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    Edward De Leon
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    This document provides a compilation of information on special tests, terminologies, pathologies, and motor, sensory and functional losses associated with different nerves. It includes sections on the median nerve, anterior interosseous nerve, ulnar nerve, radial nerve and posterior interosseous nerve. For each nerve, it lists the associated motor losses, sensory losses and resulting functional deficits. The purpose is to help understand difficult signs and symptoms and make differential diagnoses.

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    This document provides a compilation of information on special tests, terminologies, pathologies, and motor, sensory and functional losses associated with different nerves. It includes sections on the median nerve, anterior interosseous nerve, ulnar nerve, radial nerve and posterior interosseous nerve. For each nerve, it lists the associated motor losses, sensory losses and resulting functional deficits. The purpose is to help understand difficult signs and symptoms and make differential diagnoses.

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    29 views6 pages

    Conditions

    Uploaded by

    Edward De Leon
    This document provides a compilation of information on special tests, terminologies, pathologies, and motor, sensory and functional losses associated with different nerves. It includes sections on the median nerve, anterior interosseous nerve, ulnar nerve, radial nerve and posterior interosseous nerve. For each nerve, it lists the associated motor losses, sensory losses and resulting functional deficits. The purpose is to help understand difficult signs and symptoms and make differential diagnoses.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
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    of 6

    Conditions

    compilation

    This is a compilation of PT Evaluation


    Transcribed by Ed DL

    EDL
    SPECIAL TESTS  To unravel difficult signs and symptoms

    TERMINOLOGIES/PATHOLOGIES
    PRINCIPLES
    Paratenotis – Inflammation of the paratenon of the tendon
    Paratendon – Outer covering of the tendon whether or not it is
    GENERAL lined with synovium
    Tendinitis – Acute condition where the tendons that connect
    muscles to bone become inflamed
    RATIONALE Tendinosis – Actual degeneration of the tendon itself, does not
     To confirm a tentative diagnosis involve inflammation
     To make a differential diagnosis
     To differentiate between structures
     To understand unusual signs
    EBLOW

    NERVE MOTOR LOSS SENSORY LOSS FUNCTIONAL LOSS


    Pronator teres
    Flexor carpi radialis Pronation weak or lost
    Palmaris longus Palmar aspect of hand with Weak wrist flexion and abduction
    Flexor digitorum superficialis thumb, index, middle, and lateral Radial deviation at wrist lost
    Flexor pollicis longus half of ring finger Inability to oppose or flex thumb
    MEDIAN NERVE (C6 – C8,T1)
    Lateral half of flexor digitorum Dorsal aspect of distal third of Weak thumb adduction
    profundus index, middle, and lateral half of Weak grip
    Pronator quadratus ring finger Weak or no pinch (ape hand
    Thenar eminence deformity)
    Lateral two lumibricals
    Flexor pollicis longus Pronation weak especially at 90
    Lateral half of flexor digitorum elbow flexion
    ANTERIOR INTEROSSEUS
    profundus Weak opposition and flexion of
    NERVE (BRANCH OF None
    Pronator quadratus thumb
    MEDIAN NERVE)
    Thenar eminence Weak finger flexion
    Lateral two lumbricals Weak pinch (no tip-to-tip)
    Weak wrist flexion
    Flexor carpi ulnaris Loss of ulnar deviation at wrist
    Medial half of flexor digitorum Loss of distal flexion of little
    profundus finger Loss of abduction and
    Palmaris brevis Dorsal and palmar aspect of little adduction of fingers
    ULNAR NERVE (C7 – C8, T1)
    Hypothenar eminence and medial half of ring finger Inability to extend second and
    Adductor pollicis third phalanges of little and ring
    Medial two lumbricals fingers (benediction hand
    All interossei deformity)
    Loss of thumb adduction
    Anconeus
    Brachioradialis
    Extensor carpi radialis longus and Loss of supination
    Dorsum of hand (lateral two
    brevis Loss of wrist extension (wrist
    thirds)
    Extensor digitorum drop)
    Dorsum and lateral aspect of
    RADIAL NERVE (C5 – C8, T1) Extensor pollicis longus and Inability to grasp
    thumb
    brevis Inability to stabilize wrist
    Proximal two-thirds of dorsum of
    Abductor pollicis longus Loss of finger extension
    index, middle, and half rig finger
    Extensor carpi ulnaris Inability to abduct thumb
    Extensor indices
    Extensor digiti minimi
    Extensor carpi radialis brevis
    Extensor digitorum
    Wear wrist extension
    Extensor pollicis longus and
    POSTERIOR INTEROSSEUS Weak finger extension
    brevis
    NERVE (BRANCH OF None Difficulty stabilizing wrist
    Abductor pollicis longus
    RADIAL NERVE) Difficulty with grasp
    Extensor carpi ulnaris
    Inability to abduct thumb
    Extensor indices
    Extensor digiti minimi
    EBLOW

