Motor Response of Upper Limb Nerves to Stimulation.

    Peripheral Nerve Stimulation is the most common method used to identify nerves percutaneously. Pure ulnar/radial/median nerve stimulation can only be achieved at the axilla or below. Indicates motor supply of the nerve. Sensory stimulation can be achieved with some peripheral nerve stimulators. Patient cooperation is desirable but not essential—sedation or GA is possible, but the patient should not have received neuromuscular blocking drugs. Possible reduced potential for nerve damage, because there is no
need for direct physical contact with the nerve (paresthesia). Usually comfortable for the patient.

• Median Nerve:  Finger and wrist flexion and pronation of the wrist. Thumb opposition.

• Ulnar Nerve:  Adduction of thumb, flexion ring, and little finger, supination. Ulnar deviation.

• Radial Nerve: Wrist and finger extension. Thumb abduction.

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