Kinesiology Perspectives in Occupational Therapy - Lecture Notes Table

Muscle & Action Origin & Insertion Innervation Serratus Anterior O: Ribs 1-9 I: Anterior surface on Medial border of Scapula Long Thoracic Nerve (C5,6,7) O: External Occipital Protuberance, Superior nuchal line of occiput, Nuchal ligament, Spinous process of C7 I: Lateral 1/3 of clavicle & acromion process of scapula O: Spinous processes of T1-T5 I: Acromion Process & Spine of Scapula MotorAccessory Nerve O: Spinous processes of T6T12 I: Tubercle at root of scapula spine medially MotorAccessory Nerve Upward Rotation Protraction Upper Trapezius Elevation Retraction Upward Rotation Middle Trapezius Retraction Upward Rotation Lower Trapezius Depression Retraction Rhomboids Retraction Downward Rotation SensoryC3-C4 MotorAccessory Nerve SensoryC3-C4 SensoryC3-C4 O: Spinous Dorsal processes of C7-T5 Scapular I: Medial Border Nerve (C5) of Scapula from spine to inferior Standard Position (3/fair) Complete motion Arm at side, thumb up, move into 120⁰ of scaption while stabilizing opposing scapula 5/Normal 4/Good Add Add Resistance Resistance With arm in 120⁰ of scaption, place hand on inferior angle of scapula with thumb on lateral border, place other hand on distal forearm. Apply 25% resistance to forearm, and 75% resistance to scapula In extend/rotated/ head to shoulder position, with flat hands apply 25% resistance towards flexion to back of head and 75% resistance towards depression to distal clavicle/acromion process 2/Poor Lessen Gravity Prone, abduct arm to 90⁰ with thumb up, extend to bring arm towards ceiling. Stabilize opposing scapula. In prone, 90⁰ abducted position with thumb towards ceiling and shoulder extended, apply pressure to distal forearm (These muscles are weak, not much pressure is needed) Prone, abduct arm in scaption plane to 120⁰ with thumb up, extend to bring arm towards ceiling. Stabilize opposing scapula. In prone, 120⁰ scaption/abducted position with thumb towards ceiling and shoulder extended, apply pressure to distal forearm (These muscles are weak, not much pressure is needed) Prone, abduct arm to 90⁰ with thumb down, extend to bring arm towards ceiling. Stabilize opposing In prone, 90⁰ abducted position with thumb down towards floor and shoulder extended, apply increasing pressure to distal forearm (These muscles are Prone, in 90⁰ abducted position with thumb up, therapist takes weight of arm and asks pt to extend arm towards ceiling, look for retraction motion of scapula Prone, in 120⁰ abducted position with thumb up, therapist takes the weight of the arm and asks pt to extend arm towards ceiling, look for depression motion of scapula Prone, in 90⁰ abducted position with thumb down, therapist takes weight of arm and asks pt to Rotate & extend head opposite of muscle you are testing. Bring back of head and opposite shoulder together, while stabilizing opposing trapezius. Take weight of arm and prompt pt to relax. Assist with moving into 120⁰ of scaption and watch inferior angle of scapula for motion. Prone relax arms at side, cup under anterior shoulder for support, support weight of arm distally, ask pt to shrug shoulder & look for elevation 1/Trace Lessen Gravity and Palpate If no motion when gravity lessened, palpate for muscle contraction at origin/ribs, under armpits If no elevation with gravity lessened, palpate for muscle contraction at cervical spinal level If no retraction with gravity lessened, palpate for muscle contraction between spine of scapula and spine while pt attempts extension motion. If no depression with gravity lessened, palpate for muscle contraction, start by laying hand at inferior angle and moving medially, while pt attempts extension motion. If no retraction with gravity lessened, palpate for muscle contraction by coming off spine of scapula