Practical Exam Steps

Question 1

Differentiating dermatomes from peripheral nerves locations UE

Answer 1

AC Joint
Lateral antecubital fossa
Dorsal thumb
palmar surface of middle finger
palmar surface of 5th finger
medial antecubital fossa

Question 2

AC Joint

Answer 2

C4, supraclavicular N

Question 3

Lateral antecubital fossa

Answer 3

C5, lateral cutaneous

Question 4

Dorsal thumb

Answer 4

C6, radial

Question 5

Palmar surface of middle finger

Answer 5

C7, median

Question 6

Palmar surface of 5th finger

Answer 6

C8, ulnar

Question 7

Medial antecubital fossa

Answer 7

T1, medial cutaneous

Question 8

Differentiating dermatomes from peripheral nerves locations LE

Answer 8

Lateral upper thigh
medial knee
medial malleolus
dorusm of 3rd MTP
web space btwn 1st and 2nd MTP
Lateral heel
Medial posterior knee/thigh

Question 9

Lateral upper thigh

Answer 9

L2, lateral femoral cutaneous

Question 10

Medial knee

Answer 10

L3, anterior femoral cutaneous

Question 11

medial malleolus

Answer 11

L4, saphenous

Question 12

Dorsum of 3rd MTP

Answer 12

L5-S1, superficial peroneal

Question 13

Web space btwn 1st and 2nd MTP

Answer 13

L5, deep peroneal

Question 14

Lateral heel

Answer 14

S1, sural N

Question 15

Medial posterior knee/thigh

Answer 15

S2, posterior femoral cutaneous

Question 16

Documentation of Differentiating dermatomes from peripheral nerves locations

Answer 16

Describe the area of impaired sensation using intact, impaired, absent
Describe the pattern of loss

Question 17

Differentiating dermatomes from peripheral nerves locations steps

Answer 17

Demonstration with eyes open, pt answers with “yes”
testing with eyes closed
apply light touch to each of key areas, alternate between sides
vary the rhythm
once area of impairment is found, apply 5+ stimulus to determine a pattern

Question 18

Pin Prick Testing

Answer 18

Testing ability between sharp and dull stimuli, done after dermatome/peripheral nerve
Do demonstration with eye open, answer should be sharp or dull

apply sharp and dull stimulus 5 times
once an area of impaired sensation is found, apply only sharp from center of impaired to outwards.
ask patient to say when the stimulus changes

Question 19

Documentation of pin prick test

Answer 19

describe the area of impaired sensation using intact, impaired, or absent
describe the pattern of loss, figure out if its a peripheral nerve, nerve root, neither

Question 20

Vibration testing steps

Answer 20

explain that you’ll be testing pt ability to sense vibration
pt should be focusing on vibration not tuning fork
demonstrate with eyes open

testing with eyes closed
hold tuning fork by base and hit firmly against hand
place base of tuning fork against pt’s skin
squeeze the prongs to stop vibration, vary length of stimulus

Question 21

Documentation of vibration testing

Answer 21

Describe the area of impaired sensation using intact, impaired, or absent
indicate the location and side of deficit

Question 22

Proprioception test steps

Answer 22

Explain to the pt that you will be testing their ability to sense relative position of their joints in space
ask pt to respond up or down in response to passive movements
practice trial with eyes open

testing with eyes closed
hold digit or limb by lateral aspects, soft tissue that is crossing the joint you are testing
perform at least 5 movements in a random order
for a peripheral lesion, if distal is intact, you can assume its intact proximally

Question 23

Proprioception documentation

Answer 23

testing the DCML
identify limb tested
note the # of correct responses out of 5
position sense may be described as intact, impaired, absent

Question 24

Sensory Extinction Test

Answer 24

Explain that you will be testing their ability to identify simultaneous light touch on different parts of body
ask pt to respond to right, left, both
practice trial with eyes open

closed eyes testing
alternate randomly between unilateral and bilateral simultaneous light touch
equal in force
5 simultaenous stimuli at least

light touch sensation and language production should be tested beforehand

Question 25

Documentation of sensory extinction

Answer 25

testing DCML, contralateral post parietal cortex
document whether sensation of simultaneous touch is either intact, impaired, absent

Question 26

Stereognosis Test steps

Answer 26

explain to pt that you will be testing their ability to identify objects placed in hand with manipulation
perform practice trial on area w/known intact area

Light touch sensation should be completed prior

Eyes should be closed
place a common household object in pts hand, identify it
assess bilaterally
3 trials per side, different objects

Question 27

Stereognosis documentation

Answer 27

testing DCML, somatosensory cortex, contralateral posterior parietal cortex

identify limb tested
note the # of correct responses out of 3 (total 6) and list objects used/identified
intact, impaired, absent

Question 28

Graphesthesia testing steps

Answer 28

Explain that you will be testing their ability to identify letters and #s drawn on palm of hand
practice test with eyes open
Light touch sensation and language need to be intact

test with eyes closed
inform pt that you’ll be drawing letters or numbers with finger or pen
assess bilaterally
perform at least 5 trials per side

Question 29

Documentation of Graphesthesia

Answer 29

testing DCML, S2, contralateral posterior parietal cortex
identify limb tested
note the number of correct responses out of 5 (total of 10)
describe as intact, impaired, absent