Peripheral Nervous Examination Flashcards
What question should you ask before you start a ULPNE
Do you have any pain, tingling or weakness in your arms or hands?
What are you inspecting for in an ULPNE
Wasting and fasciculation (LMN) Abnormal posturing (UMN) Pronator drift (subtle UMN)
How do you test tone in an ULPNE
Pronate and supinate arm passively
Flex/extend wrist passively
Flex/extend elbow passively
How do you test power in an ULPNE
Shoulder abduction Elbow flexion Elbow extension Wrist extension Finger extension Finger flexion Thumb abduction Finger abduction
What are the nerve roots for:
Shoulder abduction Elbow flexion Elbow extension Wrist extension Finger extension Finger flexion Thumb abduction Finger abduction
Shoulder abduction - C5 Elbow flexion - C5/C6 Elbow extension - C7 Wrist extension - C6 Finger extension - C7 Finger flexion - C8 Thumb abduction - T1 Finger abduction - T1
What reflexes do you have to test in ULPNE
Biceps jerk
Triceps jerk
Supinator jerk
How do you test co-ordination in ULPNE
Wiggle fingers (UMN, Parkinsons)
Hand slapping test (Cerebellar ataxia)
Finger-nose test (cerebellar ataxia)
How do you test sensation in ULPNE
All done with patient’s eyes closed:
Light touch (cotton wool) Pain touch (neurotip) Joint position in space (move thumb up and down) Vibration (tuning fork)
How do you complete an ULPNE
Detailed neurological exam of hands
LLPNE
Nerve conduction studies
CT/MRI
What questions do you ask before a LLPNE
Do you have any pain, numbness or tingling
What do you inspect for in LLPNE
Symmetry, fasciculations, muscle wasting (UMN)
Abnormal posture
Soft tissue damage (sensory neuropathy)
How do you assess tone in an LLPNE
Rock floppy leg from side to side
Suddenly pull foot into dorsiflexion to elicit clonus
How do you assess power in an LLPNE
Hip flexion Hip extension Knee flexion Knee extension Ankle dorsiflexion Big toe extension Ankle plantarflexion
What are the nerve roots for:
Hip flexion Hip extension Knee flexion Knee extension Ankle dorsiflexion Big toe extension Ankle plantarflexion
Hip flexion - L1/L2 Hip extension - L5/S1 Knee flexion - L5/S1 Knee extension - L3/L4 Ankle dorsiflexion - L4 Big toe extension - L5 Ankle plantarflexion - S1
What reflexes do you test in a LLPNE
Knee jerk
Ankle jerk
Plantar reflex
