Neurology - Clinical Neurophysiology

Question 1

the median nerve comprises which 2 cords

a.lateral and medial
b.lateral and posterior
c.medial and posterior

Answer 1

a.lateral and medial

Question 2

which cord supplies sensory fibres to the thenar eminences , thumb, index and middle fingers

a.lateral
b.medial
c.posterior

Answer 2

a.lateral

Question 3

whoch cord provides motor fibres to the median muscles of the forearm

a,lateral
b,medial

Answer 3

a.lateral

Question 4

which fibres make up the medial cord

a.c6-c7
b.c7-c8
c.c8-t1
dt1-t2

Answer 4

c.c8-t1

Question 5

which fibres make up the lateral cord

a.c6-c7
b.c7-c8
c.c8-t1
d. t1-t2

Answer 5

a.c6-c7

Question 6

which cord gives sensory fibres to the lateral 1/3 of the ring finger

a.lateral
b.medial
c.posterior

Answer 6

b.medial

Question 7

which cord gives motor fibres to median muscles of distal forearm and hand

a. lateral
b.medial
c.psoterior

Answer 7

b.medial

mostly motor

Question 8

patient with diabetes mellitus and pins and needles in median nerve distribution worse on wakening and waking them from sleep what does this indicate

a.carpal tunnel syndrome
b.anterior interosseus neuropathy
c.unlar nerve lesion
d.wrist drop
e.c8-t1 cervical radiculopathy

Answer 8

a.carpal tunnel syndrome

Question 9

which endocrine condition can present with complaints of pins and needles in the hands

a.cushings
b.addisons
c.conns
d.graves
e.hashimotos
f.acromegaly

Answer 9

f.acromegaly

or hypothyroidism

Question 10

why is the palm spared sometimes in carpal tunnel syndrome

Answer 10

palmar cutaneous branches before carpal tunnel

Question 11

an increase in time taken for the signal to reach the electrodes in a nerve conduction study indicates what

a. damage to the myelin
b.axonal loss

Answer 11

a. damage to the myelin

Question 12

an decrease in amplitude in a nerve conduction study indicates what

a. damage to the myelin
b.axonal loss

Answer 12

b.axonal loss

Question 13

which hand is more commonly affected in carpal tunnel syndrome

Answer 13

dominant

Question 14

which test is more sensitive

a.tinnels
b.phalens

Answer 14

b.phalens

Question 15

what muscle should be assessed if there is thenar wasting and weakness of thumb abduction and opposition

a.flexor carpi ulnaris
b.flexor policis longus
c.brachioradialis

Answer 15

b.flexor policis longus

Question 16

differentials for carpal tunnel syndrome

Answer 16

c6-c7 root lesion
brachial plexus lesion
proximal median nerve lesion
PN , MND

Question 17

reduced reflexes and reduced power in combination with reduced sensation in the palm and forearm indicates what\

a.proximal median nerve lesion
b.anterior interosseus neuropathy
c.brachial plexus lesion
d.wrist drop
e.c6-c7 nerve lesion

Answer 17

e.c6-c7 nerve lesion

Question 18

which nerve supplies motor fibres to flexor pollicis longus , flexor digitorum profundus and pronator quadratus

a.median
b.anterior interosseus
c.posterior interosseus
d.ulnar

Answer 18

b.anterior interosseus

Question 19

inability to light a lighter, take a photo on a camera and hold a cup but NO sensory symtpoms is indicative of damage of which nerve

a.median
b.anterior interosseus
c.posterior interosseus
d.ulnar

Answer 19

b.anterior interosseus

Question 20

fracture of what can lead to anterior interosseus neuropathy

a.radial groove of humerus
b.mid shaft of radius
c.mid shaft of ulna
d.olecranon

Answer 20

b.mid shaft of radius

Question 21

what nerve roots is the ulnar nerve derived from

a.c6-c7
b.c7-c8
c.c8-t1
d. t1-t2

Answer 21

c.c8-t1

Question 22

the ulnar nerve travels under the tendinous arch of 2 heads of which muscle

a.flexor policis longus
b.flexor carpi ulnaris
c.abductor policis brevis
d. brachioradialis

