Movement

Trunk
Flexion
(0-80)

Trunk
Extension
(0-30)

Trunk
Rotation

Muscles
Rectus Abd. (B)Intercostal T7-12
O: Crest of Pubis
I: Xiphoid Proc., cartilage ribs 5-7
Ext. Oblique (B)Intercostal T8-12
O: iliac crest and linea alba
I: lat. side of ribs 4-12
Int. Oblique (B)Intercostal T8-12
O: Iliac crest, inguinal ligament
I: ribs 9-12, linea alba
Psoas Major (B)Femoral L2-3
O: lesser trochanter
I: transverse proc. T12-L5
QL (B)Ventral Rami T12-L3
O: crest of ilium
I: transverse proc. L1-4, rib 12
Erector Spinae (B)Dorsal rami of adj.
nerves
O: Common tendon, angle of ribs,
vert. of lower back
I: Angle of ribs and vertebrae of
higher level
Transversospinalis(B)Dorsal rami of
adj. nerves
O: tran. proc. Of lower vertebrae
I: Spinous processes of higher
vertebrae
Ext. Oblique
Int. Oblique (I)
Transversospinalis(B)

Lateral
Flexion

Ext. Oblique (I)

Int. Oblique (I)
QL (I)
Erector Spinae (I)

Neck
Flexion

SCM (B)Spinal Accessory Nerve

O: Manubrium of sternum, medial
clavicle
I: Mastoid Process
Ant. Scalene (B)Ventral Rami C3-7
O: First rib
I: Tran. Processes C3-7
Mid. Scalene (B) Ventral Rami C3-7

ROM position
Standing, flex trunk.
Measure distance (cm) between
spinous proc. C7-S2. Flex trunk
and measure distance again.
Inclinometer: Zero and place
inclinometer on spine of C7 and
S2. -difference between
inclinometers.
Standing, hands on hips, extend
back.
Measurements same as flexion

Sitting feet supported. Pt.

crosses arms and holds end of
tape measure on acromion
process and greater trochanter
or PSIS

Standing, laterally flex trunk.

Watch for trunk rotation.
Measure beginning and ending
distance from tip of third finger.
Tape measure on base of chin,
base of sterna notch. Measure in
cm
Document: AROM cervical
flex/ext 2-18 cm. (16cm

MMT position
-Supine
-Grade 0: no movement, no mm activity is felt
-Grade 1: no movement, but mm activity is felt
-Grade 2: arms at sides, pt. cannot clear inf.
Angles of scapulae
-Grade 3: arms at sides, pt. can clear inf.
Angles of scapulae
-Grade 4: arms crossed at chest
-Grade 5: hands by ears, not pulling on head
-Prone
-Grade 0: no movement, no mm activity is felt
-Grade 1: no movement, but mm activity is felt
-Grade 2: arms at sides, pt cannot clear xiphoid
process
-Grade 3: arms at sides, extend and clear
xiphoid process
-Grade 4: hands held behind low back
-Grade 5: hands behind head

Supine. Cross hand toward opposite knee.

-Grade 0: no movement, no mm activity is felt
-Grade 1: no movement, but mm activity is felt
-Grade 2: arms at sides, pt. cannot clear inf.
Angles of scapulae
-Grade 3: arms at sides, pt. can clear inf.
Angles of scapulae
-Grade 4: arms crossed at chest
-Grade 5: hands by ears, not pulling on head
none

Supine. Hands in touchdown position. Resist

with fingers on forehead.

O: First rib
I: Tran. Processes C2-7
Longus Colli (B)Ventral Rami C2-7
O: Bodies/Tran. processes C3-T3
I: Bodies/Tran. processes C1-C6

Neck
Extension

Neck
Lateral
Flexion

Neck
Rotation

Splenius Cap.(B)Dorsal Rami C3-8

O: Lower lig. Nuchae, sp.
Processes C3-T3
I: Mastoid process and lat. 1/3
superior nuchal line
Splenius Cerv.(B)Dorsal Rami C3-8
O: sp. Processes T3-6
I: tran. processes C1-3
Upper Trap.(B)Sp. Accessory Nerve
O: Ext. Occipital protub., lig.
Nuchae, superior nuchal line
I: Post-sup. lat. 1/3 clavicle
Erector Sp. (B)Dorsal Rami C2-8
O: upper thoracic and lower
cervical vertebrae
I: cervical vert. above, base of skull
Transversospinal (B)Dorsal Rami C2-8
O: transverse. proc. Of upper
thoracic and lower cervical vert.
I: sp. Proc. of higher vert. and base
of skull
SCM (I)
Ant. Scalene (I)
Mid. Scalene (I)
Post. Scalene (I)
Splenius Cap.(I)
Splenius Cerv.(I)
Upper Trap.(I)
Erector Sp. (B)
SCM (C)
Splenius Cap.(I)
Splenius Cerv.(I)
Obliquus Cap. Inf. (I)
Transversospinal (B)

excursion)

Prone. Hands in touchdown position. Resist

back of head.
Same as flexion

Measure tip of acromion to

mastoid process

Measure mandible to acromion

process

none

None

Hoover test: Assess for malingering. Supine, hold pt heels, ask pt to lift 1 leg out of hand. (+) pt doesnt lift leg, no downward force of contralateral limb
Forward Flexion Test: Assess mobility of ilium or sacrum. Standing or sitting, palpate PSIS while pt slowly FB w/ LE straight, hands reaching toward floor.
(+) asymmetrical movement w/ pathological side moving more.

Lumbar Quadrant Test: assess nerve roots and IVF. Standing or sitting, assist pt in extending spine and SB ipsilateral w/ contralateral rotation, then apply
overpressure through shoulders. Repeat other side. (+) radicular symptoms due to nerve root compression, local pain from facet joints
Slump Test: assess neural mobility. Sitting w/ trunk slumped forward, neck flexed. With 1 leg, add knee ext, then DF. (+) reproduction of symptoms.
Cervical Foraminal Distraction: Assess cervical mobility and nerve root impingement. Supine/sitting. Controlled distraction of C-spine. (+) decrease of
symptoms means good intervention; pain=spinal ligament Tear, annulus tear, disk herniation
Spurling Test: Assess nerve roots & IVF. Seated. Compress C-spine in slight ext. and lat. flex. (+) referred pain, reproduction of pain implicates compromise of
IVF
Adson Test: assess for TOS of scalene triangle. Seated, palpate radial pulse. Move UE into abd, ext, ER. Rotate head toward involved side, hold breath. (+)
absent/diminished radial pulse, symptoms
SI posterior compression: assess joint surface of SI. Supine, cross hands over pts pelvis on ASIS. Apply lat. force to ASIS through hands. (+) reproduction
of pain.
SI posterior distraction: assess SI ligaments. Side-lying, apply downward force thru ant. Aspect of ASIS to create post. gapping of SI. (+) reproduction of SI
pain.