Upper limb neurological examination

The upper limb neurological examination is a critical component of the neurological assessment, focusing on the function of the nervous system in the arms. This examination helps in diagnosing neurological disorders affecting the upper limbs.

Purpose

The primary purpose of the upper limb neurological examination is to assess the integrity of the central nervous system and peripheral nervous system pathways that innervate the upper limbs. It is used to identify abnormalities in motor function, sensory function, and reflexes.

Components

The examination typically includes the following components:

Inspection

The examiner observes the upper limbs for any signs of muscle atrophy, fasciculations, or abnormal postures. The skin is also inspected for any changes that might indicate underlying neurological issues.

Tone

Muscle tone is assessed by passively moving the patient's limbs and feeling for resistance. Abnormal tone can be indicative of upper motor neuron or lower motor neuron lesions.

Power

Muscle strength is tested by asking the patient to perform specific movements against resistance. This helps in identifying any muscle weakness and determining the affected muscle groups.

Reflexes

Deep tendon reflexes are tested using a reflex hammer. Common reflexes tested include the biceps reflex, triceps reflex, and brachioradialis reflex. Abnormal reflexes can indicate neurological dysfunction.

Sensation

Sensory function is assessed by testing the patient's ability to feel light touch, pain, temperature, and vibration. This helps in identifying sensory deficits and mapping out the affected dermatomes.

Coordination

Tests for coordination, such as the finger-to-nose test, are performed to assess the function of the cerebellum and proprioception.

Clinical Significance

The upper limb neurological examination is essential in diagnosing conditions such as stroke, multiple sclerosis, peripheral neuropathy, and cervical radiculopathy. It provides valuable information about the location and nature of neurological lesions.

Related Pages

• Neurological examination
• Peripheral nervous system
• Central nervous system
• Motor neuron

Diagram of the nerves of the left upper extremity