Upper limb neuro

Inspection

Upper limbs and cervical spine

·           Wasting

·           Scars

·           Deformity

Tone

·           Shoulders

·           Elbows

·           Wrists

Power

·           Shoulder abduction: C5-6

·           Shoulder adduction: C7-8

·           Elbow flexion: C5-6

·           Elbow extension: C7-8

·           Wrist flexion: C6-7

·           Wrist extension: C6-7

·           Finger flexion: C7-8

·           Finger extension: C7-8

·           Finger abduction: C8-T1

·           Finger adduction: C8-T1

(Nothing 0, flicker 1, no gravity 2, gravity 3, reduced 4, normal 5)

Reflexes

·           Biceps C5-6

·           Triceps C7-8

·           Brachioradialis C5-6

·           Finger C7-8

(Low 1+, normal 2+, high 3+)

Co-ordination

·           Finger-to-nose

Sensation

·           DCML: light touch, vibration, proprioception

·           ALS: pain, temperature

·           C4: shoulder

·           C5: lateral arm

·           C6: lateral forearm

·           C7: middle finger

·           C8: pinkie finger

·           T1: medial forearm

·           T2: medial arm/axilla

 

 

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