Neuromuscular Review Questions #2

Question 1

Resistive testing of the extensor hallucis longus would be used to assess the:

L3 myotome
L4 myotome
L5 myotome
S1 myotome

Answer 1

L5

Question 2

Which of the following movements is most appropriate for testing the L4 myotome?

unilateral squat while supported
heel walking
toe walking
seated march

Answer 2

heel walking

Question 3

Which nerve root, if injured, would produce paresthesias in the thumb and index finger?

C5
C6
C7
C8

Answer 3

C6

Question 4

What location should be assessed to perform sensory testing for light touch of the T1 dermatome?

deltoid area
apex of the axilla
medial side of the antecubital fossa
undefined

Answer 4

medial side of the antecubital fossa

Question 5

Which dermatome corresponds to the L1-L2 spinal nerve roots?

posterior region of the thigh
buttock region
medial aspect of the knee
groin region

Answer 5

groin region

Question 6

A picture is displayed of a Q-tip touching the middle finger. Sensory testing of which dermatome is being shown

C4
C6
C7
T1

Answer 6

C7

Question 7

A patient performing shoulder abduction with dumbbells would be difficult if they had weakness in which myotome

C4
C5
C6
C7

Answer 7

C5

Question 8

A patient with weakness in which myotome would have the greatest difficulty maintaining heel strike

L3
L4
L5
S1

Answer 8

L4

Question 9

Which dermatome would be tested by assessing the perianal area?

L5
S1
S2
S3

Answer 9

S3

Question 10

Which dermatome would be tested by assessing the area of the lateral and plantar aspect of the foot?

L4
S1
S3
S4

Answer 10

S1

Question 11

Which myotome would be assessed by testing shoulder elevation?

C4
C5
C6
C7

Answer 11

C4

Question 12

Which myotome would be assessed by testing wrist extension?

C4
C5
C6
C7

Answer 12

C6

Question 13

Which myotome would be assessed by testing finger adduction?

C6
C7
C8
T1

Answer 13

T1

Question 14

Which dermatome would be tested by assessing the area of the posterior head?

C2
C3
C4
C5

Answer 14

C2

Question 15

Which myotome would be functionally tested by asking the patient to walk on their toes?

L3
L4
L5
S1

Answer 15

S1

Question 16

Which dermatome would be tested by assessing the area of the middle third of the anterior thigh?

L2
L3
L4
L5

Answer 16

L3

Question 17

Compression of the L2 nerve root would lead to weakness of which muscle group?

hip adductors
hip abductors
ankle plantar flexors
ankle dorsiflexors

Answer 17

hip adductors

Question 18

At what spinal level would a disk herniation be most likely to cause weakness of the hip flexor musculature?

T12
L2
L5
S1

Answer 18

L2

Question 19

Damage to which structure will present with neurological weakness in a single myotome?

facet joint
nerve trunk
nerve root
spinal cord

Answer 19

nerve root

Question 20

Which dermatome would be assessed by touching a patient’s skin with a cotton ball on the dorsal surface of the great toe?

L2
L3
L5
S1

Answer 20

L5

Question 21

The Modified Ashworth Scale is most commonly used to assess:

balance
posture
spasticity
strength

Answer 21

spasticity

Question 22

On the Modified Ashworth Scale for grading spasticity, which grade is described as a slight increase in muscle tone manifested by a catch and release at the end of the range?

0
1
1+
3

Answer 22

1

Question 23

What grade on the Modified Ashworth Scale would be used to describe a body part stuck rigidly in flexion or extension?

1+
2
3
4

Answer 23

4

Question 24

Which entry in the medical record would be a potential indicator for the use of the Modified Ashworth Scale?

increased evidence of fasciculations
presence of an abnormal primitive reflex
presence of a peripheral nerve injury
increased resistance to passive stretch

Answer 24

increased resistance to passive stretch

Question 25

According to the Modified Ashworth Scale, what grade would a therapist give a patient with the following clinical presentation: a slight increase in tone, manifested by a catch, followed by minimal resistance through the remaining (less than half) of the range of motion? 1 1+ 2 2

Answer 25

1+

Question 26

The Modified Ashworth Scale is least appropriate to include in a neurological assessment for patients with which diagnosis? traumatic brain injury muscular dystrophy pediatric hypertonia spinal cord injury

Answer 26

Correct Answer: muscular dystrophy The Modified Ashworth Scale is used to measure spasticity in patients with upper motor neuron lesions. Muscular dystrophy is considered a lower motor neuron disease caused by the absence of the gene required to produce the muscle proteins dystrophin and nebulin.

