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