Manual Muscle TestingWrist Flexors and Extenors PDF

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This document contains the instructions given during this lecture on manual muscle testing of the wrist. ...

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MMT: Wrist Flexors and Extensors

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Flexor Carpi Ulnaris: Flexion/Ulnar deviation o Have client start in supination with palm up while you hold onto dorsal forearm to stabilize o Ask client to bring wrist up into flexion and then over towards their little finger into ulnar deviation o If client can do: 3 (fair) ▪ Ask client to come up and ulnarly deviate and hold it while you apply resistance in the direction of radial deviation and extension at the metacarpal heads ▪ If client can withstand ● 4/5 (Good/Normal) o If client cannot do ▪ Have client rest forearm in neutral position with wrist and hand supported on table. Support at their dorsal forearm ▪ Ask client to flex hand foreword ▪ If client can: 2 (Poor) ▪ If client cannot: ▪ Palpate for flexor carpi ulnaris: Come down 5th metacarpal and just distal to the ulnar styloid ▪ Support under distal forearm ▪ Ask client to flex again and feel for tendon (muscle) ● If you feel contraction: 1 (Trace) ● If you do not: 0

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Flexor Carpi Radilias: Flexion/Radial deviation o Have client start in supination with palm up while you hold onto dorsal forearm to stabilize o Ask client to bring wrist up into flexion and then over towards their thumb into radial deviation o If client can do: 3 (fair) ▪ Ask client to come up and radially deviate and hold it while you apply resistance in the direction of ulnar deviation and extension at the metacarpal heads ▪ If client can withstand ● 4/5 (Good/Normal) o If client cannot do ▪ Have client rest forearm in neutral position supported on table and stabilize at dorsal forearm ▪ Ask client to flex wrist foreword ▪ If client can do: 2 (poor) ▪ If client cannot do: ▪ Palpate: Second metacarpal and come down to wrist ▪ Support under distal forearm ▪ Ask client to flex again and feel for tendon ● If you feel contraction: 1 (trace) ● If you do not: 0

MMT: Wrist Flexors and Extensors

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Extensor Carpi Ulnaris: Extension/Ulnar Deviation o Have client start in pronation with palm down while you stabilize at volar forearm o Ask client to bring wrist up into extension and over towards their little finger into ulnar deviation o If client can do: 3 (fair) ▪ Ask them to bring wrist back into extension and gradually apply resistance, at the head of the metacarpals, into radial deviation and flexion ▪ If client can withstand ● 4/5 (Good/Normal) o If client cannot do: ▪ Have client place arm on table in neutral position and ask them to bring palm back into wrist extension ▪ If they can: 2 (Poor) ▪ If they cannot: ● Palpate: 5th metacarpal and distal to ulnar styloid on dorsal side ● Ask client to extend again and feel for muscle contraction o If you do: 1 Trace o If you do not: 0

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Extensor Carpi Radialis Longus: Extension/Radial deviation o Ask client to hold arm out with elbow extended with their hand in pronation while you stabilize at volar forearm and under elbow o Ask client to bring wrist back into extension and move towards their thumb into radial deviation o If client can do: 3 (Fair) ▪ Ask client to come up into extension and radial deviation and apply resistance, at the head of the metacarpals, into ulnar deviation and flexion ▪ If client can withstand ● 4/5 (Good/Normal) o If client cannot do: ▪ Have client place forearm down on table in neutral position and ask client to bring wrist back ▪ If client can do: 2 (Poor) ▪ If client cannot: ● Palpate: find second metacarpal, palpate down to base, just proximal is where you palpate ● Ask client to bring wrist back ● If you feel contraction :1 (Trace) ● If you do not: 0

MMT: Wrist Flexors and Extensors

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Extensor Carpi Radialias Brevis: Extension/Radial deviation o Keep elbow at 90 ° (to  make sure you are canceling out the longus) forearm is pronated with forearm on table o Ask client to bring wrist back into extension and over to thumb into radial deviation o If client can do: 3 (Fair) ▪ Ask client to extend and radially deviate ▪ Apply resistance into ulnar deviation and flexion at the head of the metacarpals ● 4/5(Good/Normal) o If cannot do ▪ Forearm on table in neutral position and ask client to bring wrist back ▪ If can do: 2 (Poor) ▪ If cannot do ● Palpate: find 3rd  metacarpal and come down to the base ● Ask client to do extend again o If you feel: 1 Trace o If you do not: 0...