GONIOMETRY- refers to the measurement of angles created at human joints by the bones of the body. POINTS TO REMEMBER 1.

normal value of joint movement 2. know the position of pt. during the measurement. -position of the body and the joint. 3. 4. 5. Fulcrum (center of goniometer) stationary arm moving arm

F- anterior aspect of the acromial process SA- perpendicular to the trunk MA-shaft of the humerus pointing to the cubital fossa. NV- 0-180*

3. EXTERNAL ROTATION- occurs in the transverse plane around a vertical axis when the subject is in the anatomical position. Position the pt. Supine with the arm being tested in 90* shoulder abduction.

PARTS OF A GONIOMETER 1. moving arm/ distal arm- w/ the arrow 2. fulcrum 3. stationary arm

F- olecranon process SA- perpendicular to the ground MA- parallel to the ulnar shaft. Poiting to the ulnar styloid process. NV-0-90*

PLANE 1. sagittal 2. frontal/coronal 3. ex. plantar flexion/ dorsi flexion- sagittal plane shoulder internal rotation- sagittal plane hip internal rotation- horizontal plane thumb extension- coronal plane horizontal/ transverse

4. EXTENSION- motion occurs in the sagittal plane around a medial lateral axis. Position the pt. in prone with the head facing away from the shoulder being tested.

F- head of the humerus SA- perpendicular to the trunk/ midaxillary line of the thorax. MA-parallel to the arm/ lateral midline of the humerus pointing to the lateral epicondyle of the humerus. NV- 0-60*

THE SHOULDER 1. FLEXION-occurs in the sagittal plane around a medial lateral axis. Position the patient in the supine position. Fulcrum- head of the humerus stationary arm- parallel to the arm moving arm- lateral midline of the humerus pointing to the lateral epicondyle NV- 0-180*

5. INTERNAL ROTATION- motion occurs in th transverse plane around a vertical axis. Position the pt. supine with the arm being tested 90* shoulder abduction.

F- olecranon process. 2. ABDUCTION (VERTICAL)- occurs in the frontal plane, position the pt. supine or sitting. SA- parallel or perpedicular to the floor MA- parallel to the ulna, using the olecranon process

and ulnar styloid for reference.\ NV- 0-70*/ 0-90* (based on kinesiology)

SA-perpendicular to the ground MA- parallel to the pencil/pen NV-0-90*

6. ABDUCTION (HORIZONTAL)- starts in 90-90* position, sitting position

3. FOREARM SUPINATION- same as forearm pronation except: NV-0-80*

F- acromial process SA- parallel to the ground MA- parallel to the shaft of the humerus pointing to the styloid process NV-0-45* 7. ADDUCTION-motion occurs in the frontal plane. position the pt. supine or sitting.

4. WRIST FLEXION- motion occurs in the sagittal plane around a medial lateral axis. -place wrist in the edge of a table, stabilize wrist using a towel. F- ulnar styloid process SA-parallel to the lateral aspect of the ulna, using the olecranon and ulnar styloid process as reference. MA-lateral midline of the 5th metacarpal. NV- 0-80*

F- anterior aspect of the acromial process SA- perpendicular to the trunk MA-shaft of the humerus pointing to the cubital fossa. NV- 0-135* 5.WRIST EXTENSION- same as wrist flexion, except: NV- 0-70*

THE ELBOW AND FOREARM 1. ELBOW FLEXION- motion occurs in the sagittal plane around a medial lateral axis. Pt. in supine position. F-lateral epicondyle of the humerus SA-parallel to the lateral shaft/midline of the humerus, using the center of acromial process for reference. MA- parallel to the shaft of the humerus pointing to the radial styloid process NV-0-150*

6. ULNAR DEVIATION- motion occurs in the frontal plane around an anteriorposterior axis. same position as wrist flexion/extension F- capitate of the 3rd metacarpal SA-posterior aspect of the forearm using the lateral epicondyle of the humerus fore reference. MA- parallel to the 3rd metacarpal pointing to the head. NV- 0-30* 7. RADIAL DEVIATION- same as ulnar deviation, except: NV-0-20* THE HIP

2. FOREARM PRONATION-motion occurs in the transverse plane around a vertical axis. position the pt. sitting, the elbow is flexed 90*. -ask pt to hold a pen and stabilize the arm using his other hand. F- head of the 3rd metacarpal

1. FLEXION- motion occurs in the sagittal plane around a medial lateral axis. Position the pt. in supine F- greater trochanter SA-parallel to the trunk/arm

MA-parallel to the lateral aspect of the femur pointing to the tibial condyle NV-0-120* 2. EXTENSION- same as flexion except: the pt. is in supine position NV-0-30* 3.ABDUCTION- motion occurs in the frontal plane around anterior-posterior axis. Postion the pt. supine with the knees extended. F- ASIS (Anterior superior iliac spine) SA- pointing to both ASIS MA- parallel to the anterior aspect of the femur pointing to the center of the patella. NV- 0-45* 4. ADDUCTION- same as abduction except: the contralateral hip is abducted NV- 0-30* 5. INTERNAL/EXTERNAL ROTATION- occurs in the transverse plane around a vertical axis. Position pt. sitting on a supporting surface with the knees flexed 90* over the edge of the surface. F- center of the patella SA- perpendicular to the ground MA- parallel to the tibial crest. NV-0-45* THE KNEE 1. FLEXION- motion occurs in the sagittal plane around a medial lateral axis. Pt. is in supine position. F-lateral tibial condyle/ lateral epicondyle of the femur SA-lateral aspect of the shaft of the femur pointing to the greater trochanter MA- lateral aspect of the shaft of the fibula pointing to the lateral malleolus NV-0-135* 2. EXTENSION- same as flexion except: pt. is in prone position, THE ANKLE

