脊髓損傷肌力檢查-

脊髓損傷神經(jīng)學(xué)分類(lèi)國(guó)際標(biāo)準(zhǔn)(2011年修訂)肌力檢查編輯版ppt1C5屈肘|肱二頭肌,肱肌3級(jí)病人體位:肩關(guān)節(jié)內(nèi)收，肘伸直，前臂旋后，腕關(guān)節(jié)放松位.治療師體位:Supportthewrist.提示:Bendyourelbowandtrytoreachyourhandtoyournose.Action:Thepatientattemptstomovethroughthefullrangeofmotioninelbowflexion.編輯版ppt2C5屈肘|肱二頭肌,肱肌4&5級(jí)病人體位:肩關(guān)節(jié)內(nèi)收，肘關(guān)節(jié)屈曲90°，前臂旋后.治療師體位:固定肩前部，抓住腕關(guān)節(jié)施加伸肘的力.提示:Holdyourarm.Don’tletmemoveit.Action:Thepatientresiststheexaminer’spullandattemptstomaintaintheelbowflexedat90°.編輯版ppt3C5屈肘|肱二頭肌,肱肌2級(jí)病人體位:肩關(guān)節(jié)內(nèi)收，內(nèi)旋，前臂放在腹部上方。肘關(guān)節(jié)屈曲30°，前臂肘關(guān)節(jié)放松.治療師體位:Supportthearm.提示:Bendyourelbowandtrytobringyourhandtoyournose.Action:Thepatientattemptstomovetheelbowthroughafullrangeofmotioninelbowflexion.編輯版ppt4C5屈肘|肱二頭肌,肱肌0&1級(jí)病人體位:同2級(jí)治療師體位:一手托住前臂，一手握住肘關(guān)節(jié)，觸診或看到肌腱的收縮.提示:Bendyourelbowandtrytobringyourhandtoyournose.Action:Thepatientattemptstomovetheelbowthroughafullrangeofmotioninelbowflexion.編輯版ppt5C6伸腕|腕長(zhǎng)、腕短伸肌3級(jí)病人體位:肩關(guān)節(jié)內(nèi)收，肘關(guān)節(jié)伸直，前臂旋前，腕關(guān)節(jié)屈曲.治療師體位:Onehandsupportsthedistalforearmtoallowthewristtobepre-positionedinsufficientflexionfortesting.提示:

Bendyourwristupwards.Liftyourfingerstowardtheceiling.Action:Thepatientattemptstoextendthewristthroughafullrangeofmotion.編輯版ppt6C6伸腕|腕長(zhǎng)、腕短伸肌4&5級(jí)病人體位:同上，除腕關(guān)節(jié)伸展.治療師體位:一手握住腕關(guān)節(jié)，一手在掌骨施加屈腕的力.提示:Holdyourwristup.Don’tletmepushitdown.Action:Thepatientresiststheexaminer’spushandattemptstomaintainthewristinthefullyextendedposition.編輯版ppt7C6伸腕|腕長(zhǎng)、腕短伸肌0，1&2級(jí)病人體位:同3級(jí)/肩關(guān)節(jié)稍屈曲，內(nèi)旋，內(nèi)收，上臂放在腹部上方，屈肘90°，前臂旋前，腕關(guān)節(jié)屈曲.治療師體位:一手握住腕關(guān)節(jié)，一手觸診腕背側(cè).提示:Bendyourwristbackwards.Action:Thepatientattemptstoextendthewristthoughafullrangeofmotioninwristextension.編輯版ppt8C7伸肘|肱三頭肌3級(jí)病人體位:肩前屈90°，肘關(guān)節(jié)屈曲，手貼近耳朵.治療師體位:Supporttheupperarm.提示:Straightenyourarm.Action:Thepatientattemptstomovethroughthefullrangeofelbowextension.編輯版ppt9C7伸肘|肱三頭肌4&5級(jí)病人體位:Sameasgrade3,excepttheelbowisin45°offlexion.治療師體位:Supporttheupperarm.Graspthewristandapplyresistancetothedistalforearminthedirectionofelbowflexion.提示:Holdthisposition.Don’tletmebendyourelbow.Action:Thepatientresiststheexaminer’spressureandattemptstomaintainthepositionoftheelbowin45°offlexion.編輯版ppt10C7伸肘|肱三頭肌2級(jí)病人體位:肩內(nèi)旋內(nèi)收，前臂在腹部上方，肘關(guān)節(jié)屈曲.

