BRACHIAL & ELBOW REGION
PTHY 6401 KINESIOLOGY I LAB - 2015
I.
Palpation
Medial Epicondyle & Supracondylar Ridge
Wrist Flexor Muscle bellies
(know the order & location of superficial group)
Medial Collateral Ligament
Lateral Epicondyle & Supracondylar Ridge
Wrist Extensor Muscle bellies
(know the order & location of superficial group)
Lateral Collateral Ligament
Radial Head
Olecranon Bursa
Olecranon Process
Olecranon Fossa
Ulnar Nerve
Radial Styloid Process
Ulnar border
Ulnar Head
Ulnar Styloid Process
Triceps brachii
Anconeus
Biceps brachii
Brachialis
Brachioradialis
Pronator Teres
Cubital Fossa
Biceps Tendon
Brachial Artery (Pulse)
Median Nerve
The following examination skills will be compiled together with the palpation practical skills.
UE and LE Anthropometric Measures (see attached handout). Upper arm, elbow, forearm,
thigh, knee, low leg, ankle, leg length
UE & LE Deep Tendon Reflexes [aka: monosynaptic stretch reflex]
1.
2.
3.
4.
5.
Biceps (C5)
Brachioradialis (C6)
Triceps (C7)
Quadriceps Reflex (L3 - 4)
Achilles Reflex (S1 - 2)
Grading scales for reflex integrity: With such a varying & subjective range of normal, a bilateral comparison
is of great importance. Acceptable Scales:
 Absent, Diminished (Hyporeactive), Normal, Hypereactive
 0, 1+, 2+, 3+, 4+ scale; with 1+, 2+, 3+ being normal unless asymmetric
 (0) , (-) , (+) , (++); with (+) representing the range of normal
II.
AROM Measurement
Reese &
Bandy
Movement
Body Position
Axis
Stationary
Arm
Moving Arm
Normal
ROM
86
Elbow
Flexion
Supine; anatomical
position (towel roll)
Lateral
Epicondyle
Acromion
(arm midline)
Radial Styloid
0-140
88
Elbow
Extension
Supine; anatomical
position (towel roll)
Lateral
Epicondyle
Acromion
(arm midline)
Radial Styloid
0
NOTE on Flexion/Extension: What alignment should be used at the forearm if the
patient cannot fully supinate?
90
Forearm
Supination
Seated, elbow flex
90; forearm neutral
in line with ulnar
styloid
Parallel w/
Humerus midline
Anterior-distal
Forearm in line
with styloid
0-80
92
Forearm
Pronation
Seated, elbow flex
90; forearm neutral
in line with ulnar
styloid
Parallel w/
Humerus midline
Posterior-distal
Forearm in line
with styloid
0-80
MUSCLE LENGTH TESTING
Reese
Muscle Tested
& Bandy
III.
154
Triceps
156
Biceps
Body Position
Movement
Seated, shoulder full flexion;
Passive OR Active
elbow extended, forearm
elbow flexion
supinated or neutral
Supine, elbow extended,
forearm pronated
PROM OR Active
shoulder extension
Measurement
Options
Goniometry of
elbow flexion
Can also be done
in supine
Goniometry of
shoulder extension
Manual Muscle Testing
see text for recommendations on stabilization and location of resistance
Movement
Muscle(s) Tested
Gravity Resisted Position
Gravity Elim Position
95
Elbow FlexionSupinated
Biceps
Brachialis
Seated, UE anatomical position
(supinated)
Seated-shoulder abd 90
elbow extended, forearm
supinated (supported)
99
Elbow Flexionpronated
Brachialis
Same except forearm pronated
Same except forearm
pronated
Reese
NOTE: An Elbow Flexion-Forearm Neutral MMT is not recommended by Reese b/c Brachialis and
Brachioradialis appear to be very active in both neutral and pronated positions.
103
Elbow Extension
107
Forearm
Supination
111
Forearm
Pronation
Triceps
Anconeus
Supine-shoulder flexed 90°,
elbow flexed, forearm supinated
Seated-shoulder abd 90
elbow flexed, forearm
supinated (supported)
Supinator
Biceps
Seated-elbow flexed 90°,
forearm pronated
Seated-shoulder flex 90
elbow flex 90°, forearm
pronated (supported)
Pronator Teres,
Pronator Quadratus
Seated-elbow flexed 90°,
forearm supinated
Seated-shoulder flex 90
elbow flex 90°, forearm
supinated (supported)
HANDHELD DYNAMOMETRY
Movement
Reese
Body Position
Placement
Stabilization
465
Elbow FlexionSupinated
Seated-shoulder abd 90
elbow flex 90°, forearm supinated
(supported)
Anterior Distal Forearm
Ipsilateral Shoulder
467
Elbow Extension
Seated-shoulder abd 90
elbow flex 10°, forearm supinated
(supported)
Posterior Distal Forearm
Ipsilateral Shoulder
Plain Film Radiology of the Upper Arm & Elbow Girdle Region:
Humerus: AP view & Lateral view (usually w/ elbow flexed 90°and humerus in ext rotation)
Elbow: AP, Lateral (elbow at 90°) and Oblique views