Components of the Neuromuscular Screen Flashcards
Where does the NMS fall?
Examination and Evaluation
What is the purpose of the NMS?
Identifies or rules out signs consistent with a lower motor neuron pathology (radiculopathy) or an upper motor neuron pathology (spinal cord compression, stroke, TBI)
What does the NMS use to determine the source and location of neurological dysfunction?
Uses sensory, motor, and reflex testing to determine the source and location of neurological dysfunction
What are the components of a basic neurological screening examination
1) Motor testing
2) Somatosensory/ Sensory Testing
3) Reflex Testing
4) Central Nervous System Screen
Neck Flexion
C1 & C2 UQ Myotomes.
Neck Sidebending
C3 UQ Myotome.
Shoulder Elevation
C4 UQ Myotome.
Shoulder Abduction
C5 UQ Myotome.
Elbow Flexion
C6 UQ Myotome.
Elbow Extension
C7 UQ Myotome
Thumb Abduction
C8 UQ Mytome
Finger Abduction
T1 UQ Myotome
Hip Flexors
L2-3 LQ Myotome
Knee Extensors
L3-4 LQ Myotome
Ankle Dorsiflexors
L4 LQ Myotome
Hallux Extension
L5 MQ Myotome
Ankle Plantar Flexors
S1 LQ Myotome
Mid-deltoid
C5 UQ Dermatome
Radial Aspect of 2nd Metacarpal
C6 UQ Dermatome
Dorsal aspect middle finger
C7 UQ Dermatome
Ulnar Aspect of 5th Metacarpal
C8 UQ Dermatome
Medial Forearm
T1 UQ Dermatome
Inguinal Area
L1 LQ Dermatome
Anterior mid- thigh
L2 LQ Dermatome
Medial Knee
L3 LQ Dermatome
Medial Malleolus
L4 LQ Dermatome
Distal Medial Dorsum of foot
L5 LQ Dermatome
Lateral border of Foot
S1 LQ Dermatome
Medial/ Posterior Calcaneus
S2 LQ Dermatome
What is a monosynaptic reflex?
Reflex that automatically regulates muscle length by tapping then tendon it places a quick stretch on the muscle and activates muscle spindles. It results in contraction of stretched muscle.
What is Hypo-reflexive?
Lower motor neuron (possible nerve root compression or neuropathy)
What is Hyper- reflexive?
Upper motor neuron (possible CNS pathology)
What would a possible finding of an Upper Quarter reflex mean?
Reflexes found to be diminished or absent can be correlated with the dermatome and myotome assessments to determine the presence of nerve root pathology. Those that are hyperactive may indicate upper motor neuron pathology.
Biceps Brachii Upper Quarter Reflex?
C5
Brachioradialis Upper Quarter Reflex?
C6
Triceps Upper Quarter Reflex?
C7
Patellar Lower Quarter reflex?
L2-4
Achilles Lower Quarter Reflex?
S1-2
What would a possible finding of a lower quarter reflex mean?
Reflexes found to be diminished or absent can be correlated with the dermatome and myotome assessments to determine the presence of nerve root pathology. Those that are hyperactive may indicate upper motor neuron pathology.
What is the Jendrassik Maneuver?
Patient locks fingers together and pulls hard as you tap whatever area you are testing.
What is a clonus?
A series of involuntary muscular contraction due to sudden stretching of the muscle (reflex response)
Clonus
Clonus= central nervous system disorders (e.g stroke, multiple sclerosis, spinal cord damage) Specifically diseases or disorders that damage the upper motor neurons or associated tracts; most commonly testing in the ankles and wrist.
When is a clonus considered abnormal?
Only sustained clonus (5 beats or more) is considered abnormal.
What is a normal response of the babinski?
The toes will flex
What is a positive response of the babinski?
Hallux extension; great tow will span out
