Quick reference dictionary for athletic training part 2

Lateral Hamstrings: Biceps Femoris Patient positioning: Prone with knee flexed approx 50 degrees, hip externally rotated and tibia externally rotated.. Examiner positioning: Grasp distal

n total sample size

N total population size

␮ micron (former term for micrometer)

␲ pi, 3.1416, ratio of circumference of a circle to its diameter

公 root, square root, radical

+ plus, excess, positive

– minus, deficiency, negative

± plus or minus, indefinite

> greater than or equal to

< less than or equal to

: ratio, “is to”

:: equality between ratios, “as”

▼ depression, downward, caudal

▲ elevation, upward, cephalic

  outward, expand

anterior:front, ventral

anteroposterior: front to back

caudal:toward the tail (or feet)

cephalad: toward the head

cranial:relating to the head

decubitus:lying down

deep:underneath, further from the surface

distal:further from the beginning, further from the trunk

dorsal:back, posterior

horizontal:parallel to the floor, perpendicular to a vertical line

inferior:below, lower than

lateral:toward the side of the body

medial:toward the midline of the body

posterior:back, dorsal

posteroanterior:from back to front

pronation:internal rotation of the forearm so as to place the palm down

prone:with the front or ventral surface down, lying face down

proximal:closer toward the beginning, closer to the trunk

recumbent:lying down

sagittal:A vertical plane passing through the body from front to back The midsagittal plane divides the body into left and right halves

superficial:on top, near the surface, shallow

supine:with the back or dorsal surface downward, lying face up

transverse:a horizontal plane (parallel to the ground) passing through the body

ventral:front, anterior

vertical:upright, perpendicular to horizontal

APPENDIX 5

Muscles—Origin, Insertion, Action

Figure 1 Anterior superficial muscles (reprinted with permission

from Leonard P Quick and Easy Terminology 2nd ed Philadelphia,

Pa: WB Saunders; 1995)

Figure 2.Anterior deep muscles (reprinted with permission from

Leonard P Quick and Easy Terminology 2nd ed Philadelphia, Pa:

WB Saunders; 1995)

Figure 3.Posterior superficial muscles (reprinted with permission

from Leonard P Quick and Easy Terminology 2nd ed Philadelphia,

Pa: WB Saunders; 1995)

Figure 4.Posterior deep muscles (reprinted with permission from

Leonard, P Quick and Easy Terminology 2nd ed Philadelphia, Pa:

WB Saunders; 1995)

T12 & lumbar vertebrae; supraspinal ligament to lip of iliac cr

Lat head: post surface of

Pr

Hip Psoas Major

lumbar spine; sides and corr

Sartorius

Adductor Longus

Leg/Foot Extensor Hallucis

Flexor Digitor

of femur; capsule of knee; Long head:

adjacent part of femur; capsule of knee

APPENDIX 6

Manual Muscle Testing

This section provides an overview of muscle testing procedures for the major muscle groups of the extremities Origin, insertion, action, and nerve innervation are provided in the previous appen-

dix When picture angle allows, an arrow depicts

direc-tion of patient's movement.

Hip, Thigh, Knee

Iliopsoas

abducted and flexed

extension and abduction direction

Patient positioning: Seated with hip and knee flexed to 90

degrees

stabi-lization This is accomplished by moving the lower leg

lateral-ly thereby internallateral-ly rotating the thigh at the hip

Examiner positioning: Applies pressure to the lateral aspect of

the distal lower leg in a medial (adduction) direction while thepatient resists motion

Examiner stabilization: Stabilizes the leg medially at the knee.

Internal Rotators: Tensor Fascia Latae, Gluteus Medius

External Rotators: Obturators, Piriformis, Gemelli,

Quadratus Femoris

degrees

Patient action: Externally rotates hip against examiner

stabiliza-tion This is accomplished by moving the lower leg mediallythereby externally rotating the thigh at the hip

the distal lower leg in a lateral (abduction) direction while thepatient resists motion

Examiner stabilization: Stabilizes the leg laterally at the knee.

Adductor Longus, Adductor Magnus, Adductor Brevis

Patient action: Hip adduction.

Examiner positioning: Passively abduct upper leg Stabilize

lower bottom leg to table and resist patient's attempt to adductupper leg back toward table

Examiner stabilization: Stabilize legs just proximal to the

knee

Lateral Hamstrings: Biceps Femoris

Patient positioning: Prone with knee flexed approx 50 degrees,

hip externally rotated and tibia externally rotated

Patient action: Knee flexion.

Examiner positioning: Grasp distal lower leg maintaining

exter-nal tibial rotation and resist patient's knee flexion

Examiner stabilization: Usually not necessary If patient's hip

flexes and pelvis comes off the table, stabilize pelvis by applyingpressure over the PSIS

Medial Hamstrings: Semimembranosus, Semitendinosus

hip internally rotated and tibia internally rotated

Patient action: Knee flexion.

tibial rotation and resist patient's knee flexion

Examiner stabilization: Usually not necessary If patient's hip

flexes and pelvis comes off the table, stabilize pelvis by applyingpressure over the PSIS

Gluteus Maximus

Patient positioning: Prone with knee flexed to at least 90

degrees

Patient action: Hip extension with knee flexed.

