Peripheral nerve system - UL Flashcards
How do you explain this test to your patient?
Hello my name is Tahreem Bibi. I am a first year Physician Associate student.
Can I take your full name and DOB please?
Today I have been asked to perform an examination of the nerves of your arms. This will involve me looking and moving your arms as well as testing for sensation and reflexes.
Would that be okay?
Are you in any pain or discomfort?
What do you observe during inspection?
- Mobility aids / Medication
- Muscle wasting
- Fasciculations
- Muscle wasting
- Involuntary movement
- Tremor
What is the general method of this test?
- Tone
- Power
- Coordination
- Sensation
- Reflexes
When assessing tone, what instructions do you give to the patient?
Keep your arms relaxed and let me know if you are in any pain at any time.
How do you assess tone?
- Hand shake
- Hand drop
- Bend arm
- Show muscles
How do you assess power?
- Shoulder abduction/adduction (poo pose)
- Elbow flexion/extension (boxer)
- Wrist flexion/extension (Cock your wrist in front of you)
How do you assess coordination?
- Finger nose test
- Dysdiadochokinesia
Ensure to check both hands/arms
How do you access sensation?
- Light touch (cotton wool)
- Pin prick
- Vibration
- Propioception (thumb position)
When assessing sensation, which dermatomes do you check?
C5 C6 C7 C8 T1 T2
What is the special test you perform when assessing power?
Grip strength test
How do you check propioception?
Ask the patient to close their eyes and tell you which direction their thumb is in.
Where do you demonstrate the sensation method prior to performing it?
Test on sternum first
How many reflexes are there in the arms?
3
- Biceps reflex
- Triceps reflex
- Supinator reflex
Which exam would you offer your patient post this examination?
Vascular exam
Would you offer a same sex chaperone for this exam?
Yes
