Examination of the upper limbs

Question 1

What should be looked for on observation?

Answer 1

Atrophy
Fasciculation
Involuntary movements
Scars
Skeletal deformity
Tremor

Question 2

How is tone tested?

Answer 2

Exlow flexion and extension
Wrist flexion and extension
Finger flexion and extension

Question 3

How is power tested?

Answer 3

Shoulder abduction
Elbow flexion and extension
Wrist flexion and extension
Finger flexion and extension
Squeeze and spread fingers
Raise thumb to ceiling
Pronator drift

Question 4

How is pronator drift tested?

Answer 4

Ask patient to hold arms straight out in front of them, pals up, eyes closed

Question 5

How is coordination tested?

Answer 5

Tremor
Finger nose test
Test for dysdiadochokinesis

Question 6

How is dysdiadochokinesis tested?

Answer 6

Tap the back of one hand with the other, straight then alternating on each hand

Question 7

What reflexes are tested?

Answer 7

Biceps
Supinator
Triceps

Question 8

What spinal level does the biceps reflex check?

Answer 8

C5/6

Question 9

What spinal level does the supinator reflex check?

Answer 9

C6

Question 10

How is the supinator reflex checked?

Answer 10

Place thumb over point 3-4cm distal to the end of the radius with the patient’s hand semi-pronated and strike own thumb

Question 11

What spinal level does the triceps reflex check?

Answer 11

C7

Question 12

How is the triceps reflex checked?

Answer 12

Strike tendon directly above olecranon

Question 13

What are the methods by which sensation is tested?

Answer 13

Light sensation
Sharp sensation
Vibration sense
Joint position sense

Question 14

What regions should be checked in sensation?

Answer 14

Little finger
Middle finger
Thumb
Lateral and medial forearm
Lateral and medial arm

Question 15

What should you ask the patient when testing light sensation?

Answer 15

To tell you when they feel something

Question 16

What should you ask the patient when testing sharp sensation?

Answer 16

To tell you if they feel a sharp or blunt sensation

Question 17

Where should light and sharp sensation be checked?

Answer 17

Lateral arm
Lateral forearm
Thumb
Middle finger
Little finger
Medial forearm
Medial arm

Question 18

What spinal level do each of the areas for light and sharp sensation check?

Answer 18

Lateral arm C5
Lateral forearm C6
Thumb C6
Middle finger C7
Little finger C8
Medial forearm T1
Medial arm T2

Question 19

Where should vibration sense be checked?

Answer 19

Most distal joint of the finger and moving proximally if no sensation

Question 20

What should you ask the patient when testing vibration sense?

Answer 20

When they can feel vibration

Question 21

How is joint position sense checked?

Answer 21

Hold the patient’s finger on either side and move it up or down, and ask the patient to tell you which way it is moving