Part 2: Muscle Testing for the Shoulder, Elbow, Wrist, and Hand Upper Extremity Part 2: Muscle Testing for the Shoulder, Elbow, Wrist, and Hand

Group 3 Meggan McLeod- 0300906 Carly Lepp- 0296317 Katie Ferrell- 0294961 Shayne Young- 0220662 Luke

The Shoulder

The Yergasen Test

The Yergasen Test The Yergason test is used to test the stability of the biceps tendon within the bicipital groove. The patient is instructed to fully flex at the elbow The clinician grasps the elbow in one hand while holding the wrist in the other hand. The stability of the biceps tendon is tested by externally rotating the patients arm as the patient resists. The elbow is pulled downward to prevent medial rotation and supination. If the biceps tendon is unstable it will pop out of the bicipital groove and the patient will experience pain. If stable, the tendon will remain in place. The biceps tendon can become unstable from injury sustained by repetitive overhead arm movement resulting in biceps tendonitis

The Drop Arm Test

The Drop Arm Test Patient sits or stands with affected arm passively abducted to 90` and is instructed to slowly lower arm. If a rotator cuff injury is present (especially one involving supraspinatus) patient will not be able to lower arm slowly and smoothly; arm will drop to patients side. Other signs of rotator cuff injury may include pain in the lateral aspect of the shoulder, weakness in the shoulder, and marked decrease in active range of motion. Muscles affected in rotator cuff injuries include teres minor, subscapularis, supraspintus and infraspinatus. Common causes of rotator cuff injuries may include falling, lifting and repetitive arm activities, especially those done overhead.

The Apprehension Test

The Apprehension Test The apprehension test involves abducting and externally rotating the patients arm to a position where it might easily dislocate. If the shoulder is ready to dislocate the patient will have a noticeable look of apprehension or alarm on his face and will resist further motion. It is a test for chronic shoulder dislocation, which commonly occurs because of glenohumeral joint instability. Shoulder Dislocation occurs when the head of the humerus slips out of the glenoid fossa of the scapula. Symptoms of shoulder dislocation are pain in the shoulder, arm externally rotated and abducted. The muscles involved in glenohumeral joint instability are the rotator cuff muscles which are the supraspinatus, infraspinatus, teres minor, and subscapularis. May also result in a tear, detachment, or attenuation of the glenoid labrum cartilage

The Elbow

The Ligaments Test

The Ligaments Test The elbow ligament test is used to assess the stability of the medial (ulnar) and lateral (radial) collateral ligaments. The test involves the clinician stabilizing the elbow with the left hand and grabbing the wrist with the right, while the arm is slightly flexed (the patient can be either sitting or standing for this test) The clinician than administers a small amount of force laterally with the right hand, producing a valgus stress on the medial side of the elbow joint. While the elbow is stressed the clinician will palpate the ulnar collateral ligament with the left hand to assess if there is any or no gapping between the humerus and ulna. The hand that is holding the elbow joint not only acts as a fulcrum but also used to palpate the joint for gapping. Once the ulnar collateral ligament is assessed the clinician can switch hands and assess the stability of the radial collateral ligament in the same fashion. The muscles involved with the elbow ligament tests include the wrist flexors and extensors. This injury can occur from tennis, baseball, javelin, shot-put, discus any movement that will put stress on these ligaments.

The Tinel Sign Test

The Tinel Sign Test The Tinel Sign test is designed to elicit tenderness over a neuroma within the ulnar nerve. It is used to detect neuroma in the ulnar nerve at the site of the elbow. The test involves the clinician tapping between the medial epicondyle and the olecranon process with his/her index finger while the patient is sitting on an examination table. If neuroma is present the patient will experience a tingling sensation down the forearm to the 4th and 5th phalanges. The muscles that could be affected by the neuroma of the ulnar nerve includes the flexor carpi ulnaris muscle, and in some cases the palmaris longus. The type of injury that may cause neuroma in the ulnar nerve could be trauma to the posterior aspect of the elbow which includes falling on the medial/posterior elbow, etc.

The End