Neurological Integrity Testing

Neurological examination of the upper limb is demonstrated as a model for limb testing more broadly. The main sensory tests include light touch, pinprick, and temperature. Light touch is ideally assessed with cotton wool while the patient’s eyes are closed, comparing left and right sides and moving through multiple areas to detect subtle sensory loss. Pinprick is used to assess small-fiber function, with attention to consistent comparison points and using an unaffected area if symptoms are bilateral. Temperature testing is shown with warm and cool coins, focusing especially on symptomatic regions. Reflexes and muscle strength are then covered. Biceps, triceps, and brachioradialis reflexes are compared side to side, with interpretation linked to peripheral versus central nervous system findings. Myotomal strength testing includes cervical movements, shoulder elevation and abduction, elbow flexion and extension, thumb extension, and interossei function. The summary then moves to neurodynamic testing for heightened nerve mechanosensitivity: straight leg raise, slump test, upper limb neurodynamic testing with median nerve bias, and radial nerve bias. Emphasis is placed on reproducing familiar symptoms, applying movements step by step, and using structural differentiation to clarify whether neural tissue is involved.