COMPS MMT

Question 1

Cervical spine flexion

Answer 1

Passively assess cervical spine flexion range of motion
Encourage patient to flex cervical spine to end of range of motion
Palpate cervical flexors
Apply resistance through the forehead

Rectus capitis anterior/lateralis, Longus capitis, Sternocleidomastoid, Longus colli, Scalenus anterior

Question 2

cervical spine extension

Answer 2

• pt prone
  Passively assess cervical spine extension range of motion
  Encourage patient to extend cervical spine
  Palpate cervical extensors
  Apply resistance through the base of cranium

Question 3

SCM

Answer 3

-pt supine
Passively assess cervical spine lateral flexion from a contralaterally rotated position
Encourage patient to laterally flex from the contralaterally rotated position
Palpate Sternocleidomastoid
Apply resistance through the forehead

Question 4

trunk flexion- rectus abdominis

Answer 4

Passively assess full trunk flexion range of motion until bilateral inferior angles clear table
Encourage patient to flex trunk until bilateral inferior angles clear table
Palpate trunk flexors
Repeat with various arm positions if patient is unable to perform motion from original starting position
-PT should Maintaining lower extremity and pelvic stability

• look for patient clearing inferior angle of scap
  5- hands behind head
  4- arms crossed on chest
  3- arms at side slide them down
  2- arms at side partially come up can clear scap
  1- arms at side patient cant lift shoulder w/ activity
  0- no motion

Question 5

trunk extension- erector spinae

Answer 5

stabilze The posterior, mid-thighs
Cues
Passively assess full trunk extension range of motion until sternum clears the table
Encourage patient to extend trunk until sternum clears the table
Palpate trunk extensors
Repeat with various arm positions if patient is unable to perform motion from original starting position

5- arms behind head- clear xiphoid
4- arms behind on lowr back
3- arms at side clear xyphoid
2- arm at side partially come up
1- little movement yes palpation
0- no motion

Question 6

Pelvic elevation

Answer 6

• supine
  Passively assess pelivc elevation range of motion
  Encourage patient to elevate pelvis to end of range of motion
  Palpate quadratus lumborum
  Apply resistance by pulling on the ipsilateral leg proximal to the malleoli in an inferior direction
  5- no breaking
  4- slight breaking but patient can still maintain resistance
  3 -breaks quite easily
  2- pt cannot elevate the pelvis fully
  1- palpate contraction but no movement
  0- no contrcation

Question 7

Hip flexion with gravity

Answer 7

-pt seated
- Stabilization
Ipsilateral iliac crest
Cues
Passively assess full hip flexion range of motion
Encourage patient to flex hip through the full range of motion
Palpate iliacus and psoas muscles
Apply resistance at anterior distal femur into hip extension

Question 8

hip flexion GE

Answer 8

-sidelying with test limb on bottom
- facing away from you
- Stabilization
Support upper non-test limb, holding underneath the knee and lower leg
Cues
Passively assess hip flexion range of motion
Encourage patient to flex hip through the full range of motion
Palpation is difficult due to muscle location depth

Question 9

hip extension against gravity

Answer 9

• prone
• Stabilization
  Ipsilateral posterior iliac crest of the pelvis
  Cues
  Passively assess full hip extension range of motion, keeping knee extended
  Encourage patient to extend hip through the full range of motion, keeping knee extended
  Palpate gluteus maximus and hamstrings
  Apply resistance at posterior distal femur into hip flexion, keeping knee extended

Question 10

hip extension GE

Answer 10

• side lying, facing therapist
• Stabilization
  Support upper non-test limb, holding underneath the inner thigh, knee and lower leg
  Cues
  Passively assess hip extension range of motion
  Encourage patient to extend hip through the full range of motion
  Palpate gluteus maximus and hamstrings

Question 11

hip abduction against gravity

Answer 11

-Stabilization
Non testing limb is flexed at the hip and knee to provide stability
Tester stabilizes at the ipsilateral iliac crest of the limb being tested
Cues
Passively assess hip abduction range of motion
Encourage patient to abduct hip through the full range of motion
Palpate gluteus medius, just superior to greater trochanter
Apply resistance at lateral distal femur into hip adduction

Question 12

hip abduction GE

Answer 12

• pt supine
  Stabilization
  Ipsilateral lateral pelvis
  Cues
  Passively assess hip abduction range of motion
  Encourage patient to abduct hip through the full range of motion
  Palpate gluteus medius, just superior to greater trochanter

