Peripheral Nerves physical exam

Question 1

cervical spinal nerves

Answer 1

8

Question 2

thoracic spinal nerves

Answer 2

12

Question 3

lumbar spinal nerves

Answer 3

5

Question 4

sacral spinal nerves

Answer 4

5

Question 5

coccygeal spinal nerve

Answer 5

1

Question 6

of each spinal nerve, what contains the motor fibers

Answer 6

anterior (ventral) root

Question 7

of each spinal nerve, what contains the sensory fibers

Answer 7

posterior (dorsal) root

Question 8

spinal nerve is made of

Answer 8

anterior and posterior roots

Question 9

Spinal nerve fibers commingle with similar fibers from other levels in plexuses outside the cord, from which _______ nerves emerge

Answer 9

peripheral

Question 10

migraine, tension, cluster and trigeminal cephalagias

Answer 10

headaches

Question 11

what to assess when someone presents with HA

Answer 11

location, duration, any associated symptoms (double vision, vision changes, weakness, loss of sensation)

Question 12

what can signal meningitis

Answer 12

fever, HA, stiff neck
previous ear, sinus, throat, URI infection

Question 13

vertigo 2 main causes

Answer 13

peripheral (ear)
central (brain)

Question 14

“pins and needles”

Answer 14

paresthesia

Question 15

burning pain

Answer 15

neuropathies (diabetic)

Question 16

_____ is associated with UMN damage

Answer 16

hypertonia

Question 17

____ is associated with hypotonia

Answer 17

LMN damage

Question 18

grade for muscle strength with active movement against gravity

Answer 18

3

Question 19

grade for muscle strength with active movement against gravity AND some resistance

Answer 19

4

Question 20

spinal n. and muscle associated with shoulder abduction

Answer 20

C5-deltoid

Question 21

spinal n. and muscles associated with shoulder adduction

Answer 21

C7- pectoralis major, lattisimus dorsi

Question 22

spinal nerves and muscles associated with elbow flexion

Answer 22

C5, C6- biceps and bracioradialis

Question 23

spinal nerves and muscle associated with elbow extension

Answer 23

C6, C7, C8- triceps

Question 24

spinal nerves and muscles associated with wrist flexion

Answer 24

C6, C7, C8- flexor carpi radialis, flexor carpi ulnaris, palmaris longus

Question 25

spinal nerves and muscles associated with wrist extension

Answer 25

C6, C7, C8, radial n.- extensor carpi radialis longus and brevis

Question 26

spinal nerves involved in grip strength

Answer 26

C7, C8, T1

Question 27

spinal nerves and muscles involved with finger abduction

Answer 27

C8, T1, ulnar n.--dorsal interossei

Question 28

spinal nerve and muscle involved in finger adduction

Answer 28

T1--palmar interossei

Question 29

spinal nerves involved with opposition of the thumb

Answer 29

C8, T1, median n.

Question 30

spinal nerves and muscles involved with hip abduction

Answer 30

L4, L5, S1--gluteus medius and minimus

Question 31

spinal nerves and muscles involved in hip adduction

Answer 31

L2, L3, L4--adductors

Question 32

spinal nerves and muscle involved in hip flexion

Answer 32

L2, L3, L4---iliopsoas

Question 33

spinal nerve and muscle involved in hip extension

Answer 33

S1- gluteus maximus

Question 34

spinal nerves and muscle involved in knee flexion

Answer 34

L4, L5, S1, S2---hamstrings

Question 35

spinal nerves and muscle involved in knee extension

Answer 35

L2, L3, L4----quadriceps

Question 36

spinal nerves and muscle involved in foot dorsiflexion

Answer 36

L4, L5---tibialis anterior

Question 37

spinal nerve and muscles involved in plantarflexion

Answer 37

S1---gastrocnemius, soleus

Question 38

when testing for sharp vs dull, and light touch, what spinal nerve is tested on tops of shoulders

Answer 38

C4

Question 39

when testing for sharp vs dull, and light touch, what spinal nerve is tested on the medial and lateral aspects of forearm

