Friday, February 8, 2008
Strength Testing
Muscle strength is rated on a scale of 0/5 to 5/5:
- 0/5: no contraction
- 1/5: muscle flicker, but no movement
- 2/5: movement through a full range of motion, but not against gravity (test the joint in its horizontal plane)
- 3/5: movement through a full range of motion, but not against resistance by the examiner
- 4/5: movement possible against some resistance by the examiner (sometimes this category is subdivided further into 4–/5, 4/5, and 4+/5)
- 5/5: normal strength
Detailed Hand Motor Testing
| Action | Muscles | Nerves | Nerve Roots |
|---|---|---|---|
| Finger extension | Extensor digitorum, Extensor indicis, Extensor digiti minimi | Radial nerve (posterior interosseous nerve) | C7, C8 |
| Thumb abduction in plane of palm | Abductor pollicis longus | Radial nerve (posterior interosseous nerve) | C7, C8 |
| Finger abduction | Dorsal interossei, Abductor digiti minimi | Ulnar nerve | C8, T1 |
| Finger and thumb adduction in plane of palm | Adductor pollicis, Palmar interossei | Ulnar nerve | C8, T1 |
| Thumb opposition | Opponens pollicis | Median nerve | C8, T1 |
| Thumb abduction perpendicular to plane of palm | Abductor pollicis brevis | Median nerve | C8, T1 |
| Flexion at distal interphalangeal joints digits 2, 3 | Flexor digitorum profundus to digits 2, 3 | Median nerve | C7, C8 |
| Flexion at distal interphalangeal joints digits 4, 5 | Flexor digitorum profundus to digits 4, 5 | Ulnar nerve | C7, C8 |
| Wrist flexion and hand abduction | Flexor carpi radialis | Median nerve | C6, C7 |
| Wrist flexion and hand adduction | Flexor carpi ulnaris | Ulnar nerve | C7, C8, T1 |
| Wrist extension and hand abduction | Extensor carpi radialis | Radial nerve | C5, C6 |
| Elbow flexion (with forearm supinated) | Biceps, Brachialis | Musculocutaneous nerve | C5, C6 |
| Elbow extension | Triceps | Radial nerve | C6, C7, C8 |
| Arm abduction at shoulder | Deltoid | Axillary nerve | C5, C6 |
Lower Extremity Strength Testing
Abnormal Lower Extremity Motor Exam
| Action | Muscles | Nerves | Nerve Roots |
|---|---|---|---|
| Hip flexion | Iliopsoas | Femoral nerve, and L1-L3 nerve roots | L1, L2, L3, L4 |
| Knee extension | Quadriceps | Femoral nerve | L2, L3, L4 |
| Knee flexion | Hamstrings (semitendinosus, semimembranosus, biceps femoris) | Sciatic nerve | L5, S1, S2 |
| Leg abduction | Gluteus medius, Gluteus minimus, Tensor fasciae latae | Superior gluteal nerve | L4, L5, S1 |
| Leg adduction | Obturator externus, Adductor longus, magnus, and brevis, Gracilis | Obturator nerve | L2, L3, L4 |
| Toe dorsiflexion | Extensor hallucis longus, Extensor digitorum longus | Deep peroneal nerve | L5, S1 |
| Foot dorsiflexion | Tibialis anterior | Deep peroneal nerve | L4, L5 |
| Foot plantar flexion | Triceps surae (gastrocnemius, soleus) | Tibial nerve | S1, S2 |
| Foot eversion | Peroneus longus, Peroneus brevis | Superficial peroneal nerve | L5, S1 |
| Foot inversion | Tibalis posterior | Tibal nerve | L4, L5 |
Global Strength Testing
Abnormal Global Strength Testing
1 Comment:
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