radiculopathy Flashcards
What is the sensitivity and specificity of Spurling’s test for radiculopathy?
Sensitivity 59%, specificity 84%
helpful to rule in, not to rule out.
Also depends on how it is performed. Cx ext + LF + compression
Helpful to rule in, but not to rule out. Validity issues due to variations in performance.
Which muscles are innervated by the C5 myotome?
- Supra & Infraspinatus
- Deltoid
- Biceps Brachii
Based on MMT and EMG findings.
What are the sensitivity and specificity of sensation in neurological examination for radiculopathy?
Sensitivity: 32-40%, Specificity: 59-72%
These values indicate the test’s accuracy in detecting radiculopathy.
What is the most sensitive test for detecting disc extrusion?
Slump test with sensitivity 78%
Less than 1 neurological symptom also indicates sensitivity of 67%.
What does a normal neurodynamic screen indicate in relation to radiculopathy?
It offers a good screening test unless due to foraminal compression
Absence of neurological symptoms can moderate ability to rule out radiculopathy.
How is C8-T1 radiculopathy differentiated from ulnar neuropathy?
- C8 dermatome extends into the forearm
- Ulnar nerve only supplies sensation in medial hand and 4-5th fingers
- Ulnar nerve does not supply the thenar muscles innervated by C8 - Abductor pollicus brevis, opponens pollicus, flexor pollicus brevis, lateral lumbricals
Medial antebrachial cutaneous nerve supplies medial forearm.
What is the sensitivity and specificity of the Cervical-Flexion-Rotation test for cervicogenic headache?
Sensitivity and specificity of 70%
Effective for distinguishing cervicogenic headache from migraine and mixed headache.
What is a practical point to consider regarding neurodynamics and neurological signs?
Absence of positive neurodynamics in presence of positive neurological signs may indicate foraminal nerve compression
Important for clinical assessment of radiculopathy.
What are the key muscles innervated by the median nerve related to C8-T1?
- Flexor pollicus brevis
- Abductor pollicus brevis
- Opponens pollicis
- Lateral lumbricals
Not innervated by the ulnar nerve.
What are the accuracy statistics for motor paresis in neurological examination for radiculopathy?
Sensitivity: 22-40%, Specificity: 62-79%
These values reflect the effectiveness of the test in identifying radiculopathy.
What does the pneumonic ‘AbOF the Law’ help to remember?
Right muscles innervated by C8-T1 via the median nerve
Useful for distinguishing muscle innervation in clinical practice.
What is the normal range of motion (ROM) of C1-2, and how does it differ in those with cervicogenic headache?
Normal ROM is 45 degrees; those with CGH have an average of 25 degrees rotation towards the affected side
Migraineurs show normal ROM.
What declines with age that affects cervical range of motion?
Cervical ROM
Approximately 30% of variance in ROM can be explained by age.
What are the sensitivity and specificity of deep tendon reflexes in neurological examinations for radiculopathy?
Sensitivity: 22-25%, Specificity: 75-78%
These figures indicate the reliability of reflex testing in diagnosing radiculopathy.
What is the most specific test to rule in a radiculopathy?
Two or more neurological findings
(specificity ~70%)
Specificity varies from 65-75% depending on location/type.
In the context of foraminal nerve root compression, what is the most sensitive test?
Less than 1 neurological symptom with sensitivity of 80%
Indicates high sensitivity in identifying this condition.
how do you test the C8 myotome
resisted 4th finger flexion, abductor digiti minimi
What’s the clinical accuracy of ULNT in diagnosing radiculopathy
3 out of 4 tests positive has specificity of 96%
<1 out of 4 test positive has sensitivity of 96%
what are the limitations of the studies testing neurodynamics
- the interpretation of a positive test:
some one use 1 of:
- symptom reproduction
- sensitizing movement
- reduced ROM vs other side - lack of a true reference standard
