neurological assessment
Last reviewed 01/2018
The innervation of the hands should be assessed:
- damage to the median nerve:
- alters sensation in the palm, thumb, index finger, middle finger and half of the ring finger
- causes the muscles of the thenar eminence to become weak and wasted
- if the damage is due to the carpal tunnel syndrome, the sensation to the palm is spared
- damage to the ulnar nerve:
- alters sensation to the palm, the dorsum of the hand, the little finger and half of the ring finger
- causes a claw deformity in the little and ring fingers because of loss of innervation to their interossei and lumbrical muscles
- damage to the radial nerve:
- may alter sensation over the dorsum of the hand in the region of the anatomical snuff box
- causes wrist drop due to paralysis of the wrist extensors
- exacerbation of paraesthesia over the distribution of the median nerve following full flexion of the wrists for 2 min is characteristic of the carpal tunnel syndrome