1. SPECIAL TESTS FOR PERIPHERAL
NERVES : HANSEN’S DISEASE

2. MEDIAN NERVE
COURSE
• 02 roots – Medial Root (C8/T1) and Lateral Root
(C5/C6/C8)
• Arm – vascular branches (Brachial A) ; Muscular
branches (Pronator Teres)
• Forearm – Muscular (Supf Flexors – Pronator Teres /
FCR / PL / FDS) ; Ant Interosseus N (FDP / FPL /
Pronator Quadratus) ; Articular ; Palmar Cutaneous
Branch (Cutaneous Supply)
• Hand - Thenar Eminence / Lateral Lumbricals (02)

3. BRACHIAL PLEXUS

5. THENAR EMINENCE
• A

6. CUTANEOUS SUPPLY OF HAND
• A

7. CLINICAL TESTING
• FPL : Flexion of the Terminal Phalanx of 1st
digit ; Pt asked to flex terminal phalanx
of thumb while base is steadied by the
Examiner

8. CLINCIAL TESTING
• FDS / FDP (Lat) – Flexion of the Index Finger ;
Pt is asked to clasp hands
together, Index finger fails
to flex –
POINTING INDEX ; OSCHNER
CLASPING TEST

9. CLINCIAL TESTING
• A

10. CLINCIAL TESTING
• ABDUCTOR POLLICIS BREVIS : Abduction of
thumb ; A pen is kept at a level higher
than the thumb and the pt is asked to
touch the tip of the pen - PEN TEST

11. CLINCIAL TESTING
• OPPONENS POLLICIS : Opposition of the
thumb i.e. swinging movement of thumb
across the palm to touch tips of other fingers
Pt is asked to oppose against examiner’s
resistance

12. CLINCIAL TESTING
• a

13. ULNAR NERVE
COURSE
• Medial Cord of Brachial Plexus (C8 / T1)
• Branches :
•
•
•
•
•
MUSCULAR : FCU / FDP (medial)
PALMAR CUTANEOUS BRANCH / DORSAL BRANCH
ARTICULAR BRANCH : elbow
SUPERFICIAL TERMINAL : Palmaris brevis
DEEP TERMINAL BRANCH : Abductor Digiti Minimi / Flexor
Digiti Minimi / Opponens Digiti Minimi (HYPOTHENAR
EMINENCE) ; Medial Lumbricals (3 / 4) ; Palmar / Dorsal
Interossei (04 + 04) ; Adductor Pollicis

14. COURSE
• aa

15. HYPOTHENAR EMINENCE
• A

16. CLINCIAL TESTING
• FCU:
Flexion at Wrist – deviates hand to Radial Side

17. CLINCIAL TESTING
INTEROSSEI
• DORSAL (ABDUCTION OF FINGERS)
EGAWA TEST - Pt is asked to abduct
fingers against Examiner’s resistance;
individually tested ; Palm facing
downwards

18. EGAWA +
• zz

19. CLINCIAL TESTING
INTEROSSEI
PALMAR
CARD TEST - With palm facing upwards,
patient is asked to hold card between
02 fingers tightly against the pull
exerted by Examiner

20. WARTBERG + / CARD TEST
WARTBERG’S SIGN +

21. CLINCIAL TESTING
LUMBRICALS
Tested alongwith Interossei by testing
Extension at PIP / TIP ; Examiner steadies
Proximal Phalanx and Pt asked to extend
Middle and Terminal Phalanges against
Resistance.

22. CLINCIAL TESTING
• a

23. CLINCIAL TESTING
BOOK TEST
Testing 1st Palmar Interossei + Adductor
Pollicis ; pt is asked to hold a book between
Extended thumb and fingers with both hands
against pulll by the Examiner ; FROMENT’S
SIGN + when pt pinches grasp by flexing
thumb, using FPL

24. FROMENT’S SIGN +

25. THANK YOU