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Peripheral Neuro-vascular Examination: Identifying Abnormalities in the Knee, Lecture notes of Pathology

Oxford Brookes University (OBU)Pathology

A peripheral neuro-vascular examination focused on the knee, detailing the inspection, motor, and sensory assessments for the median, ulnar, radial, femoral, common peroneal, and tibial nerves. It also includes instructions for vascular examinations. a collaborative effort by Moath Baeshen, Fahad Alabdullatif, Saleh Alkhalifa, and Adel Al Shihri.

What you will learn

  • What is the importance of assessing the vascular system during a peripheral neuro-vascular examination?
  • How is the motor function of the ulnar nerve assessed during a peripheral neuro-vascular examination?
  • What are the three main nerves assessed during a peripheral neuro-vascular examination of the knee?

Typology: Lecture notes

2021/2022

Uploaded on 09/27/2022

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Peripheral Neuro-vascular Examination
Objective:
To be able to perform examination of the knee and to distinguish and identify an
abnormal finding that suggests a pathology.
Done By: Moath Baeshen & Fahad Alabdullatif
Edited By: Saleh Alkhalifa
Revised By: Adel Al Shihri
References: Department handout, Notes(by moath baeshen), Browse’s,433 OSCE Team.
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Download Peripheral Neuro-vascular Examination: Identifying Abnormalities in the Knee and more Lecture notes Pathology in PDF only on Docsity!

Peripheral Neuro-vascular Examination

Objective:

To be able to perform examination of the knee and to distinguish and identify an

abnormal finding that suggests a pathology.

Done By: Moath Baeshen & Fahad Alabdullatif

Edited By: Saleh Alkhalifa

Revised By: Adel Al Shihri

References: Department handout, Notes(by moath baeshen), Browse’s,433 OSCE Team.

WIPPPE

Wash hands, Introduce yourself, take Permission, ensure Privacy, Position, Exposure

Examination:

Upper limb:

❖ Median nerve:

  1. Inspection: Thenar muscle wasting.
  2. Motor: Thumb abduction or opposition (opposition of thumb to little finger and NOT to index finger for OK sign). (Opposition gets affected first) (The doctor said avoid the thumb abduction) (When the patient does the OK sign, try to open it and ask the patient to prevent you doing so)
  3. Sensory: fine touch over volar aspect of (the tip of the) index finger.

Anterior interosseous nerve is a branch of the median nerve Median nerve Examination: https://www.youtube.com/watch?v=PP9yKcDXfzA ❖ Ulnar nerve:

  1. Inspection: hypothenar muscle wasting, claw hand
  2. Motor: finger abduction, Froment’s sign (adduction of the thumb can also be used)
  3. Sensory: fine touch over volar aspect of (the tip of the) little finger

❖ Common peroneal nerve:

  1. Inspection: drop foot, anterior leg muscle wasting. (For drop foot, raise the leg passively to detect it)
  2. Motor: ankle dorsiflexion
  3. Sensory: dorsal aspect of foot

Drop foot ❖ Tibial nerve:

  1. Inspection: calf muscle wasting (Look at the back of the leg !)
  2. Motor: ankle plantar flexion
  3. Sensory: plantar aspect of foot

Vascular exam:

A. Look: Thin, shiny, hairless skin. Ulcers. Pallor. B. Feel: temperature C. Special tests:

**1. Capillary refill (normal is <2 seconds).

  1. Pulses**

Important Notes:

1- Always compare.

2- For the motor part, it’s better to ask the patient to do the movement, then assess it against resistance for power. However, The most important thing is testing the action against resistance.

3- Mention the power grade after comparing resistance on both sides. (e.g.; 5/5 on both sides)

4- When assessing the sensory function, ask the patient:

A- Do you feel it? B- Is it the same in both sides?

5- For fine touch , use a cotton.