Method Of Exam

Inspect the muscles of the shoulder, arm, forearm and hand.

• Note muscle size (bulk).
• Look for asymmetry, atrophy and fasciculation.
• Look for tremor and other abnormal movement at rest and with arms outstretched.
• Determine muscle power by gently trying to overpower contraction of each group of muscles.
  • Shoulder: Abduction (Deltoid), Adduction ( ), Shrug (Trapezius)
  • Elbow: flexion (Biceps) and extension (Triceps),
  • Wrist: Flexion ( )and extension().
  • Hand: Grip, opposition of thumb and index finger, opposition of thumb and little finger and finger abduction and adduction.
• Determine limb tone (resistance to passive stretch). With the patient relaxed, gently move the limb at the shoulder, elbow and wrist joints and note whether tone is normal, increased or decreased

Normal:

• Muscles are symmetrical in size with no involuntary movements. In some, muscles may be slightly larger on the dominant side.
• Muscle power obviously varies. You should not be able to overpower with reasonable resistance.
• You have to learn to appreciate the normal tone from practice.