Lower Peripheral Nerve Exam

Question 1

Which nerve is affected to cause foot drop?

Answer 1

Common fibular nerve

Question 2

Give a cause of footdrop

Answer 2

Most commonly caused by a fracture of the neck of the fibular eg. bumper car fracture

Question 3

Which part of the brain is affected in Parkinson’s Disease and what is the result of this?

Answer 3

Degeneration of dopaminergic neurones in the Substantia nigra (in basal ganglia)

Question 4

Give an example of a drug that can be used to treat Parkinson’s Disease.
How does it work?
Give 4 ADRs

Answer 4

L-DOPA- precusor to dopamine- nausea, vomiting, hypotension, anorexia, psychosis, tachycardia

Apomorphine- binds to dopamine receptors- hypersexuality, pathological gambling, psychosis, confusion, nausea, hypotension

Question 5

What is a positive Babinski reflex and what does it signify?

Answer 5

Toes dorsiflex when sole of foot is scraped

Signifies an UMNL

Question 6

If the patient had elicited clonus, what would this mean?

Answer 6

UMNL

Question 7

Give 3 signs of a lower motor neurone lesion

Answer 7

Hypotonia
Hypertonia
Muscle wasting
Flaccid paralysis
Fasciculations

Question 8

If you failed to elicit a patellar reflex, where would you expect to find a lesion?

Answer 8

L2-L4 level- proximal to the nerve root- along the femoral nerve

Question 9

What is the definition of a stroke?

Answer 9

Abrupt loss of focal brain function due to haemorrhage or ischaemia

Question 10

What sign of a cerebellar lesion might you elicit during examination?
Give 3 other general signs of a cerebellar lesion

Answer 10

Wide-based ataxic gait/ failed heel-shin test/ hypotonia

DANISH
Dysdiadochokinesia/ dysmetria
Ataxia
Nystagmus
Intention tremor
Slurred speech
Hypotonia

Question 11

If someone has alcohol-induced cerebellar dysfunction, what part of their body is normally spared?

Answer 11

Spares upper limbs

Question 12

Give 1 sensory modality lost and one preserved in syringomyelia

Answer 12

Lost- crude touch, pressure, pain, temperature

Preserved- fine touch, vibration, proprioception

Question 13

Describe where the L4 dermatome is

Answer 13

Medial leg

Question 14

Describe where the T1 dermatome is

Answer 14

Medial forearm

Question 15

What findings would you expect to see in the legs of a patient who has Brown-Sequard Syndrome at C6 level?

Answer 15

Ipsilateral UMN paralysis and loss of co-ordination

Contralateral loss of pain and temperature sensation

Question 16

Give 2 positive signs of a upper motor neurone lesion

Answer 16

Hypertonia
Hyperreflexia
Spastic paralysis