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Cervical spine and upper limb examination

Updated: May 6, 2022

Inspection of the neck (deformities/scars/postures)

Winging of the scapula (long thoracic nerve palsy)


Active movement of the neck

- Flexion (chin to chest)

- Extension (look up and back)

- Lateral bending (ear to shoulder)

- Rotation (look over shoulder to the back)


Spurling's test


Palpation:

- Spinous processes


Neurological examination of the upper limbs


Tone - Flaccid, Rigidity

Power - 0-5 (3 just more than gravity)


Reflexes:

- Biceps (C5)

- Brachioradialis (C6)

- Triceps extension (C7)

- Finger flexion (C8)


Myotomes:

- Elbow flexors (C5)

- Wrist extensors (C6)

- Elbow extensors (C7)

- Finger flexors (C8)

- Finger abductors (T1)


Dermatomes:

- C2 - Back of neck

- C3 - Lower part of neck

- C4 - Shoulder tip

- C5 - Lateral elbow

- C6 - Thumb

- C7 - Middle finger

- C8 - Little finger

- T1 - Medial elbow

- T2 - Axilla



Radian nerve - Wrist extension / Back of hand

Median nerve - Thumb flexion / Thumb and second finger anteriorly

Ulnar nerve - Paper between thumbs (U between the U bits!) - adductors / Small finger


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