Answer 39

C6,T1

Question 40

when testing for sharp vs dull, and light touch, what spinal nerve is tested on the thumbs and pinkie fingers

Answer 40

C6, C8

Question 41

when testing for sharp vs dull, and light touch, what spinal nerve is tested on the front of the thighs

Answer 41

L2

Question 42

when testing for sharp vs dull, and light touch, what spinal nerve is tested on the medial and lateral aspects of both legs

Answer 42

L4, L5

Question 43

when testing for sharp vs dull, and light touch, what spinal nerve is tested on the little toes

Answer 43

S1

Question 44

____ sense is often the first sensation lost in peripheral neuropathy

Answer 44

vibration

Question 45

joint position sense

Answer 45

proprioception

Question 46

___ and ____ can be seen in multiple sclerosis, B12 deficiency, diabetic neuropathy, and others

Answer 46

loss of position sense and loss of vibration

Question 47

ability to identify object by feeling it

Answer 47

Stereognosis

Question 48

ability to identify numbers when writing it on patients hand

Answer 48

graphesthesia

Question 49

lesions of ____ cortex are involved with parietal lobe

Answer 49

sensory

Question 50

lesions of _____ cortex are involved with frontal lobe

Answer 50

motor

Question 51

grade for average/normal muscle stretch reflex

Answer 51

2

Question 52

____ are seen in CNS lesions of the descending corticospinal tract

Answer 52

hyperactive reflexes

Question 53

weakness, spasticity, or a positive Babinski sign

Answer 53

upper motor neuron findings

Question 54

___ or ____ reflexes occur in lesions of the spinal nerve roots, spinal nerves, plexuses, or peripheral nerves

Answer 54

hypoactive or absent

Question 55

weakness, atrophy, or fasciculations

Answer 55

lower motor neuron findings

Question 56

_____ initiates voluntary movement (located in the brain)

Answer 56

UMN

Question 57

____ carries out the voluntary movement (located in the spinal cord)

Answer 57

LMN

Question 58

spinal nerves involved with biceps reflex

Answer 58

C5, C6

Question 59

spinal nerves involved with triceps reflex

Answer 59

C6, C7

Question 60

spinal nerves involved in brachioradialis reflex

Answer 60

C5, C6

Question 61

spinal nerves involved with the quadriceps (patellar) reflex

Answer 61

L2, L3, L4

Question 62

spinal nerves involved with the Achilles (ankle) reflex

Answer 62

S1

Question 63

present if rhythmic oscillations between dorsiflexion and plantar flexion are felt or seen; points to CNS disease

Answer 63

clonus

Question 64

spinal nerves involved with plantar reflex

Answer 64

L5, S1

Question 65

a positive ____ response is when there is dorsiflexion when doing plantar response and means there is a CNS lesion affecting what tract

Answer 65

Babinski response; corticospinal tract

Question 66

assess for meningeal inflammation Technique: Flex the patient’s neck, watch the hips and knees in reaction to your maneuver. Normally they should stay relaxed/motionless. If the hips and knees flex it is a positive sign

Answer 66

Brudzinski sign

Question 67

assess for meningeal inflammation Technique: Flex patient’s leg at hip and knee, and then slowly extend the leg and straighten the knee. Pain and increased resistance to knee extension are a positive sign

Answer 67

Kernig sign

Question 68

assess for lumbosacral radiculopathy - Technique: Place patient in a supine position. Raise the patient’s relaxed and straightened leg, flexing the thigh at the hip. Assess the degree of elevation at which pain occurs, the quality and distribution of pain. Pain radiating in into the ipsilateral leg is + finding

Answer 68

Straight-leg raise

Question 69

Assesses for metabolic encephalopathy (like in kidney disease Technique: Ask patient to “stop traffic” by extending both arms, with hands cocked up and fingers spread. Watch for 1 to 2 minutes. Sudden, brief, nonrhythmic flexion of hands and fingers followed by recovery indicates ____

Answer 69

Asterixis