nerve roots upper ext. thoracic and upper lumbar spine Flashcards
a. What is the MRS when testing nerve root C5?
a. Disc level: C4
b. Muscle tests:
i. Deltoid (axillary nerve) - shoulder abduction
ii. Biceps (musculocutaneous nerve) - forearm flexion
c. Reflex:
i. Biceps
d. Sensation
i. Lateral arm
b. What is the MRS when testing nerve root C6?
a. Disc level C5
b. Muscle test
i. Wrist extension
1) Extensor carpi radialis longus and brevis
2) Extersor carpi ulnaris (radial nerve)
c. Reflex:
i. Bracioradialis
d. Sensation:
i. Anterior lateral forearm
ii. Palm
iii. Thumb
iv. 2nd digit
c. What is the MRS when testing nerve root C7
a. Disc level C6
b. Muscle tests:
i. Triceps (radial nerve)
1) Elbow extension
ii. Flexor carpi radialis (median nerve) flexor carpi ulnaris (ulnar nerve)
1) Wrist flexion
iii. Extensor digitorum communis
extensor indicis profundus
extensor digit minimi (radial nerve
1) Finger extension
c. Reflex
i. Triceps
d. Sensation
i. 3rd digit, middle of palm
d. What is the MRS when testing nerve root C8?
a. Disc level C7
b. Muscle test
i. Flexor digitorum superficialis
flexor digitorum profundus
lumbricals (median and ulnar nerve)
c. Reflex
i. NONE
d. Sensation
i. 4th and 5th digits
ii. Antero-medial hand and forearm
e. What is the MRS when testing nerve root T1
a. Disc level T1
b. Muscle tests
i. Dorsal interossei (ulnar nerve)
1) Finger ABDUCTION
ii. Palmer interossei (ulnar nerve)
1) Finger ADDUCTION
c. Reflex
i. NONE
d. Senstaion
i. Antero-medial arm (distal aspect of arm to proximal aspect of forearm)
f. What is the MRS when testing nerve root T2-T12
a. Disc level: T2-T12
b. Muscles
i. Intercostals [segmented innervated and difficult to evaluate individually]
rectus abdominus
1) Rib elevation
c. Reflex:
i. NONE
d. Sensation:
i. T4: nipple line
ii. T7: xyphoid process
iii. T10: umbilicus
iv. T12: groin
g. Nerve roots T2-12 overlap so that no anesthesia will occur if only one nerve root is involved, T/F
i. True
h. What is the MRS when testing nerve root L1, L2 and L3?
a. Disc level T12-L2
b. Muscle test:
i. Iliopsoas (L1-L3)
1) Primary hip flexor
c. Reflex:
i. NONE
d. Sensation:
i. Anterior thigh
1) Obliquely from lateral to media [L1 top of thigh, L2 middle of thigh, L3 lower thigh]
i. What is the MRS when testing nerve root L2, L3 and L4
a. Disc level L1-L3
b. Muscles:
i. Quadriceps femoris
vastus medialis
vastus intermedius (L2-L4, femoral nerve)
1) Primary knee extenros
ii. Adductor longus, adductor brevis
adductor magnus (L2-L4, obturator nerve)
c. Reflex: patellar
d. Sensations:
i. L2 middle of thigh
ii. L3 lower thigh
iii. L4 anteriomedial leg below the knee and medial side of the foot
a. What is the MRS when testing nerve root L4?
a. Disc level L3
b. Muscles
i. Tibialis anterior (deep fibular/peroneal nerve)
1) Foot dorsiflexion and inversion
c. Reflex:
i. Patellar tendon
d. Sensation:
i. Medial aspect of leg
ii. Medial foot
iii. Medial aspect of big toe
b. What is the MRS when testing nerve root L5?
a. Disc level L4
b. Muscles
i. Entensor hallucis longus (deep fibular/peroneal nerve)
1) Big toe dorsiflexion
ii. Extensor digitorum longus and brevis (deep fibular/peroneal nerve)
1) Toe 2,3,4 dorsiflexion
iii. Gluteus medius and minimus (superior gluteal nerve)
1) Hip and pelvis abduction
c. Reflex
i. NONE
d. Sensation
i. Lateral leg
ii. Dorsum of foot
iii. Middle three toes
c. What is the MRS when testing nerve root S1
a. Disc level L5
b. Muscles
i. Fibular/peroneus longus and brevis (superficial fibular/peroneal nerve)
1) Foot plantar flexion and eversion
ii. Gluteus maximus (inferior gluteal nerve)
1) Hip extension
c. Reflex
i. Achilles
d. Sensation:
i. Posterio aspect of leg
ii. Lateral aspect of foot
iii. Lateral aspect of little toe
d. What is the MRS when testing nerve root S2?
a. Disco level S1
b. Sensation:
i. Posterior aspect of thigh over popliteal fossa onto posteromedial calf