Question 13

hip adduction against gravity

Answer 13

• side lying test limb on bottom
• tabilization
  Support non-test limb on top underneath the inner thigh, medial knee and lower leg
  Non tested knee in 60-90 degrees of flexion
  Non tested hip maintained in 25-30 degrees of abduction
  Cues
  Passively assess hip adduction range of motion
  Encourage patient to adduct hip through the full range of motion
  Palpate adductor muscle group
  Apply resistance at medial distal femur into hip abduction

Question 14

hip adduction GE

Answer 14

• Supine
• Stabilization
  Ipsilateral lateral pelvis
  Cues
  Passively assess hip adduction range of motion
  Encourage patient to adduct hip through the full range of motion
  Palpate adductor muscle group

Question 15

hip IR against gravity

Answer 15

• Tensor fascia lata, Gluteus minimus/medius
  -seated
• Stabilization
  Ipsilateral iliac crest
  In a seated position, patient’s body weight stabilizes the pelvis
  Cues
  Passively assess full hip internal range of motion
  Encourage patient to internally rotate hip through the full range of motion
  Palpate the tensor fasciae latae and gluteus medium muscles
  Apply resistance on the lateral surface of the tibia proximal to the ankle into hip external rotation

Question 16

Hip IR GE

Answer 16

• supine
  Stabilization
  Ipsilateral pelvis
  Cues
  Passively assess full hip internal range of motion
  Encourage patient to internally rotate hip through the full range of motion
  Palpate anterior gluteus medius and tensor fascia lata

Question 17

Hip ER against gravity

Answer 17

Piriformis, Gemellus superior/inferior, Obturator internus/externus, Quadratus femoris
- Stabilization
In a seated position, patient’s body weight stabilizes the pelvis
Cues
Passively assess full hip external range of motion
Encourage patient to externally rotate hip through the full range of motion
Palpation is difficult due to muscle depth, piriformis can be palpated between the posterior aspect of the pelvis and the grater trochanter
Apply resistance at anterolateral distal femur and medial distal tibia into hip internal rotation

Question 18

sartorius

Answer 18

Stabilization
Ipsilateral iliac crest, allowing for hip flexion, but preventing elevation of the pelvis
Once patient is positioned, utilize both hands for applying resistance and maintaining alignment
Cues
Passively assess combined motions of hip flexion, abduction, and external rotation
Encourage patient to slide heel of test limb up the contralateral tibia through the full range of the combined motions
Palpate sartorius
Apply resistance at anterolateral distal femur and medial distal tibia

Question 19

Knee flexion

Answer 19

• prone
• Stabilization
  Ipsilateral iliac crest (gluteus maximus), allowing for hamstring contraction, but preventing elevation of the pelvis
  Once patient is positioned, utilize a weight shift when applying resistance and maintain alignment of the testing extremity
  Cues
  Passively assess available knee flexion motion of hip flexion
  Encourage patient to lift heel towards the buttocks
  Palpate medial and lateral hamstring tendons
  Apply resistance through the posterior aspect of the mid-tibia into knee extension

-GE sidelying facing you

Question 20

knee extension

Answer 20

• Stabilization
  Ipsilateral iliac crest
  Cues
  Passively assess full knee extension range of motion
  Encourage patient to extend knee through the full range of motion
  Palpation should be performed directly over the anterior thigh (Quadriceps)
  Apply resistance over the anterior, mid-tibia into knee flexion

Question 21

shoulder flexion antigravity

Answer 21

anterior delt, coracobrachialis
stabilization
Superior aspect of the ipsilateral shoulder
Cues
Passively assess shoulder flexion range of motion
Encourage patient to flex shoulder to end of range of motion
Palpate anterior deltoid
Bring shoulder down to 90 degrees of flexion
Apply resistance proximal to the elbow

Question 22

shoulder extension

Answer 22

lats, post delt, teres major
Stabilization
Ipsilateral border of the scapula staying off of the spinous processes
Cues
Passively assess shoulder extension range of motion
Encourage patient to extend shoulder to end of range of motion
Palpate latissimus dorsi and teres major
Apply resistance to distal humerus

Question 23

shoulder abduction

Answer 23

middle deltoid, supraspinatus
Stabilization
Ipsilateral superior border of the scapula
Cues
Passively assess shoulder abduction range of motion
Encourage patient to abduct shoulder to end of range of motion
Palpate the middle deltoid
Bring shoulder down to 90 degrees of abduction
Apply resistance to distal humerus

