Neurology - Patterns of Signs Flashcards
C5
Movements:
- shoulder abduction (axillary nerve, deltoid)
- elbow flexion (musculocutaneous nerve, bicep)
**Sensation: **Lateral upper arm supinator
**Reflex: **biceps
C6
Movements:
- elbow flexion (musculocutaneous nerve, bicep)
- wrist extension (radial and posterior interosseous nerve, extensor CU and CR)
Sensation: Lateral lower arm and thumb
Reflex: biceps
biceps
C7
Movements:
- elbow extension (radial nerve - tricep)
- wrist extension (radial and posterior interosseous nerve - extensor CU and CR)
- wrist flexion (median and ulnar)
Sensation: Middle of hand (middle finger)
Reflex: triceps
C8
Movements:
- wrist flexion (median and ulnar)
- finger abduction (ulnar, dorsal interossei + ADM)
- finger adduction (ulnar - palmar interossei)
- thumb opposition (median - opponens policis)
Sensation: Medial hand and wrist
Reflex: triceps
T1
Movements:
- finger abduction (ulnar, dorsal interossei + ADM)
- finger adduction (ulnar - palmar interossei)
- thumb opposition (median - opponens policis)
Sensation: Medial arm (around elbow)
Radial Nerve
Movements:
- elbow extension (triceps)
- wrist extension (extensor carpi radialis/ulnaris)
- finger extension (extensor digitorum)
- thumb abduction (APL)
- thumb extension (EPB and EPL)
[also: elbow flexion in semi-supination (brachioradialis) and supination (supinator)]
Sensation: anatomical snuff box
(supplies whole dorsal forearm including dorsum of hand and thumb)
Reflexes: radial nerve is the efferent part of the triceps and supinator reflexes
Screening:
thumbs up
snuffbox sensation
Ulnar Nerve
Movements:
- Finger abduction (dorsal interossei)
- Finger adduction (palmar interossei)
- Thumb adduction (AP)
[Also: forearm and finger flexion (FCU and FDP) but median may compensate. Also:movement of the little finger (ODM, AbDM, FDMB)]
Sensation: little and half of ring finger (anterior and tips)
Screening:
cross your fingers
little finger sensation
Froment’s sign: pinching a piece of paper, weak adduction of the thumb leads to thumb flexing at the IP joints to try and maintain grip
Median Nerve
Movements:
- Flexion and pronation of wrist and fingers (almost all of the anterior forearm compartment)
- Thumb opposition, abduction and flexion (LOAF muscles)
Sensation: thumb, index, middle and 1/2 ring finger (anterior and tips)
Screening:
OK sign
index finger sensation
Tinel’s and Phalen’s test
Upper Brachial Plexus
(C5/C6)
Movements:
- unable to abduct, externally rotate, or supinate (“waiter’s tip” position)
Sensation: lost over lateral arm and forearm
Erb’s Palsy - usually secondary to birth trauma or motorcycle accident (neck stretched)
Lower Brachial Plexus
(C8/T1)
**Movements: **
- intrinsic muscles of the hand - all fingers clawed
Sensation: lost over medial hand and forearm
Klumpke’s palsy - usually breech birth or motorcycle (stretching arm up)
