Upper Limb Examination Flashcards
What are the steps in upper limb examination?
- General observation
- Inspection
- Tone
- Power
- Reflexes
- Co-ordination
- Sensation
- Function
What should you look for on general observation in upper limb examination?
Clues such as wheelchair, orthoses or splints, helmet, or dysmorphic features
In what position should you inspect the upper limbs?
Child standing
What should you inspect for in upper limb examination?
- Posture
- Contractures
- Muscle bulk. wasting, and (pseudo)hypertrophy
- Involuntary muscles and fasciculations
- Scars
- Limb shortening
How should you assess tone in upper limb examination?
Whilst holding onto their hand passively, move their arm in unexpected, irregular movements
What nerve root provides shoulder abduction?
C5
What nerve root provides shoulder adduction?
C7 and 8
What nerve root provides elbow flexion?
C5 and 6
What nerve root provides elbow extension?
C7 and 8
How should you assess power in the hands?
- Squeeze my fingers
- Spread your fingers out wide
What reflexes should be tested in upper limb examination?
- Biceps
- Triceps
- Brachioradialis
What nerves are involved in the biceps reflex?
C5 and 6
What nerves are involved in the triceps reflex?
C7 and 8
What nerves are involved in the brachioradialis reflex?
C5 and 6
How should you test for co-ordination in upper limb examination?
- Finger nose test
- Hand tapping
What does the finger nose test assess for?
Dysmetria
How should the finger nose test be performed?
Ask the child to touch their nose with their index finger, then your finger. You must move your finger to different sites at different arm lengths
What does hand-tapping assess for?
Dysdiadokinesia
How is hand-tapping assessed?
Get them to tap one hand on the back of the other, and alternative between tapping between the palm and back of the hand
What dermatome does C4 supply?
Tip of shoulder
What dermatome does C5 supply?
Lateral surface of upper arm
What dermatome does C6 supply?
Lateral surface of forearm
What dermatome does C7 supply?
Radial surface of middle finger
What dermatome does C8 supply?
Ulnar border of hand
What dermatome does T1 supply?
Medial surface of forearm
What dermatome does T2 supply?
Medial surface of upper arm
How is the function of the upper limb assessed?
Asking the child to draw/write/pick up objects
