Tests

Question 1

Barr’e-Lie’ou Test

Answer 1

Procedure: patient seated, pt rotates head back and forth as fast as they can

Purpose: rule out vascular insufficiency, cervicogenic vertigo, vestibular apparatus

Positive: vertigo, dizziness, visual disturbances, nausea, syncope, nystagmus

Question 2

DeKleyn’s Test

Answer 2

Procedure: pt lies supine. Rotates and hyper-extends and couts back from 20.

Purpose: rule out vascular insufficiency

Positive: vertigo, dizziness, visual disturbances, nausea, syncope, nystagmus

Question 3

dermatomes of note

Answer 3

T4, T7, T10, T12

Question 4

muscle strength testing

Answer 4

0/5 = complete paralysis
1/5 = twitch of movement (0-10%)
2/5 = moderate to severe paresis (11-25%)
3/5 = moderate paresis (26-50%)
4/5 = mild paresis (51-75%)
5/5 = normal (76-100%)

Question 5

Supraspinatus

Answer 5

Seg: C5, C6
Periph: Suprascapular

Question 6

Deltoid

Answer 6

Seg: C5, C6
Periph: Axillary

Question 7

Biceps

Answer 7

Seg: C5, C6
Periph: Musculocutaneous

Question 8

Brachioradialis

Answer 8

Seg: C5, C6
Periph: Radial

Question 9

Wrist Extension

Answer 9

Seg: C6, C7, C8
Periph: Radial

Question 10

Triceps

Answer 10

Seg: C6, C7, C8
Periph: Radial

Question 11

Wrist Flexion

Answer 11

Seg: C6, C7, C8
Periph: Median, Ulnar

Question 12

Finger Extension

Answer 12

Seg:C6, C7, C8
Periph: Radial

Question 13

Finger Flexion

Answer 13

Seg: C7, C8, T1
Periph: Median, Ulnar

Question 14

Finger Abduction

Answer 14

Seg: C8, T1
Periph: Ulnar

Question 15

Finger Adduction

Answer 15

Seg: C8, T1
Periph: Ulnar

Question 16

Deficit Phenomena

Answer 16

loss of normal neurological fxn. Reductions in muscle tone, muscle stretch reflexes, muscle strength and muscle volume. LMN lesions produce only deficit phenomena

Question 17

Release Phenomena

Answer 17

Exaggerations or perversions of normal neurological fxn and are due to a loss of cortical inhibition. Hyper-reflexia, hypertonia and pathological reflexes would be release phenomena.

Question 18

Tone or Tonis

Answer 18

a reflex phenomena. Afferent and efferent components influence it

Question 19

Reflex grading system

Answer 19

0/2 = absent with reinforcement
\+1/2 = hypoactive with reinforcement
\+2/2 = normal
\+3/2 = hyperactive
\+4/2 = hyperactive with transient/sustained clonus

Question 20

Jendrassik

Answer 20

reinforcement of the reflexes

Question 21

most commonly tested superficial reflexes

Answer 21

1. gag reflex
2. corneal blink reflex
3. epigastric reflex
4. upper abdominal reflex
5. middle abdominal reflex
6. lower abdominal reflex
7. cremasteric reflex
8. gluteal reflex
9. plantar reflex
10. anal reflex

Question 22

Gag reflex

Answer 22

CN IX & X

Question 23

Corneal Blink

Answer 23

CN V & VII

Question 24

Epigastric reflex

Answer 24

T5-T7

Intercostal nerve

Question 25

Upper Abdominal reflex

Answer 25

T7-T9

intercostal nerve

Question 26

Middle Abdominal reflex

Answer 26

T9-T11

intercostal Nerve

Question 27

Lower Abdominal reflex

Answer 27

T11-T12

Intercostal, Iliohypogastric, ilioinguinal nerves

Question 28

Cremasteric reflex

Answer 28

L1-L2
ilioinguinal, genitofemoral nerves
stroke from above–>down direction

Question 29

Gluteal reflex

Answer 29

L4-S2

inferior gluteal nerve

Question 30

Plantar reflex

Answer 30

L4-S2
Tibial nerve
Normal: plantar flexion of toes & foot
Abnormal: dorsiflexion of great toe & flaring of other toes

Question 31

Anal reflex

Answer 31

S2-S5

Inferior Hemorrhoidal

Question 32

Hoffmann Sign

Answer 32

Lesion above C5 in corticospinal tract
flick pts middle finger
UMNL: flexion of fingers & adduction of thumb

Question 33

Tromner Sign

Answer 33

Lesion above C5 in corticospinal tract
tap volar surface of middle finger
UMNL: flexion of fingers & adduction of thumb

Question 34

Rossolimo Sign

Answer 34

corticospinal tract
tap ball of foot or tap tips of toes
UMNL: plantar flexion of toes

Question 35

Babinski Sign

Answer 35

Corticospinal Tract
stroke plantar foot from heel to metatarsals to big toe
Normal: plantar flexion of toes & foot
UMNL: dorsiflexion of great toe & flaring of other toes

Question 36

Chaddock sign

Answer 36

Corticospinal tract
stroke lateral malleolus from heel to toe
Normal: no motion of toes & foot
UMNL: dorsiflexion of great toe & flaring of other toes

Question 37

Oppenheim Sign

Answer 37

Corticospinal tract
stroke anterior tibial surface from S –> I
Normal: no motion
UMNL: dorsiflexion of great toe & flaring of other toes

Question 38

Gordon Sign

Answer 38

corticospinal tract
squeeze calf
normal: no motion
UMNL: dorsiflexion of great toe & flaring of other toes

Question 39

Schaefer Sign

Answer 39

corticospinal tract
squeeze achilles
Normal: no motion
UMNL: dorsiflexion of great toe & flaring of other toes

Question 40

visceral reflexes

Answer 40

1. pupillary light reflex
2. accommodation reflex
3. ciliospinal reflex
4. oculocardiac reflex
5. carotid sinus reflex
6. bulbocavernosus reflex

Question 41

pupillary light reflex

Answer 41

afferent: CN II
efferent: CN III

Question 42

accommodation reflex

Answer 42

CN III

Question 43

Ciliospinal reflex

Answer 43

Afferent: Cervicals & CN V
Efferent: cervical sympathetics
painful stimulus to skin of neck
normal: dilation of pupil on painful side of stimulation

Question 44

Oculocardiac reflex

Answer 44

Afferent: CN V
Efferent: CN X
thumb pressure on eyeballs
dec heart rate & blood pressure

Question 45

Carotid sinus reflex

Answer 45

Afferent: CN IX
Efferent: CN X
pressure on carotid sinus
Dec heart rate & blood pressure

Question 46

Bulbocavernosus reflex

Answer 46

S3-S4
stroke, prick, pinch the dorsum of glans penis
contraction of bulbocavernosus muscle & urethral constriction and contraction of external anal sphincter