Orthopedic Exam / Special Tests for Physical Therapy: SHOULDER
ULTT 2 – Upper Limb Tension Test 2: (Median nerve, Musculocutaneous nerve, Axillary nerve)
ULTT Test 2: Median Nerve:
The median nerve originates from the lateral and medial cords of the brachial plexus, and has contributions from ventral roots of C6 & C7 (lateral cord) and C8 & T1 (medial cord). The median nerve has no voluntary motor or cutaneous function in the brachium. It gives vascular branches to the wall of the brachial artery. These vascular branches carry sympathetic fibers. It innervates all of the flexors in the forearm except flexor carpi ulnaris and that part of flexor digitorum profundus that supplies the 4th and 5th digits.
ULTT 2: Musculocutaneous Nerve:
The musculocutaneous nerve innervates the coracobrachialis, biceps brachii, and the greater part of the brachialis. The musculocutaneous nerve arises from the lateral cord of the brachial plexus, opposite the lower border of the pectoralis major, its fibers being derived from C5, C6 and C7. It penetrates the coracobrachialis muscle and passes obliquely between the biceps brachii and the brachialis, to the lateral side of the arm; a little above the elbow it pierces the deep fascia lateral to the tendon of the biceps brachii and is continued into the forearm as the lateral cutaneous nerve of the forearm.
ULTT 2: Axillary Nerve:
The axillary nerve or the circumflex nerve originates from the brachial plexus (upper trunk, posterior division, posterior cord) at the level of the axilla and carries nerve fibers from C5 and C6. The axillary nerve supplies the (1) deltoid, (2) teres minor, and (3) long head of the triceps brachii.
Special Test: ULTT 2 – Upper Limb Tension Test 2
- To test for the Musculocutaneous, Median, and Axillary nerves as the source of the patient’s painful shoulder and arm.
Video Demo Instructions, Procedure, Positive Test:
ULTT2 – Upper Limb Tension Test 2: Video Demo (Procedure below)
ULTT Test2 – Upper Limb Tension Test 2: PROCEDURE:
• Patient is supine, with their side being tested at the edge of the table
• Examiner applies a depressive force to the patient’s affected shoulder
• With examiner’s other hand, hold the client’s wrist and abduct patient’s affected humerus to 10°
• Slowly extend patient’s wrist and fingers
• Fully supinate patient’s forearm then slowly extend their elbow
ULTT2 – Upper Limb Tension Test 2: POSITIVE SIGN:
- Recurrence of their shoulder and arm pain.