{"id":1124,"date":"2010-12-04T08:55:15","date_gmt":"2010-12-04T08:55:15","guid":{"rendered":"https:\/\/cloverock.info\/mockosce23\/new\/muscle-tests-4\/"},"modified":"2024-02-01T11:29:38","modified_gmt":"2024-02-01T11:29:38","slug":"muscle-tests-4","status":"publish","type":"post","link":"https:\/\/www.qpercom.com\/sim\/index.php\/the-examination-of-the-upper-extremities\/the-wrist-and-the-hand\/muscle-tests-4\/","title":{"rendered":"Muscle Tests"},"content":{"rendered":"<hr \/>\n<h3><span style=\"color: #003366;\">Procedure<\/span><\/h3>\n<ul>\n<li><span style=\"color: #003366;\">The patient sits with lower arms resting on a table and the elbows in <span style=\"color: #33cccc;\"><strong>90\u00b0 flexion<\/strong><\/span>.<\/span><\/li>\n<li><span style=\"color: #003366;\">Examine the muscles by allowing them to be tensed isometrically (<em>without movement<\/em>). <\/span><\/li>\n<li><span style=\"color: #003366;\">During this, offer resistance (<em>white arrow on photos<\/em>) to the force elicited by the patient (<em>black arrow on photos<\/em>) in response to a request to initiate a certain movement. <\/span><\/li>\n<li><span style=\"color: #003366;\">Whilst performing the test, enquire about any pain. <\/span><\/li>\n<li><span style=\"color: #003366;\">If pain is indicated, compare left with right.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span style=\"color: #003366;\"><strong><em>Muscle Test Wrist\/Hand<\/em><\/strong><\/span><\/p>\n<p><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/124036769?dnt=1&amp;app_id=122963\" width=\"640\" height=\"480\" frameborder=\"0\" allow=\"autoplay; fullscreen; picture-in-picture\"><\/iframe><\/p>\n<hr \/>\n<ul>\n<li><span style=\"color: #003366;\">If necessary, palpate the muscles:<\/span>\n<ul>\n<li><span style=\"color: #003366;\">To determine the tone and the maximum point of pain.<\/span><\/li>\n<li><span style=\"color: #003366;\">To differentiate between lipoma etc. and muscle herniation.<\/span><\/li>\n<li><span style=\"color: #003366;\">If an avulsion or muscle rupture is suspected.<\/span><\/li>\n<\/ul>\n<\/li>\n<li><span style=\"color: #003366;\">In principle, an isometric test of pain of the different muscle groups should suffice. <\/span><\/li>\n<li><span style=\"color: #003366;\">If the patient indicates pain symptoms during this test, examine the individual muscles of the muscle group in question (<em>following a left-right comparison<\/em>). <\/span><\/li>\n<li><span style=\"color: #003366;\">Ensure that these are tensed as selectively as possible.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span style=\"color: #003366;\"><em><strong>Muscle Tests Groups Lower Arm\/Wrist<\/strong><\/em><\/span><\/p>\n<p><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/124036754?dnt=1&amp;app_id=122963\" width=\"640\" height=\"480\" frameborder=\"0\" allow=\"autoplay; fullscreen; picture-in-picture\"><\/iframe><\/p>\n<hr \/>\n<ul>\n<li><span style=\"color: #003366;\">The extensors of the wrist (<em>particularly the extensor digitorum muscle, extensor carpi radialis longus and brevis muscles, and extensor carpi ulnaris muscle<\/em>).<\/span><\/li>\n<li><span style=\"color: #003366;\">the pronators (particularly the pronator teres muscle, pronator quadratus muscle, flexor carpi radialis muscle)<\/span><\/li>\n<li><span style=\"color: #003366;\">the supinators (particularly the supinator muscle and biceps brachii muscle)<\/span><\/li>\n<li><span style=\"color: #003366;\">the flexors of the wrist and the fingers (particularly the palmaris longus muscle, flexor digitorum profundus and superficialis muscles, flexor carpi radialis muscle, flexor carpi ulnaris muscle, flexor pollicis longus muscle, palmar and dorsal interosseous muscles, lumbrical muscles)<\/span><\/li>\n<li><span style=\"color: #003366;\">the ulnar abductors (particularly the flexor carpi ulnaris muscle, extensor carpi ulnaris muscle)<\/span><\/li>\n<li><span style=\"color: #003366;\">the radial abductors (particularly the flexor carpi radialis muscle, extensor carpi radialis longus and brevis muscles)<\/span><br \/>\n<span style=\"color: #003366;\"><em>NB. For a description of how to carry out the above mentioned muscle tests, refer to &#8220;The Elbow&#8221;.