Faculty of Health, Deakin University, Waurn Ponds, Victoria, Australia
Neurology, Melbourne University St Vincent's Hospital, Fitzroy, Victoria, Australia.
Postgrad Med J. 2019 Sep;95(1127):465-468. doi: 10.1136/postgradmedj-2019-136571. Epub 2019 Jul 10.
The current technique taught for examining the muscles of the upper limb does not differentiate between the various causes of weakness in the arm, in particular peripheral nerve and nerve root lesions. The 5.3.5 rule describes examining the muscles in a specific order: 5 at the shoulder, 3 at the elbow and 5 at the wrist and hand. The examiner records the number of the weak muscles. They then consult the tables to determine the cause of the weakness. This rule enables the diagnosis of all peripheral nerve and nerve root problems (radiculopathy) that cause weakness in the arm. It does not require detailed knowledge of neuroanatomy. It does require the examiner to learn how to examine each muscle so that they do not miss weakness or 'detect' weakness when there is none.
目前教授的上肢肌肉检查技术无法区分手臂无力的各种原因，特别是周围神经和神经根病变。5.3.5 规则描述了按特定顺序检查肌肉：肩部 5 块、肘部 3 块、手腕和手部 5 块。检查者记录无力肌肉的数量。然后他们参考表格来确定无力的原因。该规则可诊断所有导致手臂无力的周围神经和神经根问题（神经根病）。它不需要神经解剖学的详细知识。它确实要求检查者学习如何检查每块肌肉，以免遗漏无力或在没有无力时“检测”到无力。
