Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

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Resisted extension

Positioning.

The subject stands with the arm alongside the body, the elbow flexed to 90° and
the forearm in supination. The examiner stands level with the elbow. One hand supports the distal part of the forearm and the other hand is on top of the shoulder.

Procedure.

Resist the subject’s attempt to extend the elbow.

Common mistakes:

• In strong subjects, flexion cannot sufficiently be resisted if the resistance is
not given perpendicular to the subject’s forearm.
• Movement is allowed at the elbow.

Anatomical structures tested:

Muscle function:

• Most important extensor:

– Triceps brachii
• Less imporfa1lt exte1lsor:
– Anconeus.

Common pathological situations:

• The test is painful when a lesion of the triceps is present.
• Weakness occurs in lesions of either the radial nerve or the C7 nerve root.
• Painful weakness may indicate a partial rupture of the triceps or a fracture of the olecranon.

Resisted pronation

Positioning.

The subject stands with the arm alongside the body, the elbow bent to a right
angle and the forearm in neutral position. The examiner stands in front of the subject. The ipsilateral hand carries the forearm, the thenar against the palmar and distal aspect of the radius and the fingers against the dorsal aspect of the
ulna. The other hand reinforces: thenar on ulna and fingers on radius.
Procedure. Resist the subject’s attempt to pronate the forearm.

Common mistakes:

• The subject abducts the shoulder.
• Too much local pressure on the radius/ulna may provoke tenderness.
• Movement is allowed at the elbow.

Anatomical structures tested:

Muscle function:
• Pronator teres
• Pronator quadratus.
• Less importaNt sup;lIalor:
– Brachioradialis.

Common pathological situations. Pain is the result of a lesion of the biceps or, more rarely, a lesion of the supinator muscle.

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