Question 27

What is the correct technique to assess the spasticity of the hip extensors? move the test leg from maximal flexion to extension quickly move the test leg from maximal flexion to extension slowly move the test leg from maximal extension to flexion quickly move the test leg from maximal extension to flexion slowly

Answer 27

move the test leg from maximal extension to flexion quickly

Question 28

What is the best time to assess spasticity for a patient with multiple sclerosis? before the patient takes their anti-spasticity medication after the patient takes their anti-spasticity medication before and after the patient takes their anti-spasticity medication spasticity is not typically a symptom of multiple sclerosis

Answer 28

before and after the patient takes their anti-spasticity medication

Question 29

If a patient was determined not to be a candidate for the Modified Ashworth Scale, what other clinical measure could be utilized to assess spasticity? Berg Balance Scale Rancho Los Amigos Levels of Cognitive Functioning Glasgow Coma Scale Brunnstrom’s Stages of Recovery

Answer 29

Brunnstrom's Stages of Recovery

Question 30

What is the correct description for a grade of 3 on the Modified Ashworth Scale? considerable increase in muscle tone, passive movement difficult no increase in muscle tone marked increase in muscle tone, affected part(s) easily moved affected part(s) in rigid flexion or extension

Answer 30

considerable increase in muscle tone, passive movement difficult

Question 31

What is the minimum score obtainable on the Glasgow Coma Scale? 0 1 2 3

Answer 31

3

Question 32

Which parameter is not assessed as part of the Glasgow Coma Scale? eye opening motor response reflex response verbal response

Answer 32

reflex response

Question 33

What is the highest attainable score on the Glasgow Coma Scale? 6 12 15 18

Answer 33

15

Question 34

Which patient response in the motor component of the Glasgow Coma Scale would receive the largest score? extensor response follows motor commands localizes withdraws

Answer 34

follows motor commands

Question 35

Spontaneous eye opening on the Glasgow Coma Scale would receive a score of: 1 2 3 4

Answer 35

4

Question 36

What three categories does the Glasgow Coma Scale evaluate? tone, breathing, reflexes motor response, verbal response, respiratory function eye opening, motor response, verbal response eye opening, verbal response, tone response

Answer 36

eye opening, motor response, verbal response

Question 37

Which of the following Glasgow Coma Scale scores indicates severe brain injury? 7 9 11 14

Answer 37

7

Question 38

A score of 5 on the Glasgow Coma Scale indicates: severe head injury severe spasticity moderate head injury moderate spasticity

Answer 38

severe head injury

Question 39

Which of the following scores on a Glasgow Coma Scale is indicative of a moderate brain injury? 6 8 10 13

Answer 39

10

Question 40

What is the Glasgow Coma Scale score of a patient who withdraws from pain, converses but is confused, and opens his eyes spontaneously? 6 9 12 15

Answer 40

12

Question 41

What nerve innervates the hamstrings muscle? obturator nerve posterior femoral nerve sciatic nerve common peroneal nerve

Answer 41

sciatic

Question 42

What artery is used as a point of reference when naming the cords of the brachial plexus? axillary artery carotid artery subclavian artery vertebral

Answer 42

axillary

Question 43

Which muscle is innervated by the ulnar nerve? anconeus extensor carpi radialis flexor digitorum profundus supinator

Answer 43

FDP

Question 44

Which muscle of the lower extremity is not innervated by the tibial nerve? flexor hallucis longus flexor digitorum longus flexor digiti minimi tibialis posterior

Answer 44

flexor digiti minimi

Question 45

Which muscle is innervated by the femoral nerve? adductor longus iliopsoas quadriceps femoris hamstrings

Answer 45

quadricep femoris

Question 46

Which spinal nerve roots contribute to the brachial plexus? C1-T1 C3-C8 C5-C8 C5-T1

Answer 46

C5-T1

Question 47

Deltoid atrophy may be associated with an injury to the: axillary nerve median nerve radial nerve subclavian nerve

Answer 47

axillary nerve

Question 48

At which of the following sites might the median nerve be compressed? passing through the two heads of the pronator teres passing beneath the pisohamate ligament passing between the two heads of the supinator passing through the canal of Frohse

Answer 48

passing through the two heads of the pronator teres

Question 49

Paralysis of which nerve gives rise to scapular winging? suprascapular nerve long thoracic nerve subscapular nerve thoracodorsal nerve

Answer 49

long thoracic nerve

Question 50

Which nerve innervates the diaphragm? phrenic nerve ventral rami of lumbar nerves L2-L4 cranial nerve V cranial nerve XI

Answer 50

phrenic nerve

Question 51

Injury to the posterior cord of the brachial plexus could involve all of the following except: thoracodorsal nerve radial nerve axillary nerve musculocutaneous nerve

Answer 51

musculocutaneous nerve

Question 52

The supraspinatus and infraspinatus muscles are both innervated by which nerve? axillary suprascapular lower subscapular upper subscapular

Answer 52

suprascapular

Question 53

Which of the following muscles is innervated by the anterior division of the obturator nerve? pectineus adductor magnus adductor longus gracilis

