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Level II Upper quadrant


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C-Spine Osteokinematics SF/Rot

ipsilateral SF and rotation
AA arthokinematics flexion / extension

flexion: posterior glide

extension: anterior glide 

AA Arthrokin lateral translation
opposite to side of rotation
AA Arthrokin rotation contralateral
anterior / inferior glide
AA Arthrokin rotation ipsilateral
posterior / inferior glide
AA Joint Classification



AA muscles producing ext (4)

rectus capitus post. min

inferior oblique


semispinalis capitus all working together 

AA muscles producing flex (2)
longus capitus, rectus capitus ant maj
AA Osteokinematics flexion / extension axis
odontoid C2
AA Osteokinematics flexion / extension total ROM
10-30 degrees
AA Osteokinematics flexion / extension 
AA Osteokinematics rotation

coupled sideflexion 



AA Osteokinematics rotation axis
vertical axis through dens
AA Osteokinematics rotation ROM
40-45 degrees
AA rotation muscles
obliqus capitus inferior
AC joint capsular pattern
pain at extremes or range
AC joint close pack position
30 or 90 degrees abd or full elevation
AC joint resting position
arm at side supported
AC joint  Osteokin abd / add
abd / add
AC Osteokin flex / ext
elevation depression
AC Osteokin med / lat rotation
protraction / retraction
Accessory Movements abduction
initial superior, small amount of inf translation
Accessory Movements ext rotation
posterior translation
Accessory Movements extension >35
posterior translation
Accessory Movements flexion >55
anterior translation
Accessory Movements int rotation
anterior translation
Accessory Movements Mid range flex / ext
No translation
Acromioclavicular joint classification



simple if disc is not there

unmodified ovoid  

Action Latissimus Dorsi (4)
IR, Add, ext, depression
Action Lev Scapulae (2)
elevation, downward rotation
Action lower trapezius (3)
depression, upward rotation, retraction
Action Pec Major (5)
add, IR, flex, horizontal flex, depression
Action Rhomboid min / maj (3)
Retraction, elevation, downward rot.
Action Serratus anterior (4)
protraction, upward rotation, depression, elevation
Action upper trapezius (3)
elevation, upward rotation, retraction
Atlanto-Occipital Joint Osteokin Side-flexion
Swing with contralateral conjunct rotation Axis through the nose
Atlanto-Occipital Joint Osteokin flexion/extension
10 degrees flex 20 degrees ext Axis through earlobe
Axillary nerve (2)
Teres minor Deltoid
C-spine Capsular pattern
C-Spine flexion muscles(3)
Longus colli, scaleni, SCM Bilat.
C-spine joint

z-joint: synovial

uncovertebral joint: fibrous 

C-Spine muscles extension (3)
trapezius, splenius capitis, semispinalis capitis
C-Spine muscles side flexion (4) / rotation
splenius, levator scapulae, longissimus capitis, ipsilateral scalenes
Cardinal Signs (6)
Diplopia Drop attacks dysarthria dysphagia cord signs and symptoms cranial nerve signs and symptoms
CV locking
sidebend, rotate away
Dorsal Scapular nerve (2)
Rhomboid min and maj
Eliminating the middle ear
hold head still, rotate the spine beneath it.
glenohumeral capsular pattern
external rotation>abd>med rotation
glenohumeral close pack

90 abd

lat rotation


Glenohumeral jt classification
simple, unmodified ovoid, triaxial
Glenohumeral neurology peripheral anterior and inferior capsule
axillary nerve C5, C6
Glenohumeral neurology peripheral inferior capsule
Posterior cord of the brachial plexus: C5,C6,C7,(C8)
Glenohumeral neurology peripheral post and superior capsule
suprascapular nerve branches:(C4), C5, C6
Glenohumeral neurology peripheral anterior and superior capsule
lat pectoral nerve C5,C6,C7
Glenohumeral neurology segmental
(C4), C5, C6, (C7,C8)
glenohumeral resting position

30 flex

30 abd

30 medial rotation 

Hautard's test
sit with both arms at 90 degrees flex. Eyes open and closed. check arms. add rotation and or ext.
Humeroradial close pack position

90 flex forearm sup 5

90 flex mid pronation 

Humeroradial joint classification



modified ovoid 

Humeroradial resting position

70 flex

ext with supination 

Humerordial capsular pattern
Key muscles
C1/2-short neck flexors C3/4-shoulder elevation C5-shoulder abduction C6-elbow flex/wrist ext C7-elbow ext./wrist flex C8-thumb ext T1-5th digit abd
Lateral pectoral nerve (1)
pec major upper
Long Thoracic nerve (1)
Serratus anterior
Lower subscapular nerve (2)
subscapularis Teres major
medial pectoral nerve (2)
pec major lower pec minor
Musclucutaneous nerve (3)
coracobrachilalis Biceps Brachialis
OA Athrokinematics extension
anterior glide of Occiput
OA Athrokinematics Flexion
Posterior glide of Occiput
OA athrokinematics sideflexion
contralateral translation RSF-R ant. L post. LSF-L ant. R post.
OA muscles causing extension
rectus capitis post minor superior oblique splenius, semispinalis capitis
OA muscles causing flexion
longus capitis rectus capitis ant
Radial nerve elbow (4)
Triceps Anconeus Brachialis brachioradialis
Radial nerve hand (6)
ext digitorum ext digiti minimi abd pollicis longus ext pillicis brevis ext pollicis longus ext indicis
Radial nerve wrist (3)
ext carpi radialis longus ext carpi radialis brevis ext carpi ulnaris
C4-lev scap C5-deltoid C5/6-biceps C6-brachioradialis C7-triceps
Rhomberg's test
both feet together arms held by side and close eyes
Rib joint classification
costovertebral-synovial costotransverse-synovial costochondral-synchondrosis
SC ant clavicle rotation

