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Upper Limb Neuro
 
 

Inspection of Muscles

 
 
 
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Muscle Wasting

  • Feel For

  • Decreased muscle mass. Note whether wasting is isolated to a single muscle, muscle group, limb, or is generalised.
  • Causes of Muscle Wasting

  • Localised Muscle Wasting

  • Disuse
  • Denervation - trauma, motor neurone disease, Guillain-barré Syndrome, peripheral neuropathy, polio
  • Muscular disorders - inflammatory myopathy, muscular dystrophies
  • Generalised Muscle Wasting (Sarcopaenia)

  • Frailty
  • Malnutrition - poor diet, malabsorption, cancer
  • Chronic disease - cancer, heart failure, COPD, infection, cirrhosis, kidney disease

Fasciculations

  • Look For

  • Spontaneous localised muscle contraction and relaxation.
  • Causes of Fasciculations

  • Benign / normal
  • Lower motor neuron disorders - ALS, radiculopathy, peripheral neuropathy, entrapment, syringomyelia
  • Metabolic disorders - thyrotoxicosis, tetanus, anticholinesterase medications
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