<\/em><\/span><\/li>\n<\/ul>\n<p><span style=\"color: #003366;\"><em><strong>Muscle strength tests fingers<\/strong><\/em><\/span><\/p>\n<p><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/124036775?dnt=1&amp;app_id=122963\" width=\"640\" height=\"480\" frameborder=\"0\" allow=\"autoplay; fullscreen; picture-in-picture\"><\/iframe><\/p>\n<ul>\n<li><span style=\"color: #003366;\">the thenar and hypothenar muscles (opposition of the thumb against the individual fingers) (particularly opponens pollicis muscle, opponens digiti minimi muscle) [Figure 122]<\/span><br \/>\n<span style=\"color: #003366;\"><em>NB. The extensor pollicis longus and brevis muscles and the abductor pollicis longus muscle can only be tested selectively.<\/em><\/span><\/li>\n<\/ul>\n<p><span class=\"jce_caption\" style=\"display: inline-block; color: #003366;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-1116\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/UpperExtrem_ue-fig-122.jpg\" alt=\"\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/UpperExtrem_ue-fig-122.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/UpperExtrem_ue-fig-122-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\">Figure 122<\/span><\/span><\/p>\n<p><span style=\"color: #003366;\">The following muscles can be tested more or less selectively:<\/span><\/p>\n<ul>\n<li><span style=\"color: #003366;\">extensor pollicis longus muscle [Figure 123].<\/span>\n<ul>\n<li><span style=\"color: #003366;\"><em>Function<\/em>: extension (in CMC I, MCP I and IP) and repositioning (in CMC I) of the thumb:<\/span><\/li>\n<li><span style=\"color: #003366;\"><em>Disorder<\/em>: tendonitis\u00a0<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><span class=\"jce_caption\" style=\"display: inline-block; color: #003366;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-1117\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/UpperExtrem_ue-fig-123.jpg\" alt=\"\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/UpperExtrem_ue-fig-123.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/UpperExtrem_ue-fig-123-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\">Figure 123<\/span><\/span><\/p>\n<ul>\n<li><span style=\"color: #003366;\">\u00a0 extensor pollicis brevis muscle [Figure 124].<\/span>\n<ul>\n<li><span style=\"color: #003366;\"><em>Function<\/em>: extension (in MCP I) and repositioning (in CMC I) of the thumb:\u00a0<em>\u00a0<\/em><\/span><\/li>\n<li><span style=\"color: #003366;\"><em>Disorder<\/em>: crepitating tenosynovitis<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><span class=\"jce_caption\" style=\"display: inline-block; color: #003366;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-1118\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/UpperExtrem_ue-fig-124.jpg\" alt=\"\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/UpperExtrem_ue-fig-124.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/UpperExtrem_ue-fig-124-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\">Figure 124<\/span><\/span><\/p>\n<ul>\n<li><span style=\"color: #003366;\">\u00a0 abductor pollicis longus muscle [Figure 125]. \u00a0<em>\u00a0<\/em><\/span>\n<ul>\n<li><span style=\"color: #003366;\"><em>Function<\/em>: extension and abduction (both in CMC I) of the thumb;<em>\u00a0<\/em><\/span><\/li>\n<li><span style=\"color: #003366;\"><em>Disorder<\/em>: crepitating tenosynovitis<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><span class=\"jce_caption\" style=\"display: inline-block; color: #003366;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-1119\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/UpperExtrem_ue-fig-125.jpg\" alt=\"\" width=\"400\" height=\"295\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/UpperExtrem_ue-fig-125.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/UpperExtrem_ue-fig-125-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\">Figure 125<\/span><\/span><\/p>\n<ul>\n<li><span style=\"color: #003366;\">\u00a0 palmar interosseous muscles [Figure 126] and dorsal muscles [Figure 127]. \u00a0<em>\u00a0<\/em><\/span>\n<ul>\n<li><span style=\"color: #003366;\"><em>Function<\/em>: adduction and abduction (closing and spreading) of the fingers, respectively; flexion of the MCP joints;\u00a0<em>\u00a0<\/em><\/span><\/li>\n<li><span style=\"color: #003366;\"><em>Disorder<\/em>: atrophy due to ulnar nerve lesion<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><span class=\"jce_caption\" style=\"display: inline-block; color: #003366;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-1120\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/UpperExtrem_ue-fig-126.jpg\" alt=\"\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/UpperExtrem_ue-fig-126.