Upper limb neuro exam

Question 1

Give an example of a muscle innervated by the axillary nerve

Answer 1

deltoid

Question 2

nerve root for axillary nerve

Answer 2

C5

Question 3

How to test motor innervation of axillary nerve

Answer 3

shoulder abduction (deltoid)

Question 4

Where to test for sensory innervation of axillary nerve

Answer 4

lateral aspect of lower deltoid

Question 5

Give an example of a muscle innervated by the musculocutaneous nerve

Answer 5

biceps

Question 6

How to test motor function of musculocutaneous nerve

Answer 6

elbow flexion

Question 7

musculocutaneous nerve sensory test

Answer 7

lateral side of forearm

Question 8

Biceps reflex nerve

Answer 8

musculocutaneous (C5-C6)

Question 9

Radial nerve muscle innervation

Answer 9

extensors (extensor carpi radialis/ulnaris and digitorum)

Question 10

radial nerve root

Answer 10

C7

Question 11

Radial nerve motor function

Answer 11

wrist/finger extension

Question 12

radial nerve sensation test

Answer 12

back of hand (anatomical snuff box area)

Question 13

tricep reflex nerve

Answer 13

radial nerve (C7)

Question 14

Ulnar nerve muscle example

Answer 14

first dorsal interosseous

Question 15

ulnar nerve motor function

Answer 15

index finger abduction

Question 16

ulnar nerve sensory test

Answer 16

little finger palmar side

Question 17

median nerve muscle innervation

Answer 17

abductor pollicis brevis

Question 18

median nerve motor test

Answer 18

thumb abduction

Question 19

median nerve sensation test

Answer 19

palm from thumb to middle finger

Question 20

what is a radiculopathy?

Answer 20

nerve root damage resulting in sensory disturbances in the pattern of the corresponding dermatome

Question 21

what type of sensory loss do you get in a thalamic lesion (e.g. a stroke)

Answer 21

contralateral sensory loss

Question 22

MRC staging

Answer 22

0 = no contraction
1 = flicker, or trace of contraction
2 = active movement with gravity eliminated
3 = active movement against gravity
4 = active movement against gravity and resistance
5 = normal power

Question 23

pyramidal pattern of weakness

Answer 23

upper limb extensors and lower limb flexors disproportionately weaker

Question 24

spasticity vs rigidity examples

Answer 24

spasticity = pyramidal tract lesions (e.g. stroke)

rigidity = extrapyramidal tract lesions (e.g. parkinsons)

Question 25

what does spasticity look like on examination?

Answer 25

velocity dependent - faster you move the limb, the worse it is -> typically an increased tone in the initial part of the movement which then suddenly reduces past a certain point -> often combined with weakness

Question 26

what is cogwheel rigidity?

Answer 26

tremor superimposed on the hypertonia, resulting in intermittent increases in tone during movement of the limb associated with parkinsons

Question 27

what is lead pipe rigidity

Answer 27

uniformly increased tone throughout the movement of the muscle associated with neuroleptic malignant syndrome

Question 28

which nerve is responsible for 'okay' sign

Answer 28

anterior interosseus nerve arises from median nerve above medial epicondyle

Question 29

what movement tests carpal tunnel syndrome?

Answer 29

raise your thumb vertically out of an open palmar surface

Question 30

what movement tests ulnar nerve

Answer 30

cross your middle finger over the dorsal surface of your index finger / splay open your fingers

Question 31

what is the second most common nerve entrapment after carpal tunnel syndrome?

Answer 31

cubital tunnel -> ulnar nerve at the elbow

Question 32

how do you test for cubital tunnel syndrome?

Answer 32

cross your middle finger over the dorsal surface of your index finger

Question 33

cause of wrist and finger drop

Answer 33

radial nerve palsy