Final Exam

Question 1

Nerve roots for UE reflexes

Answer 1

C5: biceps
C6: brachioradialis
C7: triceps

Question 2

Hoffman’s Reflex

Answer 2

UMN sign - cervical radiculopathy

Flick middle finger (quick stretch to extensor), whole hand flexes

Question 3

UE Myotomes

Answer 3

C5: elbow fl, shoulder ABD
C6: wrist ext, elbow fl
C7: elbow ext, wrist FL (bball)
C8: finger flexion
T1: finger AB/Adduction

Question 4

Radial nerve - motor and sensory lost

Answer 4

• Ext of elbow/wrist/finger, supination, thumb ABD

- Sensory: most of post lateral arm

Question 5

Median nerve - motor and sensory

Answer 5

• Thumb FL/opposition, digits 2-3 FL, wrist FL, radial dev, pronation
• Palm to half of ring finger, dorsum of digits 2,3,half of 4

Question 6

Ulnar nerve - motor and sensory

Answer 6

• Finger AB/Add, thumb Add, digits 4-5 FL, wrist FL and ulnar dev
• ulnar half of hand

Question 7

Axillary nerve - motor and sensory

Answer 7

• Arm ABD beyond 1st 15º

- sensory: by deltoids

Question 8

Musculocutaneous - motor and sensory

Answer 8

• Elbow FL, supination

- lateral antebrachial cutaneous

Question 9

Palsy def

Answer 9

(Peripheral) nerve involvement causing weakness (motor, usu sensory as well)

Question 10

Hypertonia

Answer 10

increase in resistance to PROM

- UMN: stroke, MS, cerebral palsy, brain injury

Question 11

Hypotonia

Answer 11

decrease of resistance to PROM

- LMN, cerebellar CNS involvement, Down’s syndrome

Question 12

Rigidity

Answer 12

• increased resistance to movement in both directions through entire range
• Parkinson’s disease

Question 13

Dysmetria

Answer 13

disturbance in coordination, past-pointing

- finger to nose and heel to shin testing

Question 14

Cauda Equina Syndrome - 5 symptoms

Answer 14

• Saddle numbness
• Fecal incontinence
• Urinary retention
• U/L or B/L sciatica
• Reduced SLR and sensory motor deficit

Question 15

Flexion - SB - Rotation is provocative for? Alleviating for?

Answer 15

• Pt reaches w both hands for one ankle
• Provocative: discogenic symptoms, muscle strain
• Alleviating: facet dysfunction, stenosis

Question 16

Extension - SB - Rotation (Quadrant) provocative for?

Answer 16

• Pt reaches down back of thigh w one hand, neuro sx? overpressure?
• Provocative: Facet dysfunction, stenosis

Question 17

Spine Flexion AROM - Optimal? Centralization?

Answer 17

• repeat flexion 5x. overpressure? 3-5 cm
• Optimal: apex at sacrum, lumbar lordosis reverses, pelvis moves posteriorly before L-spine flexes
• Peripheralizes- discogenic
• Centralizes- stenosis

Question 18

Spine Extension ROM - Optimal? Centralization?

Answer 18

• Backbend 5x, overpressure? 1-2 cm
• Optimal: initiated from hip then spine, most motion from lower segments, not from skin creases
• Peripheralizes: stenosis
• Centralizes: discogenic

Question 19

Side bending - Optimal?

Answer 19

• Pt slides hand down leg, 22 cm difference

- Optimal: smooth curve, apex at L3/L4, most motion in lower thoracic

Question 20

L-Spine Extension MMT Grading

Answer 20

• prone, lifts and clears sternum with…

5: hands on head / 4: hands behind back / 3: arms straight / 2: nose comes off ground

Question 21

L-Spine Flexion MMT Grading

Answer 21

• supine, do crunch, clears inferior angle with…
  5: hands on head / 4: hands crossed on shoulders / 3+ legs straight, reach toward knees / 3: doesn’t clear inf angle / 2: lifts head

Question 22

Findings if anteriorly tipped/rotated innominate

Answer 22

• On one side, ASIS low, PSIS high

- long SI ligament tender (1 in below PSIS)

Question 23

Findings if posteriorly tipped innominate

Answer 23

• one side ASIS high, PSIS low

- Sacrotuberous ligament tender (through glute, between sacrum and ischial tuberosity)

Question 24

Signs of UMN vs LMN Lesions

Answer 24

• Fasciculation: LMN
• Reflexes: hyper for UMN, hypo for LMN
• Tone: spasticity for UMN, decreased for LMN
• Atrophy: LMN (or UMN later, chronic disuse)
• Weakness (both)