EXAMINATION Flashcards
What is the abdominal reflex and the normal response?
- stroking each quadrant of the abs with a blunt hammer
- tests T8-L1
- expect contraction of the abs and deviation of umbilicus toward the stimulus
What is the corneal blink reflex and the normal response?
- ask patient to look up and away as your stroke cornea with cotton
- tests trigeminal and facial nerves
- in a normal response both eyes will blink
What is the cremasteric reflex and the normal response?
- scratch the skin of the upper medial thigh
- tests L1-L2
- a brisk and brief elevation of the testicle on the same side
What is the gag reflex and the normal response?
- therapist lightly stimulates each side of the back of the throat
- tests glossopharyngeal and vagal nerve
- a gag will occur!
What is the plantar reflex and the normal response?
- stroke the lateral aspect of the sole of the foot from the heel to the ball up to the big toe
- Tests L5-S1
- normal response is flexion of the toes
- am abnormal response = babinski (toe flare) signalling a CNS lesion
What is the grading scale for deep tendon reflexes?
0 = no response
1+ = diminished
2+ = active normal
3+ = exaggerated
4+ = hyperactive
Describe the bicep tendon reflex and its response
- tests C5-C6
- elbow in flexion, hand over bicep tendon
- normal response is contraction of bicep and flexion of elbow
Describe the brachioradialis tendon and its response
- level C5-C6
- forearm in neutral and supported, stroke the radius one to two inches superior to the wrist
- contraction of the brachioradialis muscle
Describe the triceps tendon muscle and its response
- level C6-C7
- strike muscle belly of tricep
- normal is contraction of the triceps muscle and elbow extension
What level does the patellar tendon reflex test?
- L3-L4
What level does the achilles tendon reflex test?
- S1 - S2
What is the most common reason for absent reflexes?
peripheral neuropathy
What causes a hyperactive DTR?
an interruption of the cortical supply to the lower motor neuron
What is an afferent nerve signal?
Sensory
What is an efferent nerve single?
Motor
What is CN I and it’s test?
- Olfactory
- smells (afferent)
- identify smells
What is CN II and its test?
- Optic
- Sight (afferent)
- visual fields and visual acuity
What is CN III and its test?
- Oculomotor
- Efferent voluntary and automatic motor of the eyeball
- test upward, downward, and medial gaze as well as reaction to light
What is CN IV and its test?
- Trochlear
- Efferent voluntary motor of superior oblique
- downward and inward gaze
What is CN V and its test?
- Trigeminal
- Afferent touch and pain of skin of face, nose, sinuses, mouth, and anterior tongue
- Efferent voluntary motor of muscles of mastication
- Test: corneal reflex, face sensation, clench teeth
What is CN VI and its test?
- Abducens
- Efferent voluntary motor of lateral rectus of eyeball
- lateral gaze
What is CN VII and its test?
- Facial
- Afferent taste of anterior tongue
- efferent voluntary motor of facial muscles
- facial movements for tests
What is CN VIII and its test?
- Vestibulocochlear
- hearing and balance from ear
- Afferent hearing and balance
- hearing tests and balance tests
What is CN IX and its test?
- Glossopharyngeal
- Afferent touch pain and taste on posterior tongue
- Efferent voluntary motor muscles pharynx
- test gag reflex and ability to swallow
What is CN X and its test?
- Vagus
- Afferent touch and pain of throat and bronchi and taste of tongue
- Efferent throat muscles and automatic of thoracic and abdominal viscera
- gag reflex, ability to swallow, say AHHHH
What is CN XI and its test?
- Accessory
- efferent voluntary motor of SCM and traps
- test resisted shoulder shrug
What is CN XII and its test?
- hypoglossal
- efferent voluntary motor of tongue
- test tongue protusion (will deviate towards injured side)
