Screening: Myotomes, Dermatomes, and Reflexes Flashcards
When is it necessary to perform an entire body muscle test
- Guillain-Barre Syndrome
- Incomplete spinal cord injury
When would you choose a “make” test over a “break” test
- when you want to check that the strength is equal in both extremities
When would you choose to avoid strength testing
- fracture
- extremely painful
- known tear
Contraindications for strength testing
- unhealed fracture
- pathologically unstable joints
- prohibited AROM
Precautions for strength testing
- advanced osteoporosis
- metastatic cancer
- osteogenesis imperfecta
How does Cyriax’s method (contractile unit testing) add to your assessment
Strong & pain free: nothing is wrong with contractile tissue
Strong & painful: inflammation not a complete tear
Weak & painful: partial tear
Weak & pain free: complete tear
What are the general “rules of thumb” for strength testing
- minimize position changes
- encourage good postural alignment
- test unaffected side first then the affected side
- if weakness is noted, ask patient to describe the difficulty holding the test position
What sensations do the dorsal column tract and the spinothamlamic tract carry
Dorsal Column: light touch, vibration, joint position, & discriminative sensation
Spinothalamic: coarse touch, temperature, & pain sensation
What does glove & stocking distribution sensory loss indicate
- neuropathy
Purpose of testing joint position sense
- to determine if patient can identify “up” or “down” position of a joint
Define stereognosis discriminative sensation test
- place a familiar object in patient’s hand (coin, key, paper clip)
- ask patient to identify object
- begin on unaffected side first
Define graphesthesia discriminative sensation test
- draw large number on patient’s extremity
- identify top/bottom of drawing area first
Define two point discrimination discriminative sensation test
- use 2 point discrimination tool of bent paper clip
- 5mm is normal for pads of fingers
Define point localization discriminative sensation test
- have patient close eyes
- touch patient on distal extremity
- have patient open eyes & point to the location that you touched
- start with unaffected side first
- move distal to proximal, as indicated
When is it a priority to test somatosensory function
- symptoms consistent with nervous system involvement
- conditions that impair distal sensation
- dysfunction at a nerve root level