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/UpperExtrem_ue-fig-126-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\">Figure 126<\/span><\/span><\/p>\n<p><span class=\"jce_caption\" style=\"display: inline-block; color: #003366;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-1121\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/UpperExtrem_ue-fig-127.jpg\" alt=\"\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/UpperExtrem_ue-fig-127.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/UpperExtrem_ue-fig-127-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\">Figure 127<\/span><\/span><\/p>\n<ul>\n<li><span style=\"color: #003366;\">\u00a0 flexor pollicis longus muscle [Figure 128]. \u00a0<em>\u00a0<\/em><\/span>\n<ul>\n<li><span style=\"color: #003366;\"><em>Function<\/em>: flexion of the thumb (in CMC I, MCP I and IP joints);\u00a0<em>\u00a0<\/em><\/span><\/li>\n<li><span style=\"color: #003366;\"><em>Disorder<\/em>: stenosing tenosynovitis<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><span class=\"jce_caption\" style=\"display: inline-block; color: #003366;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-1122\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/UpperExtrem_ue-fig-128.jpg\" alt=\"\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/UpperExtrem_ue-fig-128.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/UpperExtrem_ue-fig-128-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\">Figure 128<\/span><\/span><\/p>\n<ul>\n<li><span style=\"color: #003366;\">\u00a0 lumbrical muscles [Figure 129].<\/span>\n<ul>\n<li><span style=\"color: #003366;\"><em>Function<\/em>: flexion of the MCP joints; extension of PIP and DIP joints II through to V.<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><span class=\"jce_caption\" style=\"display: inline-block; color: #003366;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-1123\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/UpperExtrem_ue-fig-129.jpg\" alt=\"\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/UpperExtrem_ue-fig-129.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/UpperExtrem_ue-fig-129-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\">Figure 129<\/span><\/span><\/p>\n<p><span style=\"color: #003366;\"><em>NB.<\/em> For selective tests of the following muscles, refer to the section &#8220;The Elbow&#8221;:<\/span><\/p>\n<ul>\n<li><span style=\"color: #003366;\">brachioradialis muscle<\/span><\/li>\n<li><span style=\"color: #003366;\">extensor digitorum muscle<\/span><\/li>\n<li><span style=\"color: #003366;\">extensor carpi radialis longus and brevis muscles<\/span><\/li>\n<li><span style=\"color: #003366;\">extensor carpi ulnaris muscle<\/span><\/li>\n<li><span style=\"color: #003366;\">flexor carpi radialis muscle<\/span><\/li>\n<li><span style=\"color: #003366;\">palmaris longus muscle<\/span><\/li>\n<li><span style=\"color: #003366;\">flexor digitorum profundus and superficialis muscles<\/span><\/li>\n<li><span style=\"color: #003366;\">flexor carpi ulnaris muscle.<\/span><\/li>\n<\/ul>\n<p><span style=\"color: #003366;\">For the examination of muscle strength, refer to &#8220;The Neurological Examination, and for the vascular examination, refer to &#8220;The Cardiovascular Examination&#8221;.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Procedure The patient sits with lower arms resting on a table and the elbows in 90\u00b0 flexion. Examine the muscles by allowing them to be tensed isometrically (without movement). During this, offer resistance (white arrow on photos) to the force elicited by the patient (black arrow on photos) in response to a request to initiate [&hellip;]<\/p>\n","protected":false},"author":83,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[64],"tags":[141],"class_list":["post-1124","post","type-post","status-publish","format-standard","hentry","category-the-wrist-and-the-hand","tag-the-examination-of-the-upper-extremities"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Muscle Tests - Qpercom | Skills in Medicine<\/title>\n<meta name=\"description\" content=\"Online Mock OSCEs with examiners, patient actors, instant results and personalised feedback. 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