2. POWER OF MUSCLES QUICK ASSESSMENT – 1. Patient working 2. Standing up from lying & sitting position 3. Dressing or undressing 4. Lightly jumping or hopping
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6. MUSCLES OF SHOULDER GIRDLE & SCAPULA Test – The patient flexes his elbow, holds the elbow to his side and then attempts to turn the fore arm backwards against resistance Peripheral Nerve – Suprascapular Mains Segmental Supply – C5 INFRA SPINATUS Test – Ask the patient to abducted from 30º to 60º the arm against examiner resistance Peripheral Nerve – Circumflex Main Segmental Supply - C5 DELTOID Test – The patient tries to initiate abduction of the arm from the side against resistance Peripheral Nerve – Suprascapular Main Segmental Supply – C5 SUPRA SPINATUS
7. If seratous anterior is weak, scapular medial borden will become prominent – winging of scapula Test Push the wall by his hands keeping elbow extended Main Seg supply C5C6C7 P. Nerve – N. to serratus anterior SERRATUS ANTERIOR Test-2 Strech the arm out infront & than to clasp the hands together while examiner endeavour to hold them apart Test-1 Placing the hand on hip and pressing in wards Main Seg supply C5C6C7 P. Nerve – Lat. & medial pectoral N. PECTORALIS MAJOR
8. Test-2 Resist the patient’s attempt to adduct the arm when abducted to above 90º Test-1 While palpating the muscle, ask the patient to cough Main Seg supply C7 P. Nerve –Nerve to L. Dorsi LATISSIMUS DORSI
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11. MUSCLES OF ELBOW JOINT Test – Pt. attempts to extend the elbow against resistance Peripheral Nerve – Radial Mains Segmental Supply – C7 TRICEPS Test – Pt. pronates the forearm and draws the thumb towards the nose against resistance Peripheral Nerve – Radial Main Segmental Supply - C5C6 BRACHIORADIALIS Test – Pt. flexes his elbow against resistance, the forearm being supinated Peripheral N. – Musculo cutaneous Main Segmental Supply – C5 BICEPS
12. MUSCLES OF FOREARM & WRIST JOINT Peripheral Nerve - Ulnar Mains Segmental Supply – C8 FLEXOR CARPI ULNARIS Test – Examiner resist the patient attempt to flex the wrist towards the radial side Peripheral Nerve – Median Mains Segmental Supply – C6C7 FLEXOR CARPI RADIALS Test – Examiner attempt to flex the patients extended fingers at metacarpophalangeal joints Peripheral Nerve – Radial Main Segmental Supply -C7 EXTENSOR DIGITORUM Test – Pt. holds the fingers partialy extended and dorsiflexes the wrist towards the radial side against resistance Peripheral N. – Radial Main Segmental Supply – C6C7 EXTENSOR CARPI RADIALIS LONGUS
13. MUSCLES OF THUMB Test – Patients attempt to extend the thumb while the examiner attempts to flex it at the interphalangeal joint Peripheral Nerve – Radial Mains Segmental Supply – C8 EXTENSOR POLLICIS LONGUS Test – Pt. attempts to extend the thumb while the examiner attempts to flex it at MCP joint Peripheral Nerve – Radial Main Segmental Supply - C8 EXTENSOR POLLICIS BREVIS Test – Pt. attempts to maintain his thumb in abduction against the examiner resistance Peripheral N. – Radial Main Segmental Supply – C8 ABDUCTOR POLLICIS LONGUS
14. Test – Patient attempt to flex the distal phalanx of the thumb against the patient resistance (Hold the proximal phalanx) Peripheral Nerve – Median Mains Segmental Supply – C8 FLEXOR POLLICIS LONGUS Test – Ask the patient to abduct the thumb in a plane at right angle to the palmar aspect of index finger against the resistance of examiner thumb Peripheral Nerve – Median Main Segmental Supply - T1 ABDUCTOR POLLICIS BREVIS Test – Pt. attempts to touch the little finger with the thumb Peripheral N. – Median Main Segmental Supply – T1 OPPONENS POLLICIS
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16. MUSCLES OF HAND & FINGERS Pt. Tries to Adduct the fore finger against resistance Pt. Tries to abduct the fore finger against resistance Peripheral nerve ulnar Main Seg supply T1 IST DORSAL INTEROSSI & IST PALMAR INTROSSI B. Interossi – Pt. attemps to keep the fingers abducted against resistance A. Lumbricals – Pt. Tries to flex the extended fingers at the MCP Joints Median – Lumbical I & II Ulnar – lumbrical III & IV & interossi Main Seg supply C8 T1 LUMBRICAL & INTEROSSI
17. thank you Test – Back of hand is placed on the table & little finger abducted against resistance (sign of ulnar N. lesion) P. N. – Ulnar Mains Segmental Supply – T1 ABDUCTOR DIGITI MINIMI Test – Pt. Flexes the terminal phalanx of the fingers against resistance, the middle phalanx being supported P. N. – Median Ist & IInd Ulnar IIIrd & IVth Main Segmental Supply - C8 FLEXOR DIGITORUM PROFUNDUS Test – Pt. flexes the finger at the proximal inter phalangel joint against resistance (examiners fingers placed on middle phalanx) Peripheral N. – Median Main Segmental Supply – C8 FLEXOR DIGITORUM SUBLIMIS