Assessment of Upper Limb Injuries

Question 1

What are the key points you’d cover in a clinical assessment

Answer 1

ATLS - head and C spine exam

History

• pain? where is the injury
• mechanism of injury
• hand dominance, occupation, hobbies, smoking
• MHx, DHx, allergies, AMPLE

Examination - look, feel move

• injured limb - closed/open?, soft tissues?, neurovascular status
• above and below joint

Investigations
-Xray, CT, MRI

Question 2

Vascular assesment

Answer 2

Temperature
-cold => compromised flow

Colour
-pallor

Pulses

• brachial and radial
• ulnar hard to find

CRT

Question 3

Axillary nerve

• motor
• sensory
• roots

Answer 3

Axillary C5-6
M - deltoid, teres minor
S - regimental badge

Question 4

Musculocutaneous nerve

• motor
• sensory
• roots

Answer 4

Musculocutaneous C5-7
M - arm flexors
S - lat ant forearm

Question 5

Median nerve

• motor
• sensory
• roots

Answer 5

Median C6-T1
M - forearm flexors, thenars, 2 lateral lumbricals
S - 3 1/2 fingers on palmar surface

Question 6

Radial nerve

• motor
• sensory
• roots

Answer 6

Radial C5-T1
M - arm, wrist, finger extensors
S - post arm, forearm, posterolateral hand
Posterior interosseus

Question 7

Ulnar nerve

• motor
• sensory
• roots

Answer 7

Ulnar C8-T1
M - rest of hand not covered by median
S - ant, post of medial 1 1/2 fingers and palm