{"id":163,"date":"2010-06-09T09:53:45","date_gmt":"2010-06-09T08:53:45","guid":{"rendered":"https:\/\/cloverock.info\/mockosce23\/new\/upper-limbs\/"},"modified":"2023-01-12T00:22:03","modified_gmt":"2023-01-12T00:22:03","slug":"upper-limbs","status":"publish","type":"post","link":"https:\/\/www.qpercom.com\/sim\/index.php\/the-neurological-examination\/motor-function\/upper-limbs\/","title":{"rendered":"Upper limbs"},"content":{"rendered":"<p><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/116863973?dnt=1&amp;app_id=122963\" width=\"640\" height=\"480\" frameborder=\"0\" allow=\"autoplay; fullscreen; picture-in-picture\" allowfullscreen><\/iframe><\/p>\n<p><em>Serratus anterior muscle <\/em>(C5, C6 and C7, long thoracic nerve)<\/p>\n<ul>\n<li>The patient should stand with the arms stretched out and hands making contact with the wall.<br \/>\nThe hands should be placed at approximately shoulder height.&nbsp;<\/li>\n<li>Assess whether the scapulae remain against the thoracic wall [Figure 41].<\/li>\n<\/ul>\n<p><span class=\"jce_caption\" style=\"display: inline-block;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-153\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/06\/NeuroExam_n-fig-41.jpg\" alt=\"\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/06\/NeuroExam_n-fig-41.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/06\/NeuroExam_n-fig-41-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\">Figure 41<\/span><\/span><\/p>\n<p><em>Deltoid muscle <\/em>(C4, C5 and C6, axillary nerve)<\/p>\n<ul>\n<li>The patient should extend their arms out to the side and try to maintain that position.<\/li>\n<li>Try to push both arms down [Figure 42].<\/li>\n<\/ul>\n<p><span class=\"jce_caption\" style=\"display: inline-block;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-154\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/06\/NeuroExam_n-fig-42.jpg\" alt=\"\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/06\/NeuroExam_n-fig-42.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/06\/NeuroExam_n-fig-42-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\">Figure 42<\/span><\/span><\/p>\n<p><em>Biceps brachii muscle<\/em> (C5 and C6, musculocutaneous nerve)<\/p>\n<ul>\n<li>The patient flexes the arm maximally at the elbow, with the forearm in supination.<\/li>\n<li>Try to extend the arm [Figure 43].<\/li>\n<\/ul>\n<p><span class=\"jce_caption\" style=\"display: inline-block;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-155\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/06\/NeuroExam_n-fig-43.jpg\" alt=\"\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/06\/NeuroExam_n-fig-43.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/06\/NeuroExam_n-fig-43-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\">Figure 43<\/span><\/span><\/p>\n<p><em>Triceps brachii muscle <\/em>(C7 and C8, radial nerve)<\/p>\n<ul>\n<li>The patient extends the arm maximally at the elbow.<\/li>\n<li>Try to flex the arm [Figure 44].<\/li>\n<\/ul>\n<p><span class=\"jce_caption\" style=\"display: inline-block;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-156\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/06\/NeuroExam_n-fig-44.jpg\" alt=\"\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/06\/NeuroExam_n-fig-44.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/06\/NeuroExam_n-fig-44-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\">Figure 44<\/span><\/span><\/p>\n<p><em>Extensor muscles of the wrist <\/em>(C6 and C7, radial nerve)<\/p>\n<ul>\n<li>The patient should keep the wrist in extension with pronation of the forearm.<\/li>\n<li>Try to flex the wrists [Figure 45].<\/li>\n<\/ul>\n<p><span class=\"jce_caption\" style=\"display: inline-block;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-157\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/06\/NeuroExam_n-fig-45.jpg\" alt=\"\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/06\/NeuroExam_n-fig-45.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/06\/NeuroExam_n-fig-45-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\">Figure 45<\/span><\/span><\/p>\n<p><em>Flexor muscles of the wrist<\/em> (C7, C8 and Th1, median nerve)<\/p>\n<ul>\n<li>Ask the patient to lay their forearm on the table in supination, and then to make a fist and flex the wrist.<\/li>\n<li>Try to extend the wrist [Figure 46].