Upper Limb Sensory Exam

September 22, 2015 Print Friendly Version of this page Print Get a PDF version of this webpage PDF
Introduces self
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1

Confirms name & age of patient
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1

Explains & gains consent
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1

Checks pain/numbness/paraesthesia/handedness
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1

Exposes patient from waist up
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1

General inspection for walking aids, deformities, asymmetries, resting tremor, dyskinesia
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1

Closer inspection for fasciculations, cafe au lait spots, scars, wasting
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1

Assesses light touch (comparing both sides and comparing with sternum) for C4, C5
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1

Assesses light touch for C6, C7
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1

Assesses light touch for C8, T1, T2
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1

Maps out any abnormality
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1

Assesses or offers sharp touch with neurotip over C4, C5, C6
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1

Assesses or offers sharp touch with neurotip over C8, T1, T2
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1

Maps out any abnormality
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1

Vibration sense on distal joint of index finger. Ask patient to report when vibration stops before stopping it manually. Moves proximally if absent.
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1

Tests proprioception in index finger moving proximally if absent
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1

Tests Phalen, Tinel's, Froment's tests if appropriate and offers to test 2 point discrimination, inattention and temperature with hot/cold rods
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1

Thanks patient and offers help to redress
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1

Washes hands
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1

Requests full neurological exam
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1

Summarises appropriately with only key findings
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1

Offers appropriate differential diagnoses
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1

Patient global score
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1
2
Potential differentials
  • Bilateral distal sensory loss (glove and stocking distribution)
    • Diabetes/B12 and folate/Drugs etc.