Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MD1 PCP > Basic Neurological Exam of Upper Limbs > Flashcards

Basic Neurological Exam of Upper Limbs Flashcards

1
Q

What are the main steps in an exam of the upper limbs?

A 
Prepare patient
Hand hygiene
Inspection
Tone
Power
Deep tendon reflexes
Coordination
Sensory exam
Complete exam
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the adequate exposure for this exam?

A

Singlet or t-shirt off

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How do you prepare the patient?

A 
Explain reason for exam
In general what it'll involve
Ask about pain in arms
Advise them to inform you if exam uncomfortable/painful
Ensure arms adequately exposed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How do you inspect the patient?

A 
Ask patients to rest arms on pillow
Inspect upper limbs
Inspect cervical spine
- Scars
- Deformity
Posture of limbs
Muscle bulk
- Note particular pattern if any muscle wasting
Fasciculations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How do you measure tone?

A

Assess passive resistance against movement
Make sure patient is relaxed
Flex and extend elbow
Flex and extend wrist
Rapid supination and pronation of forearm whilst supporting elbow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How do you measure tone if resistance is detected?

A

Make moves unpredictable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How do you measure power?

A 
Functional testing
Compare both sides
Start at shoulder
Progress distally from joint to joint
Clear and explicit instructions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How do you test for mild upper limb weakness?

A

Ask patient to close eyes

Hold arms straight out with palms facing upwards for a minute

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What do you see in the test for mild upper limb weakness if there is reduced strength?

A

Arms start to pronate and drift down = pronator drift

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What kind of patient is the mild upper limb weakness test good for?

A

Stroke patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What may affect how a patient performs in a power exam?

A

Motivation
Pain
Changes in tone
Your own muscle strength

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which nerve roots control shoulder abduction?

A

C4, C5, C6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How do you test the power of shoulder abduction?

A

Ask patient to flex arms at elbows
Abduct shoulders to 90 degrees
Patient maintains position as you push down on elbows

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which nerve roots control elbow flexion?

A

C5, C6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How do you test the power of elbow flexion?

A

Patient flexes elbow

Apply counter resistance to forearm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which nerve roots control elbow extension?

A

C7, C8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How do you test the power of elbow extension?

A

Patient extends elbow

Apply counter resistance to forearm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Which nerve roots control wrist extension?

A

C6, C7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How do you test the power of wrist extension?

A

Patient makes fist
Place your fist against back of patient’s hand
Patient tries to bend back wrist whilst you apply counter resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which nerve roots control wrist flexion?

A

C6, C7, C8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How do you test the power of wrist flexion?

A

Patient makes fist

Flex wrist as you apply counter resistance

22
Q

Which nerve roots control finger extension?

A

C7, C8

23
Q

How do you test the power of finger extension?

A

Patient holds fingers out straight
Place your hands against back of patient’s fingers distal to metacarpophalangeal joints
Patient keeps fingers straight as you apply counter resistance

24
Q

Which nerve roots control finger flexion?

A

C7, C8

25
Q

How do you test the power of finger flexion?

A

Patient curls fingers up

Keep them flexed while you apply counter resistance

26
Q

Which nerve roots control finger abduction?

A

C8, T1

27
Q

How do you test the power of finger abduction?

A

Patient spreads fingers

Resist as you squeeze them together

28
Q

What else does testing the power of finger abduction measure?

A

Ulnar nerve function

29
Q

How do you test the power of finger adduction?

A

Patient holds folded piece of paper between fingers

You try to pull it away

30
Q

What else does testing the power of finger adduction measure?

A

Ulnar nerve function

31
Q

Which nerve roots control finger adduction?

A

T1

32
Q

Which nerve roots control thumb abduction?

A

T1

33
Q

How do you test the power of thumb abduction?

A

Abduct thumb up to touch your finger

Apply counter pressure

34
Q

In which direction is thumb abduction?

A

Same direction as finger flexion

35
Q

What else does testing the power of thumb abduction measure?

A

Median nerve function

36
Q

Where are the deep tendon reflexes in the upper limb?

A

Biceps jerk
Brachioradialis jerk
Triceps jerk
Finger jerk

37
Q

What must the patient be to test deep tendon reflexes?

A

Relaxed

38
Q

What reinforcement can be used to test deep tendon reflexes in the upper limb?

A

Clench teeth

39
Q

How do you test the biceps jerk?

A 
Patient sits facing you
Hands on lap
Place your thumb/forefinger over biceps tendon at elbow
Tap it with your tendon hammer
Look for flexion at elbow
40
Q

Which nerve roots are involved in the biceps jerk?

A

C5, C6

41
Q

How do you test the brachioradialis jerk?

A

Tap over lower end of radius

Look for flexion of elbow and/or supination

42
Q

Which nerve roots are involved in the brachioradialis jerk?

A

C5, C6

43
Q

How do you test the triceps jerk?

A

Tap over triceps tendon

Look for brisk extension of elbow

44
Q

Which nerve roots are involved in the triceps jerk?

A

C7, C8

45
Q

How do you test for the finger jerk?

A

Lift patient’s fingers passively against your own

Tap your fingers

46
Q

Which nerve roots are involved in the finger jerk?

A

C8

47
Q

How do you test for coordination in the upper limb?

A

Finger-nose test

48
Q

How do you perform the finger-nose test?

A

Ask patient to touch tip of their nose with their index finger >
Stretch out to nearly full extension of shoulder and elbow >
Touch your index finger repetitively
Perform for both arms

49
Q

What is dydiadochokinesis?

A

Clumsiness of pronating and supinating one hand on the other

50
Q

What sensations are tested in the upper limb?

A

Pain with toothpick
Light touch with cotton wool
Vibration sense with tuning fork interphalangeal joint of thumb
Proprioception of thumb

51
Q

What are the dermatome testing areas of the upper limb?

A 
C4 = shoulder
C5 = "military badge" area of upper arm
C6 = tip of thumb
C7 = tip of middle finger
C8 = tip of little finger
T1 = upper inner arm
52
Q

What is the last step in a neurological exam of the upper limb?

A

Close exam

MD1 PCP (43 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions