Upper Limb

Wash Hands Introduce Patients Name Explain Procedure Consent Expose Arms Position Upright Finger to Nose Clapping& turning o6er

Close
+han# Patient Co6er Patient Wash Hands

Inspect
Patient General Appearance Muscle Wasting Fasciculation Asymmetry cars !e"ormities

Fluency
U * M

Tone
ha#e hand "ully

Power
A$duct houlders As# to oppose pushing do%n As# to push onto examiners hands Adduct houlders& Flex El$o%s Pull examiner to pt' Push examiner a%ay Coc# $ac# %rists Hold "orearm and as# to push do%n Coc# %rists do%n As# pt' to push up Position hands palms do%n A$duct "ingers against opposition Flexion ( extension o" "ingers Palms Up& thum$ raised )ppose $eing pushed do%n

What %ould indicate an upper motor neuron pro$lem7 Hyperreflexia Upgoing plantar Increased Tone General Muscle Weakness What %ould indicate a lo%er motor neuron pro$lem7 Hyporeflexia Specific muscle group weakness Hypotonia Fasciculations What %ould rigidity classically indicated7 Parkinsonism !ed Pipe" What is the medical research council classi"ication "or po%er7 # $ %o contraction & ' Flicker ( $ Mo)ement wit* gra)ity eliminated + $ Mo)es against gra)ity ,ut not resistance - $ Weaker t*an normal

Reflexes
*iceps +riceps *rachioradialis ,Ho""man-s and Finger .er#/

Sensation
Cotton %ool in centre o" chest ide to side& each dermatome uper"icial0deep pain +emperature 1i$ration 234 H5 +%o point discrimination ensory Inattention Proprioception

Coordination

Michael mith 3828

Upper Limb
. ' %ormal

Michael mith 3828