Shoulder Flexion MMT 4/5
Follow-up Question: How would you perform the shoulder flexion MMT in a gravity eliminated position?
Name the MMT and grade being performed
Scapular elevation; 3/5
If a patient could not perform full AROM against gravity, what would his/her highest MMT possibly be?
2
Other accepted answers: 2+/3-
John suffered an acute shoulder injury when dunking on Columbia Faculty who shall not be named. On assessment he was able to actively move through full AROM into shoulder flexion, but could not tolerate even the smallest amount of resistance. What is his shoulder flexion MMT score?
3
Name the Scapular adductors (looking for 2)
rhomboids and mid trap
Shoulder Extension MMT 3/5
Follow-up Question: Name 3 ADLs that require shoulder extension.
Name the MMT and grade being performed
Scapular Abduction/Upward Rotation; 4/5
Where in the range should you apply resistance when performing an MMT to a 2 joint muscle?
Mid-Range
Cody was hypnotized into thinking he was a bird and flapped his wings for 24 hours straight. He now presents with a strain to his supraspinatus. When testing his shoulder abduction MMT, name 3 compensations you may see.
Scapular elevation
Hip hike
Lateral Trunk Lean
What two muscles are tested with a shoulder flexion MMT?
Deltoid (anterior fibers)
Coracobrachialis
Assess for Pec Minor Tightness
Follow-up Question: What ROM limitations might you see in the shoulder if one had pec minor tightness?
The therapist will demonstrate performing Shoulder Flexion/Abduction/External Rotation MMTs. What could the therapist have done better?
Less position changes
Name 3 precautions for performing an MMT (5 in your slides)
Open Wound
ICU with multiple lines
Fatigue
Pain
Dx that forbids resistance
Martin asks you a question in anatomy about the vascular structures in the hands, knowing you haven't gotten there in lab yet. He notices that you struggle to shrug your shoulders in an attempt to gesture "IDK". What nerve may be affected?
Spinal Accessory nerve
Your patient is extremely weak when performing an MMT for scapular abduction/upward elevation. What nerve may be affected? WE WANT THE ROOTS TOO
Long thoracic nerve C5-C7
Shoulder External Rotation MMT 4/5
Follow-up Question: What if you had a patient who presents with cardiac issues? How else can you perform this MMT?
Name the muscles being tested. (4)
Pec Major, Subscapularis, Lats, Teres Major
Name 3 shoulder MMTs that are tested in prone. (There are 5)
Scapular adduction
Scapular depression/adduction
Extension
Horizontal abduction
Internal/External Rotation (5,4,3)
Your patient has excruciating pain bringing and maintaining her arm in shoulder flexion to test the strength of the serratus anterior muscle. What alternate position can you test this muscle without using so much anterior deltoid?
Supine with UE elevated to 90° with elbow in extension.
You sustain an injury to the C5 nerve root. Which of the following muscles would NOT be affected?
Deltoid Subscapularis
Lats Rhomboid Major
Lats (C6-8)
Scapular Downward Rotation and Adduction MMT 5/5
Follow-up Question: The Mid trap and rhomboids are both muscle that work to adduct the scapula. How can you differentiate the two with muscle testing?
Name the muscle being tested. Then name 3 things that the therapist/patient did incorrectly.
Muscle: Low trap
Therapist: dirty lever / not stabilizing/palpating
Patient: Upper trap compensation
Where is the stabilizing hand AND resistance hand placed when performing a shoulder abduction/upward elevation MMT? In what direction is the resistance given?
Inferior angle of scapula
Above Elbow
Downward rotation
The therapist is performing a shoulder abduction MMT. Name two things the therapist is doing incorrectly, and one way the patient is positioned incorrectly.
Therapist: dirty lever, Not checking face of pt, maybe not stabilizing?
Patient: shoulder elevation compensation, lateral trunk lean, thumb down.
Name 2 muscles tested with shoulder extension MMT and the nerves that innervate them. GO
Lats - thoracodorsal nerve
Teres Major - subscapular nerve
Posterior deltoid - axillary