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UPPER EXTREMITY

UPPER EXTREMITY . UE Palpations & ROM. UE Palpations. Chest (TG 181) Clavicle (TG 65) Scapula (TG 59-65) Elbow (TG 122-123) Radius (TG 125) Wrist (TG 124, 129, 131) Ulna (TG 124) Carpals (TG 127- 131) Lister’s Tubercle (TG 126) Snuff Box (TG 160-162) . Shoulder Flexion—p. 70 (N).

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UPPER EXTREMITY

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  1. UPPER EXTREMITY UE Palpations & ROM

  2. UE Palpations • Chest (TG 181) • Clavicle (TG 65) • Scapula (TG 59-65) • Elbow (TG 122-123) • Radius (TG 125) • Wrist (TG 124, 129, 131) • Ulna (TG 124) • Carpals (TG 127- 131) • Lister’s Tubercle (TG 126) • Snuff Box (TG 160-162)

  3. Shoulder Flexion—p. 70 (N) • Supine, knees flexed, palm facing body • Stabilize scapula (table) and thorax • Axis: lateral aspect of the greater tubercle • Stationary arm: parallel to the midaxillary line of the thorax • Moving arm: lateral midline of the humerus; use lateral epicondyle for reference • Firm end-feel • 0-180°

  4. Shoulder Extension—p. 74 (N) • Prone, face turned away from shldr being tested, elbow in slight flexion (keep it close to the body), palm facing the body • Stabilize the scapula • Axis:lateral aspect of the greater tubercle • Stationary arm: parallel to the midaxillary line of the thorax • Moving arm: lateral midline of the humerus; use lateral epicondyle for reference • Firm end-feel • 0- 45°

  5. Shoulder Abduction—p. 78 (N) • Supine, shoulder in lateral rotation, palm facing anteriorly • Stabilize the scapula (table) • Axis: anterior aspect of the acromial process • Stationary arm: parallel to the midline of the anterior aspect of the sternum • Moving arm: anterior midline of the humerus, medial epicondyle may be referenced • Firm end-feel • 0-180°

  6. Internal/External Rotation—p. 82/86 • Supine, 90° shoulder abd & elbow flexion, palm facing feet • Towel under humerus so it is level with the acromion process • Stabilize shoulder • Axis: olecranon process • Stationary arm: perpendicular to the floor • Moving arm: ulnarstyloid process • Firm end-feel • Internal Rot = 0-70°; External Rot = 0-90°

  7. Elbow Flexion/Extension—p. 100 (N) • Supine, towel under humerus (ext), palm facing up • Stabilize: humerus • Axis: lateral epicondyle • Stationary arm: midline humerus/center of acromion process • Moving arm: radial head/radial styloid process • Soft end-feel (flex); hard end-feel (ext) • 0-145°

  8. Pronation—p. 102 (N) • Short sitting, elbow close to trunk, 90° flex, neutral position (thumb points towards ceiling) • Stabilize extremity • Axis: laterally and proximally to the ulnarstyloid process • Stationary arm: parallel to the anterior midline of the humerus • Moving arm: across dorsal aspect of the forearm, proximal to the styloid process • Hard/Firm end-feel • 0-90°

  9. Supination—p.104 (N) • Short sitting, elbow close to trunk, 90° flex, neutral position (thumb points towards ceiling) • Stabilize extremity • Axis: medially and proximally to the ulnarstyloid process • Stationary arm: parallel to the anterior midline of the humerus • Moving arm: across ventral aspect of the forearm, proximal to the styloid process • Firm end-feel • 0-90°

  10. Wrist Flexion/Extension—p. 120/122 • UE supported on table, wrist over edge, palm down, fingers flexed • Stabilize forearm • Axis: lateral aspect of the wrist over the triquetrum • Stationary arm: lateral midline of ulna; use olecranon process & ulnarstyloid process for reference • Moving arm: lateral midline of the 5th metacarpal (bone) • Firm end-feel (flex); firm/hard end-feel (ext) • Flex: 0-80° ; Ext: 0-70°

  11. Radial/Ulnar Deviation—p. 124/126 • On support surface, 90° shoulder & elbow flex • Stabilize forearm • Axis: dorsal aspect of the wrist over the capitate • Stationary arm: dorsal midline of the forearm; lateral epicondyle • Moving arm: dorsal midline of 3rd metacarpal • Hard/Firm end-feel (rad); Firm end-feel (ulnar) • Rad: 0-20°; Ulnar: 0-45°

  12. MCP Flexion/Extension—p. 146/148 • Hand supported on surface • Stabilize metacarpals • Axis: dorsal aspect on the MCP joint • Stationary arm: dorsal midline of the metacarpal • Moving arm: dorsal midline of the proximal phalanx • Hard/Firm end-feel (flex); Firm end-feel (ext) • Flex: 0-90°; Ext: 0°

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