34: SPAL preview - Mahoney

Question 1

nerve roots reflexes

Answer 1

knee reflex L2-4

ankle reflex S1-2

Question 2

hyporeflexia v. hyper-reflexia

Answer 2

Hyporeflexia

• Areflexia (below normal or absent reflexes)
• LMN deficit

Hyperreflexia

• Overactive or over-responsive reflexes
• Twisting or Spastic tendencies
• UMN disease
• disinhibition

Question 3

UMN v LMN lesions

Answer 3

UPPER MOTOR NEURON SIGNS

• increased muscle tone (spasticity)
• weakness
• increased reflexes
• clonus
• dysarthria, dysphagia, Horner’s syndrome, cerebellar signs, spinothalamic sensory loss.

LOWER MOTOR NEURON SIGNS

• decreased muscle tone
• weakness and wasting (atrophy) in the muscle(s) supplied by that motor nerve
• arreflexia
• muscle fasciculations.

Question 4

Pitting v. Non-Pitting Edema

Answer 4

non pitting = prtn rich exudate

pitting = prtn poor exudate

exam: press firmly with your thumb for at least 5 sec over area of max swelling. If indentation remains for over 5 sec, it is considered pitting edema

scale 1-4: indentation 2 mm-8mm