Neurological examinaton of the upper limb (illustration)

Case contributed by Leonardo Lustosa
Diagnosis not applicable

Diagram illustrating the sensory distribution and motor function of the main nerves of the upper limb.

(Download for better resolution)

A version of this illustration in Portuguese can be downloaded here: https://commons.wikimedia.org/wiki/File:Exame_neurol%C3%B3gico_do_membro_superior.png

Case Discussion

The sensory distribution is subject to intra- and inter-individual variability. Some areas that more reliably assess each nerve are 4:

  • median: palmar aspect of the thumb

  • radial: dorsal aspect of the proximal phalanx of the thumb

  • ulnar: the 5th finger

The motor function can be memorized using the "rock-paper-scissors-OK" mnemonic 1-3:

  • median (rock): flexion of the 2nd and 3rd MCPJs

  • radial (paper): extension of MCPJs and the thumb; a "thumbs up" can be used alternatively

  • ulnar (scissors): finger abduction and flexion of the 4th and 5th DIPJs

  • anterior interosseous (OK sign): flexion of the thumb and the 2nd finger (branch of the median n.)

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