Examiner positioning: Applies pressure to the distal thigh in

a downward (flexion) direction

Examiner stabilization: Stabilize the pelvis to the table at the

PSIS

Gluteus Medius

Patient positioning: Side-lying with hip abducted and

inter-nally rotated Bottom leg is positioned with knee and hipflexed

Examiner positioning: Applies pressure at lateral knee in a

downward (adduction) direction

Examiner stabilization: Stabilize trunk at the iliac crest.

Gluteus Minimus

rotated, knee extended Bottom leg is positioned with knee andhip flexed

Patient action: Resist examiner's attempt to adduct thigh Examiner positioning: Applies pressure at lateral knee in a down-

ward (adduction) direction

Examiner stabilization: Stabilize trunk at the iliac crest.

Tensor Fasciae Lata

Patient positioning: A position in-between supine and side-lying

with hip flexed and abducted and internally rotated, knee

extend-ed Bottom leg is positioned with knee and hip flexextend-ed

diagonal-ly in adduction and extension directions

Examiner stabilization: Stabilize trunk at the iliac crest.

Sartorius

externally rotated, knee flexed approximately 80 degrees

Patient action: Combined motions of flexion, abduction,

external rotation while flexing knee

com-bined movements of hip flexion, abduction, and external tion while simultaneously resisting knee flexion

distal thigh just above the knee and at the distal end of thelower leg by grasping the ankle

Rectus Femoris (as hip flexor)

Examiner positioning: Applies pressure to the distal thigh

just above the knee resisting hip flexion

Examiner stabilization: Stabilize the trunk at the shoulder.

Rectus Femoris (as knee extensor)

(legs hanging over edge of table)

Patient action: Knee extension.

Examiner positioning: Applies pressure to the distal lower leg

resisting patient's knee joint extension

Examiner stabilization: n/a

Vastus Lateralis, Vastus Medialis, Vastus Intermedius

degrees (legs hanging over table)

Patient action: Knee extension.

Examiner positioning: Applies pressure over distal lower leg

resisting patient's knee joint extension

Examiner stabilization: n/a

Lower Leg, Ankle, Foot

Gastrocnemius

of the foot near metatarsal heads resisting patient's plantarflexion

Examiner stabilization: Stabilizes foot by grasping the

calca-neus; patient may grasp table for support

Tibialis Posterior

table with foot everted

Examiner positioning: Grasps medial aspect of foot and

resists patient's plantar flexion/inversion

of the foot near metatarsal heads resisting patient's plantarflexion

Examiner stabilization: Stabilizes lower leg

Soleus

Peroneus Longus, Peroneus Brevis

with foot inverted

patient's plantar flexion/eversion

Examiner stabilization: Stabilizes lower leg.

Peroneus Tertius

Patient positioning: Seated with leg hanging over edge of table

with foot inverted

Patient action: Dorsiflexion/eversion.

Examiner positioning: Grasps lateral aspect of foot and resists

patient's dorsiflexion/eversion

Tibialis Anterior

Patient positioning: Seated with leg hanging over edge of table

with foot inverted

patient's dorsiflexion/inversion

Extensor Digitorum Longus

flexed

Patient action: Extension of the four lateral toes.

the four lateral toes in a flexion direction

plantar flexion

Extensor Hallucis Longus

Patient positioning: Seated or supine with foot in neutral and

great toe extended

Examiner positioning: Applies pressure to the dorsal aspect

of great toe to attempting to move toe into flexion

Examiner stabilization: Stabilize foot at the calcaneus in

neu-tral position

Flexor Digitorum Longus

four lateral toes

Flexor Hallucis Longus

Patient positioning: Supine.

Patient action: Flexion of great toe.

great toe

Examiner stabilization: Stabilize forefoot.

Patient positioning:Seated or supine with elbow fully flexed andshoulder flexed to approx 80 degrees.

Examiner positioning: Applies pressure at mid-bicep resisting

shoulder flexion

seated

Deltoid (anterior)

abducted to 90 degrees, elbow flexed to 90 degrees

Examiner positioning: Applies pressure to the distal humerus

resisting patient's horizontal adduction

apply-ing pressure over the shoulder joint

Shoulder, Shoulder Girdle

Coracobrachialis

Deltoid (middle)

abducted to approximately 70 degrees, elbow flexed to 90 degrees

resisting patient's abduction

Deltoid (posterior)

abducted to 90 degrees, elbow flexed to 90 degrees

Patient action: Horizontal abduction.

resisting patient's horizontal abduction

Examiner stabilization: Stabilizes the trunk to the table by

apply-ing pressure over the shoulder joint

Pectoralis Major

Patient positioning: Supine with shoulder internally rotated and

flexed to 90 degrees, elbow extended

Patient action: Horizontal flexion for upper fibers, diagonally

toward opposite hip for lower fibers

Examiner positioning: Grasp arm distal to the elbow and resist

patient's horizontal or diagonal movement

pres-sure to the opposite shoulder when testing the upper fibers andpressure to the opposite hip when testing the lower fibers

Pectoralis Minor

Patient action: Protraction.