1. PLANTAR FLEXION- motion occurs in the sagittal plane around a medial lateral axis. Position the pt. sitting or supine. with the knees flexed at least 30* always start at 20* F-below the lateral malleolus SA-parallel to the lateral aspect of the fibula MA- parallel to the 5th metatarsal NV-0-50* 2. DORSIFLEXION- same as plantar flexion exceptNV- 0-20* 3. INVERSION- position the pt. Sitting with the knees flexed to 90* and the lower leg over the edge of the supporting surface. F- anterior aspect of the ankle midway between the malleoli. SA- anterior midline of the lower leg using the tibial tuberosity for reference. MA- anterior midline of the second metatarsal. 4.EVERSION- same as inversion. METACARPOPHALANGEAL (FINGERS) JOINTS

1. FLEXION-motion occurs in the sagittal plane around a medial lateral axis. Position the pt. Sitting with the forearm midway between pronation and supination F-dorsal aspect of the MCP Joint. SA-dorsal midline of the metacarpal. MA-dorsal midline of the proximal phalanx

2.EXTENSION- same as flexion 3.ABDUCTION- occurs in the frontal plane around an anterior posterior axis. Position the pt. Sitting, with the wrist in 0* ROM. F-dorsal aspect of the MCP joint. SA-dorsal midline of the metacarpal. MA-dorsal midlineof the proximal phalanx 4. ADDUCTION- same as abduction

PROXIMAL INTERPHALANGEAL JOINTS (FINGERS) 1. FLEXION- occurs in the sagittal plane around a medial lateral axis. Position the pt. Sitting with the forearm in 0* of supination and pronation. F-dorsal aspect of the PIP joint. SA-dorsal midline of the proximal phalanx MA- dorsal midline of the middle phalanx. 2. EXTENSION-same as flexion DISTAL INTERPHALANGEAL (FINGERS) JOINTS

METACARPOPHALANGEAL (THUMB)

JOINT

1. FLEXION- occurs in the frontal plane around an anterior posterior axis. Position the pt. Sitting with the forearm in full supination. The wrist in 0* rom. F-dorsal aspect of the MCP joint SA-dorsal midline of the metacarpal. MA-dorsal midline of the proximal phalanx. 2. EXTENSION- same as flexion. INTERPHALANGEAL JOINT (THUMB) 1.FLEXION- occurs in the frontal plane around an anterior posterior axis.Position the pt. Sitting with the forearm in full supination. The wrist in 0* rom. F- dorsal surface of the IP joint. SA- dorsal aspect of the proximal phalanx. MA-dorsal midline of the distal phalanx. 2. EXTENSION- same as flexion. METATARSOPHALANGEAL JOINT (TOES) 1. FLEXION- moves in the sagittal plane around a medial lateral axis. Position the pt. Sitting or supine with the ankle and foot in 0* rom. F- dorsal aspect of the MTP joint. SA- dorsal midline of the metatarsal MA-dorsal midline of the proximal phalanx 2. EXTENSION- same as flexion 3. ABDUCTION- occurs in the transverse plane around a vertical axis. Position the pt. Sitting or supine with the foot in 0* inversion and eversion. F-dorsal aspect of the MTP joint. SA- dorsal midline of the metatarsal MA- dorsal midlineof the proximal phalanx. 4. ADDUCTION- same as abduction

1. FLEXION- occurs in the sagittal plane around a medial-lateral axis. Position the pt. Sitting with the forearm in the 0* of supination and pronation F-dorsal aspect of the DIP joint SA- dorsal midline of the middle phalanx MA- dorsal midline of the distal phalanx 2.EXTENSION- same as flexion CARPOMETACARPAL JOINT (THUMB) 1. FLEXION- occurs in the frontal plane around an anterior-posterior axis. Position the pt. Sitting with the forearm in full supination and wrist in 0* rom. F-palmar aspect of the first CMC joint. SA- ventral midline of the radius using the ventral surface of the radial head and radial styloid process for reference. MA- ventral midline of the first metacarpal. 2.EXTENSION- same as flexion. 3.ABDUCTION- occurs in the sagittal plane around a medial lateral axis. Position the pt. Sitting with the forearm midway between supination and pronation. The wrist in 0* rom. F- lateral aspect of the radial styloid process. SA-lateral midline of the second metacarpal using the center of the second MCP joint for reference. MA- lateral midline of the forst metacarpal using the center of the first MCP joint for reference. 4. ADDUCTION- same as abduction

PROXIMAL (TOES)

INTERPHALANGEAL

JOINT

1. FLEXION- occurs in the sagittal plane around a medial lateral axis. Pt in supine or sitting position. F- dorsal aspect of the interphalangeal joint being tested. SA- dorsal midline of the proximaa phalanx MA- dorsal midline of the phalanx distal to the joint being tested. 2. EXTENSION- same as flexion DISTAL INTERPHALANGEAL JOINT (TOES) 1. FLEXION- occurs in the sagittal plane around a medial lateral axis. Pt in supine or sitting position. F- dorsal aspect of the DIP joint. SA- dorsal midline of the middle phalanx. MA-dorsal midline of the middle phalanx. 2. EXTENSION- same as flexion. THE CERVICAL SPINE 1. FLEXION- motion occurs in the sagittal plane around a medial lateral axis. Position the pt. Sitting with the thoracic and lumbar spine well supported by the back of the chair. F- external auditory meatus SA- perpendicular or parallel to the ground MA- base of the nares. 2. LATERAL FLEXION- occurs in the frontal plane around an anterior posterior axis. Position the pt. Sitting. F- spinous process of the C7 vertebrae SA- spinous processes of the thoracic vertebrae so that the arm is perpendicular to the ground. MA- dorsal midline of the head, using the occipital protuberance for reference.