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Muscle Tests

Upper Extremity Muscle Tests

Muscle OriginInsertionActionTest
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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)
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)
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
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
Created by: Jones3511
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