WhencheckingGrade2,sufficientflexionoftheshouldermustbepermittedtoallowtheforearmtoclearandmoveoverthechestandabdomen.治療師體位:Supportthepatient’sarm提示:Straightenyourarm.Action:Thepatientattemptstomovethroughthefullrangeofelbowextension.編輯版ppt11C7伸肘|肱三頭肌0&1級(jí)病人體位:同上，除屈肘30°治療師體位:一手托住腕關(guān)節(jié)，一手觸診三頭肌腱.提示:Straightenyourarm.Action:Thepatientattemptstofullyextendtheelbow.編輯版ppt12C8屈中指|指深屈肌3級(jí)病人體位:內(nèi)收，肘伸直，前臂旋后，腕關(guān)節(jié)伸展，MCP和PIP固定在伸展位.治療師體位:兩手抓住手掌，固定中指MCP和PIP.提示:Bendthetipofyourmiddlefinger.Action:

Thepatientattemptstoflexthedistalinterphalangeal(DIP)jointthroughthefullrangeofmotioninflexion.編輯版ppt13C8屈中指|指深屈肌4&5級(jí)病人體位:Thesameasgrade3,excepttheDIPjointisfullyflexed.治療師體位:固定中指MCP、PIP，在指腹施加力.提示:

Holdthetipofyourfingerinthisbentposition.Don’tletmemoveit.Action:

ThepatientattemptstomaintainthefullyflexedpositionoftheDIPjoint,andresistthepressureappliedbytheexaminerinthedirectionoffingerextension.編輯版ppt14C8屈中指|指深屈肌0，1&2級(jí)病人體位:同上，除前臂旋前.治療師體位:固定中指MCP、PIP。提示:Bendthetipofyourmiddlefinger.Action:Thepatientattemptstoflexthedistalinterphalangeal(DIP)jointthroughthefullrangeofmotioninflexion.編輯版ppt15T1外展小指|小指展肌3級(jí)病人體位:肩關(guān)節(jié)內(nèi)收內(nèi)旋，屈曲15°，肘關(guān)節(jié)屈曲90°，前臂旋前.治療師體位:握住腕關(guān)節(jié)，固定MCP防止過(guò)度后伸.提示:Moveyourlittlefingerawayfromyourringfinger.

Action:

Thepatientattemptstomovethelittlefingerthroughthefullrangeofmotioninabduction.編輯版ppt16T1外展小指|小指展肌4&5級(jí)病人體位:Sameasgrade3,exceptthelittlefingerisfullyabducted.治療師體位:固定掌側(cè)MCP防止過(guò)度后伸.遠(yuǎn)端施加阻力.提示:Holdyourlittlefingerawayfromyourringfinger.Don’tletmepushitin.Action:Theexaminerexertsapushingforceagainstthesideofthedistalphalanx,andthepatientattemptstoresisttheexaminer’sforceandkeepthelittlefingerfullyabducted.編輯版ppt17T1外展小指|小指展肌0，1&2級(jí)病人體位:肩內(nèi)收，肘伸直，前臂旋前，固定MCP/肩內(nèi)收內(nèi)旋，肘屈曲90°，固定MCP.治療師體位:固定腕關(guān)節(jié)，手背施加輕微向下的力，防止MCP過(guò)度后伸，觸診外展肌.提示:Moveyourlittlefingerawayfromyourringfinger.Action:Thepatientattemptstoabductthelittlefingerthroughthefullrangeofmotion.編輯版ppt18L2屈髖|髂腰肌3級(jí)病人體位:髖膝屈曲15°.治療師體位:托住腘窩和小腿，檢查屈曲時(shí)不要讓髖關(guān)節(jié)超過(guò)90°，避免對(duì)腰椎增加脊柱后凸的壓力.提示:Liftyourkneetowardsyourchestasfarasyoucan,tryingnottodragyourfootontheexamtable.Action:Thepatientattemptstoflexhipto90°offlexion.編輯版ppt19L2屈髖|髂腰肌4&5級(jí)病人體位:Thehipisin90°offlexionwiththekneerelaxed.治療師體位:一手固定膝關(guān)節(jié)，一手固定對(duì)側(cè)髂嵴.提示:Holdyourkneeinthisposition.Don’tletmepushitdown.Action:Thepatientattemptstoresisttheexaminer’spushandkeepthehipflexedat90°.編輯版ppt20L2屈髖|髂腰肌2級(jí)病人體位:屈髖外旋45°，屈膝90°治療師體位:Supporttheleg.提示:Trytobringyourkneeouttotheside,”or“Trytoflexyourthightowardthesideofthebody.”Action:Thepatientattemptstomovethroughthefullrangeofmotioninhipflexion.編輯版ppt21L2屈髖|髂腰肌0&1級(jí)病人體位:Sameasgrade3.治療師體位:Supportthethightoeliminatefrictionwhilepalpatingthesuperficialhipflexorsjustdistaltotheanteriorsuperioriliacspine.提示:liftyourkneetowardsyourchestasfarasyoucan.Action:Thepatientattemptstoflexthehip.編輯版ppt22L3伸膝|股四頭肌3級(jí)病人體位:屈髖15°，屈膝30°.治療師體位:

