Neurological examinaton of the upper limb (illustration)

Case contributed by Leonardo Lustosa
Diagnosis not applicable
1:1
4:5
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Info

Diagram illustrating the sensory distribution and motor function of the main nerves of the upper limb.

(Download for better resolution)

A version of this illustration in Portuguese can be downloaded here: https://commons.wikimedia.org/wiki/File:Exame_neurol%C3%B3gico_do_membro_superior.png

Case Discussion

The sensory distribution is subject to intra- and inter-individual variability. Some areas that more reliably assess each nerve are 4:

  • median: palmar aspect of the thumb

  • radial: dorsal aspect of the proximal phalanx of the thumb

  • ulnar: the 5th finger

The motor function can be memorized using the "rock-paper-scissors-OK" mnemonic 1-3:

  • median (rock): flexion of the 2nd and 3rd MCPJs

  • radial (paper): extension of MCPJs and the thumb; a "thumbs up" can be used alternatively

  • ulnar (scissors): finger abduction and flexion of the 4th and 5th DIPJs

  • anterior interosseous (OK sign): flexion of the thumb and the 2nd finger (branch of the median n.)

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