head: Medial epicondyle of humerus (common flexor tendon)Ulnar Head: Coronoid process of ulna | Middle 1/3 of lateral radius | Pronates forearm at radioulnar joint (and flexes forearm) | Subject: Sit or supine; arm at side (adducted); forearm flexed ~45˚ and pronated.
Test/Mvmt: Hold position against pressure
Pressure: At distal/lower forearm, in direction of forearm supination
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| Flexor Carpi Radialis | Medial epicondyle of humerus (common flexor tendon) | Anterior bases of metacarpals #2 and 3 | Flexes and radially deviates (abducts) hand/wrist | Subject: Sit or supine; forearm slightly flexed and almost fully supinated
Test/Mvmt: Flexion of wrist toward radial side (fingers should remain relaxed
Pressure: Against thenar eminence, in direction of wrist extension toward ulnar side
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| Brachioradialis | O: Lateral supracondylar ridge of humerus (distal 1/3 of humerus) | I: Lateral side of styloid process of radius | A: Flexes forearm at elbow | Subject: Sit or supine; forearm neutral and flexed 90˚
Fixation: Forearm rests on a table or is supported by examiner
Test/Mvmt: Hold position against pressure
Pressure: Against distal forearm, in direction of forearm extension
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| Flexor Digitorum Superficialis | O: Humeral head: Medial epicondyle of humerus (common flexor tendon) Ulnar Head: Coronoid process of ulna Radial head: Proximal ½ of anterior shaft of radius | I: 4 tendons; each divides into 2 slips that attach to the sides of the anterior surface of the middle phalanges of fingers #2-5 | A: Flexes fingers #2-5 at MCP and PIP joints (and flexes hand at wrist) | T: Subject: Sit or supine; wrist neutral
Fixation: Stabilize MCP joint
Test/Mvmt: Flexion of PIP joints, individually; DIP extended (straight)
Pressure: Against palmar surface of middle phalanges, in direction of extension
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| Flexor Digitorum Profundus | O: Proximal 1/2 of anterior and medial ulna | I: Anterior surface of distal phalanges of fingers #2-5 | A: Flexes fingers 2-5 at MCP, PIP and DIP joints (and flexes hand at wrist) | T: Subject: Sit or supine; wrist slightly extended
Fixation: Stabilize proximal and middle phalanges
Test/Mvmt: Flexion of DIP joints, individually
Pressure: Against palmar surface of distal phalange (pad to pad), in direction of extension
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| Flexor Pollicis Longus 264 | O: By proximal tendons to coronoid process of ulna and medial epicondyle | I: Base of palmar side of distal phalanx of thumb | A: Flexes IP joint of thumb; assists flexion of MCP and CMC joints | Subject: forearm supinated and resting on table
Fixation: Stabilize metacarpal bone and proximal phalanx of thumb in extension
Test/Mvmt: Flexion of IP joint of thumb
Pressure: Against palmar surface of distal phalanx, in direction of extension
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| Pronator Quadratus 286,287 | O: Anterior (and medial) side of distal ¼ of ulna | I: Anterior (and lateral) side of distal ¼ of radius | A: Pronates forearm | Subject: arm at side (adducted); forearm flexed fully and pronated
Fixation: Hold elbow at their side (avoid shoulder abduction)
Test/Mvmt: Hold position against pressure
Pressure: At distal/lower forearm, in direction of forearm supination
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| Extensor Carpi Radialis Longus 284 | O: Distal 1/3 of lateral supracondylar ridge of humerus | I: Posterior side of base of metacarpal #2 | A: Extends and radially deviates (abducts) hand at wrist | Subject: Sit; arm flexed ~60˚; forearm slightly flexed and almost fully pronated
Test/Mvmt: Extension of wrist toward radial side (finger flexion is ok)
Pressure: Against dorsum of hand, in direction of flexion toward ulnar side
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| Extensor Carpi Radialis Brevis 284 | O: Lateral epicondyle of humerus (common extensor tendon) | I: Posterior side of base of metacarpal #3 | A: Extends and radially deviates (abducts) hand at the wrist | Subject: Sit; arm extended ~60˚; forearm ~fully flexed and pronated (decreases effectiveness of ECR longus)
Test/Mvmt: Extension of wrist toward radial side
Pressure: Against dorsum of hand, in direction of flexion toward ulnar side
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| Extensor Digitorum 279 | O: Lateral epicondyle of humerus (common extensor tendon) | I: Posterior side of middle and distal phalanges of fingers #2-5 | A: Extends fingers #2-5 at MCP, PIP and DIP joints (and extends hand) | Subject: Sit or supine; forearm resting on table (or not)
Fixation: Stabilize wrist, avoiding complete extension
Test/Mvmt: Extension of MCP joints of digits #2 – 5
Pressure: Against dorsal surfaces of proximal phalanges, in direction of flexion
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| Extensor Digiti Minimi 278 | O: Lateral epicondyle of humerus (common extensor tendon) | I: Into extensor expansion of little finger with extensor digitorum tendon and thereby onto posterior surface of middle and distal phalanges of little finger | A: Extends little finger at MCP, PIP and DIP joints | T: *No specific test given (grouped with extensor indices and extensor digitorum)
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| Extensor Indices 278 | O: Distal ~1/3 of posterior ulna | I: Into tendon of extensor digitorum and thereby onto posterior side of middle and distal phalanges of index finger | A: Extends index finger at MCP, PIP and DIP joints | T: *No specific test given (grouped with extensor digiti minimi and extensor digitorum)
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| Extensor Carpi Ulnaris 285 | O: Lateral epicondyle of humerus (common extensor tendon) (and posterior middle ~1/3 of ulna) | I: Posterior (and ulnar) side of base of metacarpal #5 | A: Extends and ulnar deviates (adducts) hand at the wrist | Subject: Sit or supine; arm flexed; forearm flexed and fully pronated
Test/Mvmt: Extension of wrist toward ulnar side
Pressure: Against dorsum of 5th metacarpal, in direction of flexion toward radial side
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| Palmaris Longus | Medial epicondyle of humerus | Palmar aponeurosis and flexor retinaculum of palm | Flexes hand/wrist | forearm slightly flexed and fully supinated
Fixation: Forearm rests on a table or is supported by examiner
Test/Mvmt: Cup palm and flex wrist Pressure: Against thenar and hypothenar eminences in direction of flattening the palm and extending the wrist
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