📋 Chief Complaint & History of Presenting Illness
🗺️ Nerve Localization & Distribution Mapping
Upper Limb Nerve Involvement
Lower Limb / Other Nerve Involvement
💪 Motor Examination (MRC Grading 0–5)
UPPER LIMB
| Muscle Group | Nerve | Right | Left |
|---|
| Deltoid | Axillary / C5 | | |
| Biceps brachii | Musculocutaneous / C5–6 | | |
| Brachioradialis | Radial / C5–6 | | |
| Triceps | Radial / C7 | | |
| Wrist extensors | Radial (PIN) / C7 | | |
| Wrist flexors (FCR) | Median / C7 | | |
| Wrist flexors (FCU) | Ulnar / C8 | | |
| FDP (D2,3 – index, middle) | Median (AIN) / C8 | | |
| FDP (D4,5 – ring, little) | Ulnar / C8 | | |
| Thenar (APB / Opponens) | Median / T1 | | |
| Hypothenar (ADM) | Ulnar / T1 | | |
| Interossei / Lumbricals | Ulnar / T1 | | |
LOWER LIMB
| Muscle Group | Nerve | Right | Left |
|---|
| Hip flexors (Iliopsoas) | Femoral / L1–2 | | |
| Hip adductors | Obturator / L2–3 | | |
| Quadriceps | Femoral / L3–4 | | |
| Tibialis anterior | Deep peroneal / L4 | | |
| Extensor hallucis longus | Deep peroneal / L5 | | |
| Peronei (Eversion) | Superficial peroneal / L5–S1 | | |
| Gastrocnemius/Soleus | Tibial / S1 | | |
| Hamstrings | Sciatic / L5–S2 | | |
| Gluteus medius (Hip abd.) | Sup. Gluteal / L4–5 | | |
| EDB | Deep peroneal | | |
🔬 Sensory Examination & Reflexes
Sensory Testing
| Modality | Distribution / Level | Right | Left |
|---|
| Light Touch | | | |
| Pin Prick | | | |
| Temperature | | | |
| Vibration (128 Hz) | | | |
| Proprioception | | | |
Deep Tendon Reflexes
| Reflex | Nerve / Level | Right | Left |
|---|
| Biceps | Musculocutaneous / C5–6 | | |
| Triceps | Radial / C7 | | |
| Brachioradialis | Radial / C6 | | |
| Knee Jerk | Femoral / L3–4 | | |
| Ankle Jerk | Tibial / S1 | | |
| Plantar | Pyramidal | | |
✋ Special Nerve Tests & Provocative Manoeuvres
📂 Aetiology, Risk Factors & Past History
🔬 Investigations
Imaging
Lab Investigations
✅ Working Diagnosis & Management Plan
Primary Diagnosis
Nerve / Level / Laterality
Management Plan