assessment of spinal cord 2

Question 1

measuring DTR

Answer 1

1) limb relax and symm
compare them
if you can’t elicit reflex, use reinforcement procedures

2) have patient contract by raise limb slightly OR concentrate on contract diff muscle when reflex tested

Question 2

if reflexes are brisk, ___ is seen

Answer 2

clonus = repetitive vibratory contraction in response to muscle and tendon stretch

Question 3

rating of reflexes
0
1
2
3
4
5

Answer 3

0 = absent
1 = tract or with reinforce
2 = normal
3 = brisk
4 = nonsaturated clonus
5 = sustained clonus

Question 4

DTR are normal if what number ___

unless…

Answer 4

1, 2, 3

unless asymm or difference btwn arms and legs

Question 5

other signs of hyperreflexia

Answer 5

clonus
spreading of reflex to other muscles not being tested

crossed adduction of opposite leg when medial knee tapped

Question 6

DTR may be diminished by

Answer 6

1) abnormalities in muscles, sensory neurons, LMN, NMJ
2) acute UMN lesions
3) joint disease

Question 7

test plantar response

Answer 7

scrape object along sole beginning from heel to small toe then arch medially toward big toe

normal = downward contraction of toe

Question 8

define babinski sign

Answer 8

upgoing big toe
fanning out other toes

UMN lesion anywhere along corticospinal

Question 9

if toes are downgoing one side and silent on other, then which is abnormal

Answer 9

silent side is abnormal

Question 10

finger flexors test

Answer 10

tap gently on palm with reflex hammer to test hyperreflexia

Question 11

hoffmann’s sign

Answer 11

incr reflex with finger flexors = UMN lesions

hold patient middle finger loose then flick fingernail down so finger rebound into extension

if thumb flex and adduct = Hoffmann