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The Physiotherapist’s Pocketbook
Essential facts at your fingertips
THIRD EDITION
Karen Kenyon MRes, BSc (Hons), BA (Hons), MCSP
Sussex Partnership NHS Foundation Trust, UK
Jonathan Kenyon MSc, PGCert (NMP), BSc (Hons), MMACP, MCSP
Sussex Partnership NHS Foundation Trust, UK
© 2018 Elsevier Limited. All rights reserved.
First edition 2004
Second edition 2009
No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Permissions may be sought directly from Elsevier’s Rights Department: phone: (+1) 215 239 3804 (US) or (+44) 1865 843830 (UK); fax: (+44) 1865 853333; e-mail: healthpermissions@elsevier.com. You may also complete your request online via the Elsevier website at http://www.elsevier.com/permissions.
ISBN 978-0-7020-5506-5 e-book 978-07020-7798-2
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging in Publication Data
A catalog record for this book is available from the Library of Congress
Notices
Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds or experiments described herein. Because of rapid advances in the medical sciences, in particular, independent verification of diagnoses and drug dosages should be made. To the fullest extent of the law, no responsibility is assumed by Elsevier, authors, editors or contributors for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein.
The Publisher
SECTION 1 Neuromusculoskeletal Anatomy 1
Musculoskeletal anatomy illustrations 2
Nerve pathways 29
Brachial plexus 45
Lumbosacral plexus 46
Peripheral nerve motor innervation 47
Muscle innervation chart 53
Muscles listed by function 59
Alphabetical listing of muscles 62
References and Further Reading 89
SECTION 2 Neuromusculoskeletal Assessment 91
Peripheral nerve sensory innervation 93
Dermatomes 95
Myotomes 96
Reflexes 96
Key features of upper and lower motor neurone lesions 98
The Medical Research Council scale for muscle power 99
Common locations for palpation of pulses 100
Common musculoskeletal tests 101
Common vascular tests 120
Neurological tests 121
Neurodynamic tests 124
Cranial nerves 132
Glossary of terms used to evaluate clinical tests 136
Common postures 138
Trigger points 145
Normal joint range of movement 157
Average range of segmental movement 159
Close packed positions and capsular patterns for selected joints 161
Classification of ligament and muscle sprains 162
Windows of achievement for gross motor developmental milestones 163
Joint hypermobility assessment 164
Complex regional pain syndrome 166
Distribution of referred pain 167
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Eighteen years ago we were newly qualified physiotherapists working in busy London teaching hospitals when we came up with an idea that would later become The Physiotherapist’s Pocketbook. Like hundreds of physiotherapists before us, we prepared for clinical placements and rotations by compiling pocket-sized reference notes that we could access quickly and easily when we needed to check something. As we made our way through our rotations these “crib sheets” slowly grew into a compendium of key information covering all the core areas of physiotherapy, forming the basis of the Pocketbook.
When we first wrote the Pocketbook we never thought we would be writing the third edition 14 years later. We have been overwhelmed by the favourable response to the previous two editions and have endeavoured to ensure this new edition provides a relevant and up-to-date resource that is as comprehensive and useful as possible to all clinicians. It is beyond the scope and size of the book to cover the more specialist areas of physiotherapy, but we hope that its sections on anatomy, neuromusculoskeletal examination, neurology, respiratory, pharmacology and pathology and the supporting appendices are broad enough to fulfil its main purpose – to provide quick and easy access to essential clinical information during everyday clinical practice.
A project of this size would not be possible without the support of our publishing team at Elsevier who have guided us throughout the writing and production process. In addition, we have been fortunate to work alongside a large number of colleagues, students and academics who have provided invaluable encouragement and advice. If we could name them all this would definitely not be a pocket-sized book, but we would like to say a special thanks to all our colleagues and friends at East Sussex Healthcare NHS Trust, Brighton and Sussex Hospital NHS Trust and The Sussex Musculoskeletal Partnership (Central and East).
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This book is dedicated to our wonderful children, Jack and Eva, who have had to put up with more “physio stuff” than any child should ever be subjected to.
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Neuromusculoskeletal anatomy
Musculoskeletal anatomy illustrations 2
Nerve pathways 29
Brachial plexus 45
Lumbosacral plexus 46
Peripheral nerve motor innervation 47
Muscle innervation chart 53
Muscles listed by function 59
Alphabetical listing of muscles 62
References and Further Reading 89
Musculoskeletal anatomy illustrations
Cephalic
Superior
Inferior
Lateral
Medial
Dorsum of foot
Caudad
Plantar surface of foot
Sagittal (median) plane
Coronal (frontal) plane
Transverse (horizontal) plane
Anterior
Posterior
Dorsum of hand
Palmar surface of hand
Proximal
Distal
Figure 1.1 Anatomical position showing cardinal planes and directional terminology.
Levatores costarum breves
External intercostal
Quadratus lumborum
Transversus, origin from thoracolumbar fascia
Lateral intertransverse muscle
Multifidus
Figure 1.4 Deep muscles of the back.
Spinalis thoracis
Iliocostalis thoracis
Longissimus thoracis
Iliocostalis lumborum
Quadratus lumborum
Erector spinae
Semispinalis capitis
Sternocleidomastoid
Trapezius
Deltoid
Latissimus dorsi
Thoracolumbar fascia
Obliquus internus
Obliquus externus
Fascia covering gluteus medius
Fascia covering gluteus maximus
Splenis capitis
Levator scapulae
Rhomboideus minor
Supraspinatus
Infraspinatus
Teres minor
Teres major
Rhomboideus major
Serratus anterior
Serratus posterior inferior
Obliquus internus
Erector spinae
Gluteus maximus
Figure 1.5 Superficial muscles of the back, neck and trunk.
Latissimus dorsi
Digitations of serratus anterior
Intercostal internus of 10th intercostal space
Figure 1.6 Muscles of the right side of the trunk.
Rectus abdominis
Obliquus internus
Sternocostal part of pectoralis major
Clavicular part of pectoralis major
Costo-abdominal part of pectoralis major
Deltoid
Serratus anterior
Latissimus dorsi
Coracobrachialis
Biceps
Brachialis
Triceps
Triceps (long head)
Triceps (medial head)
Brachioradialis
Figure 1.7 Superficial muscles of the anterior chest and arm. Left side.
Medial intermuscular septum of arm
Flexor carpi radialis
Palmaris longus
Flexor carpi ulnaris
Flexor digitorum superficialis
Tendon to ring finger
Pisiform
Flexor retinaculum
Palmar brevis
Palmar aponeurosis
Bicipital aponeurosis
Pronator teres
Brachioradialis
Flexor digitorum superficialis, radial head
Flexor pollicis longus
Flexor pollicis brevis
Abductor pollicis brevis
Adductor pollicis, transverse head
Second lumbrical
Figure 1.10 Superficial flexors of the left forearm.
