PNS Upper limb

Question 1

How do you positively reinforce reflexes in upper limb and lower limb tests?

Answer 1

Jendrassik Maneouvre;
Upper limb - Clenched teeth
Lower limb - grasp hands and pull apart

Question 2

What is the mmemonic after WIPPPE for upper limb?

What does it stand for?

Answer 2

TPR CS
(total peripheral resistance cs)

Tone 
Power
Reflexes
Coordination
Sensation

Question 3

What condition displays a glove and stocking distribution of loss of sensation?

How do you test for this?

Answer 3

Peripheral neuropathy
(note many conditions fit under this umbrella)
symmetrical distribution

light touch test

Question 4

When assessing proprioception, where should you hold the thumb and hallux and why?

Answer 4

on the sides so that the patien cant feel pressure lest this distorts testing of propioception

Question 5

How do we test for pain sensation?

Answer 5

Pin prick

Question 6

How do upper motor neurone lesions present?
(Remember you are commenting on TPR)

Where can lesion be found?

Answer 6

Increased tone
Reduced power (weakness but normal muscle bulk)
Brisk reflexes

brain or spinal cord

remember;
“upper” is for “up” the tone n reflexes

Question 7

How do lower motor neurone lesions present?
(Remember you are commenting on TPR)

Where can lesion be found?

Answer 7

Reduced tone (flaccidity)
Reduced power (weakness)
Reduced or absent reflexes
Muscle wasting + atrophy

Remember;
“lower” is for “low” the tone and reflexes

Lesion in peripheral nerve (anterior horn cell body and below)