    NERVE MOTOR LOSS SENSORY LOSS FUNCTIONAL LOSS


    Pronator teres
    Flexor carpi radialis Pronation weak or lost
    Palmaris longus Palmar aspect of hand with Weak wrist flexion and abduction
    Flexor digitorum superficialis thumb, index, middle, and lateral Radial deviation at wrist lost
    Flexor pollicis longus half of ring finger Inability to oppose or flex thumb
    MEDIAN NERVE (C6 – C8,T1)
    Lateral half of flexor digitorum Dorsal aspect of distal third of Weak thumb adduction
    profundus index, middle, and lateral half of Weak grip
    Pronator quadratus ring finger Weak or no pinch (ape hand
    Thenar eminence deformity)
    Lateral two lumibricals
    Flexor pollicis longus Pronation weak especially at 90
    Lateral half of flexor digitorum elbow flexion
    ANTERIOR INTEROSSEUS
    profundus Weak opposition and flexion of
    NERVE (BRANCH OF None
    Pronator quadratus thumb
    MEDIAN NERVE)
    Thenar eminence Weak finger flexion
    Lateral two lumbricals Weak pinch (no tip-to-tip)
    Weak wrist flexion
    Flexor carpi ulnaris Loss of ulnar deviation at wrist
    Medial half of flexor digitorum Loss of distal flexion of little
    profundus finger Loss of abduction and
    Palmaris brevis Dorsal and palmar aspect of little adduction of fingers
    ULNAR NERVE (C7 – C8, T1)
    Hypothenar eminence and medial half of ring finger Inability to extend second and
    Adductor pollicis third phalanges of little and ring
    Medial two lumbricals fingers (benediction hand
    All interossei deformity)
    Loss of thumb adduction
    Anconeus
    Brachioradialis
    Extensor carpi radialis longus and Loss of supination
    Dorsum of hand (lateral two
    brevis Loss of wrist extension (wrist
    thirds)
    Extensor digitorum drop)
    Dorsum and lateral aspect of
    RADIAL NERVE (C5 – C8, T1) Extensor pollicis longus and Inability to grasp
    thumb
    brevis Inability to stabilize wrist
    Proximal two-thirds of dorsum of
    Abductor pollicis longus Loss of finger extension
    index, middle, and half rig finger
    Extensor carpi ulnaris Inability to abduct thumb
    Extensor indices
    Extensor digiti minimi
    Extensor carpi radialis brevis
    Extensor digitorum
    Wear wrist extension
    Extensor pollicis longus and
    POSTERIOR INTEROSSEUS Weak finger extension
    brevis
    NERVE (BRANCH OF None Difficulty stabilizing wrist
    Abductor pollicis longus
    RADIAL NERVE) Difficulty with grasp
    Extensor carpi ulnaris
    Inability to abduct thumb
    Extensor indices
    Extensor digiti minimi
    EBLOW

