Posterior Cord Injury Examination

The video presents a clinical examination of a 46-year-old male patient experiencing hand weakness following right arthroscopic shoulder surgery. The examination focuses on assessing the strength and range of motion of various muscles and tendons in the arm and hand, particularly related to radial nerve function.

Key Scientific Concepts and Discoveries:

• Radial Nerve Examination: The assessment involves testing the strength and range of motion of muscles innervated by the radial nerve.
• Strength Grading System: Muscle strength is graded on a scale from 0 to 5, with:
  • 0: No muscle contraction
  • 1: Flicker of contraction
  • 2: Active movement with gravity eliminated
  • 3: Active movement against gravity
  • 4: Active movement against some resistance
  • 5: Active movement against full resistance
• Active vs. Passive Range of Motion: The examination distinguishes between active (patient-initiated) and passive (examiner-initiated) movements to assess functional capacity and weakness.
• Muscle and Tendon Assessment: Specific muscles tested include:
  • Triceps
  • Brachioradialis
  • Supinator
  • Wrist extensors (ECRL and ECRB)
  • Extensor digitorum communis (EDC)
  • Thumb extensors

Methodology for Examination:

• Assess active and passive range of motion for elbow extension and flexion.
• Test strength against resistance for:
  • Triceps
  • Brachioradialis
  • Supinator
  • Wrist extensors (ECRL and ECRB)
  • Finger extension (EDC)
  • Thumb extension
• Palpate tendons to evaluate their function during movement.

Researchers/Sources Featured:

• Nick Pulus, Hand and Microvascular Surgeon, Mayo Clinic