Placethearmunderthetestedkneeandrestthehandonthepatient’sdistalthigh.Thiscausesthetestedkneetoflextoapproximately30°.提示:Straightenyourknee.Action:

Thepatientattemptstostraightenthekneethroughthefullrangeofmotioninextension.編輯版ppt23L3伸膝|股四頭肌4&5級(jí)病人體位:Sameasgrade3,exceptthekneeisin15°offlexion.治療師體位:

Placethearmunderthetestedkneeandrestthehandonthepatient’soppositethigh.Graspthelegtobetested,justproximaltotheankle.提示:Holdthisposition.Don’tletmebendyourknee.Action:

Examinerexertsdownwardforceintokneeflexionwhilethepatientattemptstoholdthekneein15degreesofflexion.編輯版ppt24L3伸膝|股四頭肌2級(jí)病人體位:Thehipisinexternalrotationand45°offlexion.Thekneeisflexedat90°.治療師體位:

Supportthedistalthighandleg.提示:Straightenyourknee.Action:

Thepatientattemptstomovethroughthefullrangeofmotion.編輯版ppt25L3伸膝|股四頭肌0&1級(jí)病人體位:屈髖屈膝15°.治療師體位:Supporttheleg.Palpatethepatellartendonorthebellyofthequadricepsmusclefortracefunction.Themusclebellymayalsobeobservedformovement.提示:Straightenyourknee.Action:

Thepatientattemptstostraightentheknee.編輯版ppt26L4踝背屈|脛骨前肌3級(jí)病人體位:髖膝稍屈曲，手放在小腿下。治療師體位:Atthepatient’sside.Supporttheleg.提示:Pullyourtoesupwardtowardyourhead,lettingyouranklebend.Action:Thepatientattemptstodorsiflexanklethroughafullrangeofmotion.編輯版ppt27L4踝背屈|脛骨前肌4&5級(jí)病人體位:Sameasgrade3,excepttheankleisfullydorsiflexed.治療師體位:手在足背施加跖屈的力量.提示:Holdyourankleinthisposition.Don’tletmepushitdown.Action:Thepatientattemptstoresisttheexaminerandmaintaintheankleinfulldorsiflexion.編輯版ppt28L4踝背屈|脛骨前肌2級(jí)病人體位:髖外展外旋45°治療師體位:Supporttheleg.提示:Liftthetoesupwardtowardthehead,allowingtheankletobend.Action:Thepatientattemptstodorsiflexanklethroughthefullrangeofmotion.編輯版ppt29L4踝背屈|脛骨前肌0&1級(jí)病人體位:Thekneeisfullyextendedandtheankleslightlyplantarflexed.治療師體位:觸診肌腱或肌腹.提示:Bringyourtoesupwardtowardyourhead,lettingyouranklebend.Action:Thepatientattemptstodorsiflextheankle.編輯版ppt30L5趾伸|拇長(zhǎng)伸肌3級(jí)病人體位:下肢中立位.治療師體位:Atthepatient’sside.Supportthefoot.提示:Liftyourbigtoeupwardstowardyourknee.Action:Thepatientattemptstomovethegreattoethroughthefullrangeofmotion.編輯版ppt31L5趾伸|拇長(zhǎng)伸肌4&5級(jí)病人體位:Sameasgrade3,exceptthetoeisfullyextended.治療師體位:拇指在大腳趾遠(yuǎn)端施加趾屈的力量.提示:Keepyourtoeliftedupward.Don’tletmepushitdown.Action:Thepatientattemptstoresisttheexaminerandmaintainthegreattoeinfullextension.編輯版ppt32L5趾伸|拇長(zhǎng)伸肌2級(jí)病人體位:Thehipisinexternalrotation,45°abduction.Thekneeisflexed.Theankleandlongtoeareinarelaxed,neutralposition.治療師體位:Supporttheleg.提示:Liftyourbigtoeupwardstowardtheknee.Action:Thepatientattemptstoextendthegreattoethroughthefullrangeofmotion.編輯版ppt33L5趾伸|拇長(zhǎng)伸肌0&1級(jí)病人體位:Sameasgrade3.治療師體位:Supportthelegandpalpatetheextensortendonofthelongtoefortracefunction.提示:Liftyourbigtoeupwardstowardyourknee.Action:Thepatientattemptstoexte