MEDIAN Inspect

Low: Thenar wasting Simian hand/thumb Trophic changes

ULNAR

RADIAL
Only effect SRN

Hypothenar wasting Ulnar claw hand st Dorsal web guttering esp 1 web space Trophic changes

High: Volar f/arm wasting

Ulnar volar f/arm wasting (Less claw- ulna paradox)

Dorsal forearm wasting

Very High (axilla): Tricep wasting

Motor

Low: Abd pollicis brevis Opponens pollicis

Froments test (Add pollicis) Cross finger test (Palm interos) ADM st 1 Dorsal interossei

High: FDS FDP IF FPL Very High(Axilla):

FDP LF FCU

Finger extensors Wrist extensors

Triceps

Sensory

Low: IF/Thumb High: Thenar region Very High (Axilla):

LF

ASB

Dorsal ulnar hand

ASB

Post part of f/arm + arm

Special tests for Compressive neurpathy

Carpal tunnel Syndrome: Tinels, Phalens, Durkans Pronater teres syndrome: Tinels, Pronator compression test

Cubital tunnel synd: Tinels, Elbow flexion compression test, Look for cubital valgus, thickened ulnar nerve, ulnar nerve instability Ulnar tunnel synd: Tinels, compression test

SRN syndrome (Wartenberg syndrome): Tinels Radial tunnels syndrome PIN syndrome

Differentiating Median nerve and AIN injuries MEDIAN (after AIN branch) Inspect
Thenar wasting Simian hand/thumb Trophic changes Volar f/arm wasting Abd pollicis brevis Opponens pollicis FDS IF/Thumb Thenar region

AIN (Pure motor)

Volar f/arm wasting

Motor

FDP IF FPL (Also pronator quadratus) NIL

Sensory

Differentiating Radial nerve and PIN injuries RADIAL Inspect

Dorsal forearm wasting Tricep wasting

PIN (pure motor)

Dorsal forearm wasting

Motor

Finger extensors Wrist extensors Triceps (if very high lesion - in axilla) ASB Post part of f/arm + arm (if very high lesion - in axilla)

Finger extensors

Sensory

NIL

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