<\/li>\n<\/ul>\n<p><span class=\"jce_caption\" style=\"display: inline-block;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-158\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/06\/NeuroExam_n-fig-46.jpg\" alt=\"\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/06\/NeuroExam_n-fig-46.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/06\/NeuroExam_n-fig-46-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\">Figure 46<\/span><\/span><\/p>\n<p><em>Flexor muscles of the fingers<\/em> (C7, C8 and Th1, median nerve)<\/p>\n<ul>\n<li>Ask the patient to squeeze your outstretched index and middle finger as hard as possible [Figure 47].<\/li>\n<\/ul>\n<p><span class=\"jce_caption\" style=\"display: inline-block;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-159\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/06\/NeuroExam_n-fig-47.jpg\" alt=\"\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/06\/NeuroExam_n-fig-47.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/06\/NeuroExam_n-fig-47-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\">Figure 47<\/span><\/span><\/p>\n<p><em>Extensor muscles of the fingers<\/em> (C7, C8, radial nerve)<\/p>\n<ul>\n<li>Instruct the patient to extend their fingers. Try to flex the fingers at the metacarpophalangeal joint [Figure 48].<\/li>\n<\/ul>\n<p><span class=\"jce_caption\" style=\"display: inline-block;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-160\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/06\/NeuroExam_n-fig-48.jpg\" alt=\"\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/06\/NeuroExam_n-fig-48.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/06\/NeuroExam_n-fig-48-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\">Figure 48<\/span><\/span><\/p>\n<p><em>Opponens pollicis muscle <\/em>(C6, C7, median nerve)<\/p>\n<ul>\n<li>Ask the patient to hold the tip of their thumb and the tip of their little finger together as tightly as possible.<\/li>\n<li>Using your finger, try to break the circled formed by the&nbsp;patient\u2019s thumb and finger [Figure 49].<\/li>\n<\/ul>\n<p><span class=\"jce_caption\" style=\"display: inline-block;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-161\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/06\/NeuroExam_n-fig-49.jpg\" alt=\"\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/06\/NeuroExam_n-fig-49.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/06\/NeuroExam_n-fig-49-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\">Figure 49<\/span><\/span>&nbsp;<\/p>\n<p><em>Interosseus muscles<\/em> (C8, Th1, ulnar nerve)<br \/>\nAsk the patient to extend their fingers and spread them apart.<\/p>\n<ul>\n<li>Do the same and place your fingers between those of the patient.<\/li>\n<li>Ask the patient to close their fingers using as much force as possible [Figure 50].<\/li>\n<li>Carry this out on the left and right hand simultaneously to enable you to make a good comparison.<\/li>\n<\/ul>\n<p><span class=\"jce_caption\" style=\"display: inline-block;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-162\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/06\/NeuroExam_n-fig-50.jpg\" alt=\"\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/06\/NeuroExam_n-fig-50.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/06\/NeuroExam_n-fig-50-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\">Figure 50<\/span><\/span><strong>&nbsp;<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Serratus anterior muscle (C5, C6 and C7, long thoracic nerve) The patient should stand with the arms stretched out and hands making contact with the wall. The hands should be placed at approximately shoulder height.&nbsp; Assess whether the scapulae remain against the thoracic wall [Figure 41]. Figure 41 Deltoid muscle (C4, C5 and C6, axillary [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[8],"tags":[113],"class_list":["post-163","post","type-post","status-publish","format-standard","hentry","category-motor-function","tag-the-neurological-examination"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Upper limbs - Qpercom | Skills in Medicine<\/title>\n<meta name=\"description\" content=\"Online Mock OSCEs with examiners, patient actors, instant results and personalised feedback. 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