Leprosy tests by aseem

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Leprosy tests by aseem

  1. 1. SPECIAL TESTS FOR PERIPHERAL NERVES : HANSEN’S DISEASE
  2. 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. 3. BRACHIAL PLEXUS
  4. 4. THENAR EMINENCE • A
  5. 5. CUTANEOUS SUPPLY OF HAND • A
  6. 6. 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
  7. 7. 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
  8. 8. CLINCIAL TESTING • A
  9. 9. 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
  10. 10. 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
  11. 11. CLINCIAL TESTING • a
  12. 12. 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
  13. 13. COURSE • aa
  14. 14. HYPOTHENAR EMINENCE • A
  15. 15. CLINCIAL TESTING • FCU: Flexion at Wrist – deviates hand to Radial Side
  16. 16. CLINCIAL TESTING INTEROSSEI • DORSAL (ABDUCTION OF FINGERS) EGAWA TEST - Pt is asked to abduct fingers against Examiner’s resistance; individually tested ; Palm facing downwards
  17. 17. EGAWA + • zz
  18. 18. 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
  19. 19. WARTBERG + / CARD TEST WARTBERG’S SIGN +
  20. 20. 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.
  21. 21. CLINCIAL TESTING • a
  22. 22. 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
  23. 23. FROMENT’S SIGN +
  24. 24. THANK YOU

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