    NERVE MOTOR LOSS SENSORY LOSS FUNCTIONAL LOSS


    Pronator teres
    Flexor carpi radialis Pronation weak or lost
    Palmaris longus Palmar aspect of hand with Weak wrist flexion and abduction
    Flexor digitorum superficialis thumb, index, middle, and lateral Radial deviation at wrist lost
    Flexor pollicis longus half of ring finger Inability to oppose or flex thumb
    MEDIAN NERVE (C6 – C8,T1)
    Lateral half of flexor digitorum Dorsal aspect of distal third of Weak thumb adduction
    profundus index, middle, and lateral half of Weak grip
    Pronator quadratus ring finger Weak or no pinch (ape hand
    Thenar eminence deformity)
    Lateral two lumibricals
    Flexor pollicis longus Pronation weak especially at 90
    Lateral half of flexor digitorum elbow flexion
    ANTERIOR INTEROSSEUS
    profundus Weak opposition and flexion of
    NERVE (BRANCH OF None
    Pronator quadratus thumb
    MEDIAN NERVE)
    Thenar eminence Weak finger flexion
    Lateral two lumbricals Weak pinch (no tip-to-tip)
    Weak wrist flexion
    Flexor carpi ulnaris Loss of ulnar deviation at wrist
    Medial half of flexor digitorum Loss of distal flexion of little
    profundus finger Loss of abduction and
    Palmaris brevis Dorsal and palmar aspect of little adduction of fingers
    ULNAR NERVE (C7 – C8, T1)
    Hypothenar eminence and medial half of ring finger Inability to extend second and
    Adductor pollicis third phalanges of little and ring
    Medial two lumbricals fingers (benediction hand
    All interossei deformity)
    Loss of thumb adduction
    Anconeus
    Brachioradialis
    Extensor carpi radialis longus and Loss of supination
    Dorsum of hand (lateral two
    brevis Loss of wrist extension (wrist
    thirds)
    Extensor digitorum drop)
    Dorsum and lateral aspect of
    RADIAL NERVE (C5 – C8, T1) Extensor pollicis longus and Inability to grasp
    thumb
    brevis Inability to stabilize wrist
    Proximal two-thirds of dorsum of
    Abductor pollicis longus Loss of finger extension
    index, middle, and half rig finger
    Extensor carpi ulnaris Inability to abduct thumb
    Extensor indices
    Extensor digiti minimi
    Extensor carpi radialis brevis
    Extensor digitorum
    Wear wrist extension
    Extensor pollicis longus and
    POSTERIOR INTEROSSEUS Weak finger extension
    brevis
    NERVE (BRANCH OF None Difficulty stabilizing wrist
    Abductor pollicis longus
    RADIAL NERVE) Difficulty with grasp
    Extensor carpi ulnaris
    Inability to abduct thumb
    Extensor indices
    Extensor digiti minimi
    PELVIS

    NERVE MOTOR LOSS SENSORY LOSS FUNCTIONAL LOSS


    MERALGIA PARATHETICA
    ILIOINGUINAL NERVE

    HIP

    COMMON SITE OF KEY SIGNS &


    NERVE SENSORY LOSS
    ENTRAPMENT SYMPTOMS
    Ischial spine, sacrospinous
    Pain medial to ischium
    ligament, and lesser sciatic notch
    Sciatic notch tenderness and
    entrance External genatilia
    piriformis muscle spasm and
    PUDENDAL NERVE (L2 – S4) Greater sciatic notch and Skin around anus & perineum
    tenderness
    piriformis Pelvic floor
    Obturator internus spasm and
    Alcock’s canal and obturator
    tenderness
    internus
    Positive seated piriformis stretch
    and/or active piriformis tests
    Ischial tenderness
    Pain in the posterior thigh to the
    Piriformis and obturator
    Entire foot except the instep and popliteal fossa aggravated with
    SCIATIC NERVE (L4 – S3) internus/gemelli complex
    medial malleolus running
    Proximal hamstring
    Positive ischial femoral
    impingement test
    High steppage gait & inability to
    stand on the heel or toes
    SUPERIOR GLUTEAL
    NERVE (L4 – S1)
    FEMORAL NERVE (L2 – L4)
    OBTURATOR NERVE (L2 –
    L4)

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