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Respiratory Exam


July 1st, 2020

Wasting of Hand Muscles

In the context of the respiratory examination, we examine for muscle wasting as a sign of denervation secondary to an apical lung tumour. A Pancoast tumour in the apex of the lung may compress the brachial plexus and result in localised wasting of the hand.
  • Look For

  • Decreased mass of the thenar and/or hypothenar eminence.
  • Causes of Wasting of Hand Muscles

  • Localised Wasting

  • Median nerve lesion
  • Ulnar nerve lesion
  • Brachial plexus compression
  • Generalised Wasting

  • Normal aging
  • Disuse
  • Malnutrition - poor diet, malabsorption, cancer
  • Denervation - trauma, motor neuron disease, Guillain-Barre Syndrome, polyneuropathy
  • Muscular disorders - inflammatory myositis, muscular dystrophies
  • Chronic disease - cancer, heart failure, COPD, infection, cirrhosis, kidney disease


  • Tip

  • Muscle wasting and shiny skin with reddish discolouration is a very specific for reflex sympathetic dystrophy.
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