Examiner positioning: Apply pressure to the anterior aspect of

the shoulders resisting patient's protraction

Serratus Anterior

rotated, flexed approximately 125 degrees, and abductedapproximately 45 degrees

Examiner positioning: Applies downward (extension) force

to the upper arm proximal to the elbow Palpate for patient'sinability to stabilized the scapula

bor-der of the scapula to track the movement of the scapula

Subscapularis, Pectoralis Major, Teres Major, Latissimus Dorsi (internal rotators)

Patient positioning: Supine with humerus at the patient's side,

elbow flexed to 90 degrees

Patient action: Internal rotation of the shoulder joint.

side of the patient's arm near the wrist resisting internal shoulderrotation

patient's body

Teres Major

Patient positioning: Prone with back of hand on posterior iliac

crest creating an internally rotated position

inter-nally rotated

patient's extension and adduction

Examiner stabilization: Stabilize trunk to table by applying

pres-sure to the shoulder girdle

Teres Minor, Infraspinatus (external rotators)

elbow flexed to 90 degrees

Patient action: External rotation of the shoulder joint.

Examiner positioning: Applies pressure distally to the dorsal side

of the patient's arm near the wrist resisting external shoulder tion

rota-Examiner stabilization: Stabilize the elbow medially at the side of

the patient's body

Latissimus Dorsi

neutral, abducted approximately 30 degrees, and internally ed

rotat-Patient action: Shoulder joint adduction.

Examiner positioning: Grasps forearm distally and resists

patient's adduction

Examiner stabilization: Stabilize trunk by applying pressure to

the sacrum

Levator Scapulae

Patient action: Shoulder girdle elevation while retracted Examiner positioning: Applies pressure to the superior aspect

of the shoulder joint over the acromion process and resistspatient's elevation of shoulder girdle

shoulder to keep patient from laterally flexing at the trunk

Upper Trapezius

abducted to 90 degrees upward rotated shoulder girdle, and headextended and laterally flexed toward shoulder

Patient action: Shoulder girdle upward rotation.

aspect of the shoulder and attempts to "pry" apart

Examiner stabilization: Stabilize the head.

Lower Trapezius

abducted approximately 130 degrees

Patient action: Flexion, abduction of the shoulder: resist

examin-er's attempt to move arm in a downward direction

above the wrist in a downward direction Observe patient's la

scapu-Examiner stabilization: Not necessary.

Patient positioning:Prone with shoulder abducted to 90 degrees.The shoulder is positioned in external rotation for middle trapez-ius and internal rotation for rhomboids.

downward direction (ie, toward floor)

shoul-der

Rhomboids, Middle Trapezius

Patient positioning: Forearm pronated, elbow nearly extended,

loosely closed fist Performed with elbow flexed for brevis

extension and radial deviation

Examiner stabilization: Stabilizes forearm distally.

Extensor Carpi Ulnaris

loosely closed fist

Examiner positioning: Grasps wrist and applies pressure to resist

extension and ulnar deviation

Elbow, Forearm, Wrist

Extensor Carpi Radialis Longus and Brevis

Flexor Carpi Radialis

Patient positioning: Forearm supinated, elbow 90 degrees or

greater, wrist in slight ulnar deviation

Patient action: Flexes and radial deviates.

Examiner positioning: Grasps hand and applies pressure to

resist flexion and radial deviation

Flexor Carpi Ulnaris

Patient positioning: Forearm supinated, elbow 90 degrees or

greater, wrist in slight radial deviation

Patient action: Flexes and ulnar deviates.

Examiner positioning: Grasps hand and applies pressure to

resist flexion and ulnar deviation

Examiner stabilization: Stabilizes forearm distally.

Pronator Quadratus

fore-arm in neutral position

pronation

body

Pronator Teres

degrees, forearm in neutral position

pronation

body

Supinator

fore-arm in neutral position

Examiner positioning: Grasps patient's wrist and resists patient's

supination

Examiner stabilization: Stabilizes elbow.

Biceps Brachii

Patient positioning: Elbow flexed to approximately 100 degrees,

forearm supinated, elbow resting in examiner’s hand

Patient action: Elbow flexion while supinated.

Examiner positioning: Applies pressure to the distal forearm

resisting patient elbow flexion

Examiner stabilization: Stabilizes upper arm at the elbow.

Brachialis

forearm pronated, elbow resting in examiner’s hand

Patient action: Elbow flexion while pronated.

resisting patient elbow flexion

Brachioradialis

Patient positioning: Elbow flexed to approximately 100 degrees,

forearm in neutral position, elbow resting in examiner’s hand

Patient action: Elbow flexion, neutral forearm position.

resisting patient elbow flexion

Examiner stabilization: Stabilizes upper arm at the elbow.

forearm in neutral position

Patient action: Extends elbow.

and resists patient elbow extension

body and against table