Thumb opposition

Opponens pollicis: C8, T1 roots. Median nerve

Patient tries to touch the base of the 5th finger with thumb against resistance

Finger abduction

Patient tries to touch the base of the 5th finger with thumb against resistance

Finger abduction

1st dorsal interosseus: C8, T1 roots. Ulnar nerve Abductor digiti minimi: C8, T1 roots. Ulnar nerve

Fingers abducted against resistance

1st dorsal interosseus: C8, T1 roots. Ulnar nerve Abductor digiti minimi: C8, T1 roots. Ulnar nerve

Fingers abducted against resistance

[Note: not all muscle groups are included in the foregoing, but only those required to identify and differentiate nerve and root lesions.]

SENSATION Pain

Pin prick with a sterile pin provides a simple method of testing this important modality. Firstly, check that the patient detects the pin as 'sharp', i.e. painful, then rapidly test each dermatome in turn.

Memorising the dermatome distribution is simplified by noting that 'C7' extends down the middle finger.

If pin prick is impaired, then more carefully map out the extent of the abnormality, moving from the abnormal to the normal area.

Light touch

This is tested in a similar manner, using a wisp of cotton wool.

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