Position patient sitting on bed edge. Ask to hold out both hands, palms up, arms extended, eyes closed for 30 seconds. Downward drift suggests UMN weakness, upward drift indicates cerebellar disease, searching movements of fingers suggest proprioception loss.
Ask the patient to relax. Assess for stiffness and rigidity in shoulder, elbow, and wrist.
Use MRC scale: 0 (no contraction) to 5 (normal power). For finger adduction, place paper between fingers and ask patient not to let go as you pull.
Push down on outstretched arms and suddenly release. Look for excessive, uncontrolled upward movement.
Ask patient to touch nose, then your finger at arm's length. Repeat several times, moving your finger. Test both sides.
Ask patient to tap palm then dorsum of one hand on the other, alternating as fast as possible. Look for poor coordination or slow movements.
Use pin. Demonstrate on sternum first. Start distally, work proximally, test each dermatome, compare sides.
For vibration, use tuning fork on DIPJ. For proprioception, move DIPJ up/down, patient reports direction with eyes closed.
Use cotton wool with dabbing motion. Start distally, work proximally, test each dermatome, compare sides.
Classification: absent, + (reduced), ++ (normal), +++ (increased). Use reinforcement (e.g., teeth clenching) if needed.
C5/6
C7/8
Brachioradialis: C5/6
Items Completed: 0 / 39
Score: 0%