【摘 要】
：
Patients with work-related upper limb conditions frequently present a triad of neuropathic symptoms like pain, weakness and numbness/tingling that suggests the involvement of the peripheral nerves.Con
【机 构】
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Department of Occupational Medicine Hospital of South-western Jutland Denmark
【出 处】
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BIT`s 3rd Annual World Congress of NeuroTalk-2012(2012第三届国际神
论文部分内容阅读
Patients with work-related upper limb conditions frequently present a triad of neuropathic symptoms like pain, weakness and numbness/tingling that suggests the involvement of the peripheral nerves.Consequently, the physical examination must be able to identify or rule out an impaired function of these.I propose an examination technique based on a recognized classical paradigm, namely that an impaired function of a peripheral nerve leads to reduced strength of the muscles it innervates.A previously validated extensive physical examination of the upper limb nerves has permitted accurate identification and location of nerve afflictions in a high proportion of patients and occupationally exposed subjects.This approach may be regarded as complicated and time consuming.Therefore, I suggest a simple and rapid neurological screening of three antagonist muscle pairs (Pectoral-Posterior deltoid, Biceps-Triceps, Flexor carpi radialis-Extensor carpi radialis brevis) and three additional individual muscles (Extensor carpi ulnaris, Abductor pollicis brevis, Abductor digiti minimi).In my presentation Ⅰ shall review the examination technique and its interpretation.This examination enables the clinician to identify patterns of weakness in accordance with specific locations of peripheral nerve afflictions.These patterns are present in a major proportion of work-related upper limb disorders including the so-called "non-specific" disorders that are currently uncovered by diagnostic criteria because a conventional physical examination cannot demonstrate physical abnormalities.We propose testing of these nine muscles to be routinely integrated in the physical upper limb examination.
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