humeral add, ext, lat rot

scapular elevation, protraction, downward rot

sternal exp

head contralateral rot, sf, f


SC joint capsular pattern
pain at extreme range
SC joint classification

unmodified sellar


SC joint close pack
full elevation and protraction
SC joint resting position
arm at side supported
SC post clavicle rotation

humeral flex 0-60 clavicle elevates

>60 clavicle posteriorly rotates

humeral abd, int rot

sternal isp.

scapular depression,retraction,upward rot

head ips rot,sf,ext. 

Scapular Anterior tilt (1)
pec min
Scapular depression (2)
lower traps lower Serratus ant
Scapular elevation (5)
upper traps lev scaps rhomboid min rhomboid maj upper Serratus ant
Scapular lateral (upward) rotation (3)
Serratus ant lower fibres of traps upper fibres of traps
Scapular medial (downward) rotation (4)
Rhomboids maj rhomboids min middle fibres of traps lev scap
Scapular Post tilt (1)
lower fibres of traps
Scapular protraction (2)
Serratus ant pec minor
Scapular retraction (3)
middle traps rhomboid min rhomboid maj
Shoulder Abduction (5)
Deltoids Supraspinatus Infraspinatus Teres Minor Subscapularis
Shoulder Adduction (6)
Pec Major Teres Major Coracobrachialis Latissimus Dorsi Triceps Biceps
Shoulder Extension (4)
Deltoids (post) Triceps Latissimus Dorsi Teres Major
Shoulder External Rotation (3)
Deltoid Teres Minor Infraspinatus
Shoulder Flexors (4)
Biceps (long head) Coracobrachialis Deltoids (ant) Pec major
Shoulder Internal Rotation (4)
Latissimus Dorsi Pec Major Subscapularis Teres Major
Stability Testing AA joint

anterior shear

lateral shear 

Stability Testing OA joint

anterior shear

posterior shear

lateral shear

compression, traction 

Subclavian nerve (1)
sup radioulnar joint resting position
mid position
superior radioulnar joint classification



modified ovoid 

superior radioulnar joint close pack position
full sup or pronation
Suprascapular nerve (2)
supraspinatus infraspinatus
T-spine classification
synovial, ovoid and planar
Ulnohumeral arthrokin extension glide
post med glide of ulna
Ulnohumeral arthrokin flexion glide
ant lat glide of ulna
Ulnohumeral close pack
ext with supination
Ulnohumeral joint capsular pattern


pronation = supination 

Ulnohumeral joint classification

compound synovial

modified sellar 

ulnohumeral resting position

70 flex

10 supination 

Upper subscapular nerve (1)
Vertebral artery dissection
head and neck P unilateral sub occipital sharp and severe Pain acute trauma related stiffness 14 day delay
Vertebral Artery Testing
Rotation as far as possible hold 10 sec back to start, hold 10 sec rotate to other side, hold 10 sec Ext. then rotation + extension
Vertebral Body Landmarks

C1: mastoid process and angle of mandible

C2:angle of mandible

C3:lateral to hyoid

C4:superior thyroid cartilage

C5:inferior thyroid cartilage

C6:cricoid cartilage

C7:thyroid isthmmus 

vertebrochondral flexion arthrokin costotransverse
PMS (planar)
Vertebrosternal extension arthrokin costotransverse
inferior glide
Vertebrosternal extension arthrokin vertebrochondral
Vertebrosternal extension arthrokin z-jts
inferior posterior
vertebrosternal flexion arthrokin costotransverse t3-7
superior glide (concavoconvex) spin with ant roll
vertebrosternal flexion arthrokin z-jts
Vestibular testing
collar or stabilize head and neck, move from ly to sit. If positive, then head and neck not responsible for dizziness
superior radioulnar jt degrees of freedom
superior radioulnar jt close pack position
full pro or sup
superior radioulnar jt resting position
35 supination with elbow flexed to 70
superior radio ulnar jt capsular pattern
equal limitation of pronation and supination
superior radioulnar jt arthrokin
sup: Aant med glide of radial head pro: PL glide of radial head
Ulnar (med) collateral lig bands
ant: taut in ext. post: taut in flex oblique transverse band: not as well developed
ulnohumeral joint neurology segmental
ulnarhumeral joint peripheral
median: ant capsule ulnar nerve: MCL,postmed capsule Musculocutaneuous: ant capsule radial nerve: post and anterolat capsule
Ulnohumeral joint Vascular supply
collalateral branches of brachial wiht radial and ulnar arteries
Elbow Flexors (7)
Biceps Brachialis Brachioradialis Pronator teres Flexor carpi radialis Palmaris longus Flexor carpi ulnaris
Elbow Extension (2)
Triceps Anconeus
Elbow Pronation (4)
Brachioradialis Pronator teres Flexor carpi radialis Pronator quadratus
Elbow Supination (3)
Biceps Brachioradialis Supinator
Humeroradial joints, ligaments
Radial collateral ligament, lateral ulnar collateral, accessory lateral collateral

Deck Info