Exam II

Question 1

where does the spinal cord end?

Answer 1

L2-L3

Question 2

what segments does the lumbar plexus run? is it ventral or dorsal rami?

Answer 2

ventral L1-L4

Question 3

what segments does the lumbosacral plexus run? is it ventral or dorsal rami?

Answer 3

dorsal L4-S4

Question 4

what are some different ways to test dermatomes?

Answer 4

(1) light touch
(2) sharp / dull (with eyes closed)
(3) thermal
(4) vibration
(5) two point discrimination

Question 5

what is considered the best way to test dermatomes?

Answer 5

two point discrimination

sharp / dull and vibration are also good tests

Question 6

what is decreased myotome response typically a sign of in the LE?

Answer 6

compression of the nerve root

Question 7

what is the myotome for L1/L2?

Answer 7

hip flexion

Question 8

what is the myotome for L3?

Answer 8

knee extension

Question 9

what is the myotome for L4?

Answer 9

ankle dorsiflexion

Question 10

what is the myotome for L5?

Answer 10

toe extension

Question 11

what is the myotome for S1?

Answer 11

ankle eversion / plantarflexion

Question 12

what is the myotome for S2?

Answer 12

knee flexion

Question 13

how long are myotomes typically held?

Answer 13

about 10 seconds

Question 14

what are the grades for DTRs?

Answer 14

0 - no response
1 - slight response; may be abnormal
2 - brisk; normal
3 - very brisk; may be abnormal
4 - hypertonic; clonus (always abnormal)

Question 15

where would you test L3/L4 DTR? how would this test be administered?

Answer 15

(1) patellar tendon

(2) seated; testing knee extension

Question 16

where would you test L5/S1 DTR? how would this test be administered?

Answer 16

(1) achilles tendon

(2) seated; ankle plantarflexion

Question 17

where would you test S2 DTR? how would this test be administered?

Answer 17

(1) biceps femoris (popliteal area)

(2) prone; knee flexion

Question 18

how do you differentiate between a spinal nerve issue and a peripheral nerve issue?

Answer 18

if all the muscles innervated by a nerve root are weak / affected, it’s probably a spinal nerve issue; if it’s just one muscle or small sensory area, more likely to be peripheral issue

Question 19

what type of deficit is usually picked up first, motor or sensory?

Answer 19

sensory

Question 20

how many times should you test a DTR?

Answer 20

5-10 times