Answer 53

adductor longus

Question 54

Which of the following nerves does not have a connection from all three trunks of the brachial plexus? lower subscapular radial suprascapular thoracodorsal

Answer 54

suprascapular

Question 55

Which nerve innervates the cremasteric muscle? ilioinguinal nerve obturator nerve genitofemoral nerve femoral nerve

Answer 55

genitofemoral nerve

Question 56

What nerve innervates the highlighted muscle in the image? suprascapular nerve radial nerve spinal accessory nerve dorsal scapular nerve

Answer 56

spinal accessory nerve

Question 57

An inability to extend the elbow could result from pathology affecting the: dorsal nerve root of C7 ventral nerve root of C7 dorsal nerve root of C8 ventral nerve root of C6

Answer 57

ventral nerve root of C7

Question 58

What nerve is identified in the image? deep peroneal nerve tibial nerve sciatic nerve superficial peroneal nerve

Answer 58

Superficial peroneal nerve

Question 59

An inability to splay the fingers would indicate damage at which spinal segments? C5-C6 C6-C7 C7-C8 C8-T1

Answer 59

C8-T1

Question 60

Which nerve innervates the highlighted muscle? thoracodorsal nerve dorsal scapular nerve spinal accessory nerve radial nerve

Answer 60

thoracodorsal nerve

Question 61

Which motor control theory is based on the premise that movement is controlled by stimulus-response and that reflexes are combined into actions that create behavior? reflex theory hierarchical theory dynamical systems theory motor program theory

Answer 61

reflex theory

Question 62

In which stage of motor learning is the individual highly focused on the task, attentive to all it demands, and developing an understanding of what is expected and involved in performance of the skill? advanced autonomous associative cognitive

Answer 62

cognitive

Question 63

Which term is consistent with providing feedback to an individual after they have performed the task? knowledge of results knowledge of performance concurrent feedback evaluation

Answer 63

knowledge of results

Question 64

Which term is consistent with feedback that is provided to an individual through the person’s own sensory systems as a result of the movement? terminal feedback inherent feedback extrinsic feedback augmented feedback

Answer 64

Inherent

Question 65

Which term refers to the adoption of strategies or behaviors that are different than pre-injury strategies or behaviors used to complete tasks? regeneration neuroplasticity recovery compensation

Answer 65

compensation

Question 66

What stage of motor learning would most commonly occur after a patient is discharged from physical therapy? associative stage cognitive stage acquisition stage autonomous stage

Answer 66

autonomous stage

Question 67

Which strategy would be the most appropriate to make a task more difficult during the autonomous stage of motor learning? dual-task training demonstrating the task for the patient allowing the patient to plan the movement providing feedback on how to improve the task

Answer 67

dual task training

Question 68

Providing an individual with feedback while performing a task is an example of: concurrent feedback parallel feedback terminal feedback intrinsic feedback

Answer 68

concurrent

Question 69

Knowledge of results is best described as: feedback during the movement regarding movement patterns feedback about the overall outcome of the movement in relation to the goal feedback about the movement prior to initiation of the task feedback every other trial

Answer 69

feedback about the overall outcome of the movement in relation to the goal

Question 70

Providing feedback on the quality of the movement pattern during the performance of the task is termed: terminal feedback knowledge of performance concurrent feedback knowledge of results

Answer 70

knowledge of performance

Question 71

Which term refers to a practice sequence organized around one task performed repeatedly without interruption by practice of any other task? blocked random massed distributed

Answer 71

blocked

Question 72

Which term refers to a practice sequence organized around a variety of tasks ordered arbitrarily across trials? blocked random massed distributed

Answer 72

random

Question 73

Proprioceptive, visual, vestibular and cutaneous signals are examples of what kind of feedback? extrinsic augmented terminal feedback intrinsic

Answer 73

intrinsic

Question 74

Which of the following refers to the ability of the brain to change and repair itself? regeneration neuroplasticity recovery compensation

Answer 74

neuroplasticity

Question 75

Which of the following is a proactive strategy that uses sensory information obtained from experience? feedback control feedforward control suspensory strategy stepping strategy

Answer 75

feedforward control

Question 76

Which type of practice may be the most beneficial for a patient that is prone to fatigue? massed distributed blocked random

Answer 76

Distributed

Question 77

Which of the following terms is most consistent with an increase in an elicited behavior from repeated presentation of a stimulus? habituation sensitization adaptation modeling

Answer 77

sensitization

Question 78

Which of the following terms is most consistent with a learned decrease or cessation of a response to a stimulus after repeated presentations? habituation sensitization adaptation modeling

Answer 78

habituation

Question 79

When learning a new motor skill, what form of extrinsic feedback best promotes long-term learning? immediate knowledge of results summary knowledge of results immediate knowledge of performance summary knowledge of performance

Answer 79

summary knowledge of results

Question 80

What term is used to describe the ability to initiate movement through a functional range of motion? hypertonia stability mobility skill

Answer 80

mobility