Answer 22

b.flexor carpi ulnaris

Question 23

which branches leave the ulnar nerve before the cubital tunnel at elbow

Answer 23

dorsal cutaneous
palmar cutaneous

Question 23

which branches leave the ulnar nerve before the cubital tunnel at elbow

Answer 23

dorsal cutaneous
palmar cutaneous

Question 24

in ulnar neuropathy which symptoms dominate a.sensory b.motor

Answer 24

b.motor

Question 25

wartenbergs signs seen in ulnar neuropathy

Answer 25

little finger gets caught when hand put into pocket abducted 5th finger due to weakness of 3rd palmar interosseus muscle

Question 26

benediction posture

Answer 26

ring and little fingers clawed thumb slightly abducted

Question 27

if sensory symptoms in ulnar neuropathy are limited to the MCP the nerve compression is most liekly to be found at which location a.wrist b.elbow c.lower brachial plexus

Answer 27

a.wrist

Question 28

if sensory symptoms in ulnar neuropathy are limited to the MCP and palmar only the nerve compression is most liekly to be found at which location a.wrist b.elbow c.lower brachial plexus

Answer 28

b.elbow below point of dorsal cutaneous branching and above the palmar branch dorsal cutaneous - this branch still supplies back of hand so that is normal

Question 29

if sensory symptoms in ulnar neuropathy extend to the mcp, palmar and dorsal ulnar nerve distributions the nerve compression is most liekly to be found at which location a.wrist b.elbow c.lower brachial plexus

Answer 29

c.lower brachial plexus

Question 30

sensory disturbance in the forearm and weakness involving abductor policis brevis indicates what a.proximal median nerve lesion b.anterior interosseus neuropathy c.brachial plexus lesion d.wrist drop e.c8-t1 radiculopathy

Answer 30

e.c8-t1 radiculopathy

Question 31

patient only has weakness, wasting and fasciculation in limbs no sensory symptoms

Answer 31

ALS

Question 32

in which condition is there bilateral wasting especially in lower limbs and is associated with a PMH of diabetes mellitus a. peripehral neuropathy b.anterior interosseus neuropathy c.brachial plexus lesion d.wrist drop e.c8-t1 radiculopathy

Answer 32

a. peripehral neuropathy

Question 33

where is the radiculopathy found in wrist drop a.c6-c7 b.c7-c8 c.c8-t1

Answer 33

b.c7-c8

Question 34

wrist drop without sensory disturbance indicates a damage where a.axillary nerve b.posterior interosseus nerve c.superficial radial

Answer 34

b.posterior interosseus nerve

Question 35

what muscle should be checked next in wirst drop (posterior interosseus nerve) with sensory disturbance (superficial radial nerve ) a.fcp b.apb c.fcu d.brachioradialis

Answer 35

d.brachioradialis

Question 36

which nerve supplies sensory to the arm a.ulnar nerve b.radial nerve c.anterior interosseus d.axillary nerve e.superficial radial

Answer 36

e.superficial radial

Question 37

wrist drop, weak suppination is indicative of what a. peripehral neuropathy b.anterior interosseus neuropathy c.brachial plexus lesion d.'saturday night palsy' e.c8-t1 radiculopathy

Answer 37

d.'saturday night palsy'

Question 38

fracture of which bone can cause wrist drop a.ulnar b.radius c.humerus

Answer 38

c.humerus

Question 39

in a brachial plexus lesion which other muscles should be weak excluding hand muscles a.deltoid and latisimus dorsi b.deltoid and pec minor c.supraspinatous and trapezius

Answer 39

a.deltoid and latisimus dorsi