Question 24

shoulder horizontal abduction

Answer 24

- post delt
Stabilization
Ipsilateral scapula
Cues
Passively assess shoulder horizontal abduction to end range of motion
Encourage patient to horizontally abduct shoulder to end range of motion
Palpate posterior deltoid
Apply resistance on distal humerus

Question 25

shoulder horizontal adduction

Answer 25

- pec major Stabilization Ipsilateral shoulder on the distal 1/3 of the clavicle Cues Passively assess shoulder horizontal adduction to end range of motion Encourage patient to horizontally adduct shoulder to end range of motion Palpate anterior deltoid Apply resistance through distal humerus

Question 26

shoulder IR

Answer 26

- subscap Stabilization Ipsilateral surface of the scapula Cues Passively assess shoulder internal rotation to end range of motion Encourage patient to internally rotate shoulder to end range of motion Palpate subscapularis in the axillary border Apply resistance proximal to the wrist

Question 27

shoulder ER

Answer 27

``` - infraspinatus, teres minor Stabilization Ipsilateral border of the scapula Cues Passively assess shoulder external rotation to end range of motion Encourage patient to externally rotate shoulder to end range of motion Palpate teres minor and infraspinatus Apply resistance proximal to the wrist ```

Question 28

scapular elevation antigravity

Answer 28

- upp trap and levator scapulae - seated tabilization Ipsilateral side of the head Cues Passively assess bilateral scapular elevation range of motion and strength Position patient to test individual upper trapezius with head turned to the contralateral side Encourage patient to elevate scapula to end of range of motion Palpate the upper trapezius muscle Apply resistance through the acromion towards the ground

Question 29

scapular elevation GE

Answer 29

- prone Cues Passively assess scapular elevation range of motion Encourage patient to elevate scapula to end of range of motion Palpate upper trapezius

Question 30

scapular adduction antigravity

Answer 30

Mid trap - prone Therapist Position Standing on contralateral side of testing limb Stabilization Place pressure over the contralateral thorax Cues Passively assess scapular adduction range of motion Encourage patient to adduct scapula to end of range of motion Palpate middle trapezius Apply resistance into abduction through the medial border of scapula

Question 31

scapular adduction GE

Answer 31

- sitting arm at 90 - Stabilization Prevent the patient from rotating the trunk during testing Cues With a towel under the arm, passively assess scapular adduction Encourage patient to adduct the scapula to end range of motion Palpate middle trapezius along the medial border of the scapula

Question 32

scapula add and depression

Answer 32

- lower trap - Prone with head turned to contralateral side Shoulder abducted 130 degrees Therapist Position Standing on contralateral side of testing limb Stabilization Contralateral thorax Cues Passively assess scapular adduction and depression range of motion Encourage patient to adduct and depress scapula to end of range of motion Palpate lower trapezius Apply resistance through the lateral surface of the scapula towards scapular abduction and elevation

Question 33

scapular adduction/ downward rotation

Answer 33

- rhomboid major and minor - prone - tabilization Contralateral thorax from the side you are testing Cues Passively assess scapular adduction and downward rotation range of motion Encourage patient to adduct and downwardly rotate scapula to end of range of motion with shoulder elevation Palpate rhomboids Apply resistance through the medial border of the scapula towards scapular abduction and upward rotation GE- sitting

Question 34

scapular adduction and upward rotation

Answer 34

-serratus ant - seated Stabilization Superior aspect of ipsilateral shoulder Cues Passively assess scapular abduction and upward rotation range of motion in 125-130 degrees shoulder flexion Encourage patient to abduct and upwardly rotate scapula to end of range of motion in 125 degrees shoulder flexion Palpate serratus anterior over lateral aspect of upper 8-9 ribs Apply resistance through inferior angle of scapula and above the elbow into adduction and downward rotation

Question 35

elbow flexion

Answer 35

- biceps - seated - Stabilization Superior acromion of the ipsilateral limb Cues Passively assess elbow flexion to end range of motion Encourage patient to flex elbow to end range of motion Palpate biceps brachii muscles Position elbow in 90 degrees of flexion Apply resistance through distal forearm into elbow extension For brachialis fully pronate the forearm and repeat steps 1-5 For brachioradialis place forearm between pronation and supination and repeat steps 1-5

Question 36

elbow extension

Answer 36

- supine elbow flexed to 90 shoulder 90 Stabilization Maintain humerus at 90 deg. by stabilizing the proximal, anterior aspect of the shoulder Cues Passively assess elbow extension to end range of motion Encourage patient to extend elbow to end range of motion Palpate tricep muscles Apply resistance through distal forearm into elbow flexion