Anatomic Basis of Clinical Testing Pt. 2 (9/5c)

Question 1

Reflex

Answer 1

Tests the afferent (spinal cord) and efferent (muscle) areas

Question 2

CNS/PNS Neurons

Answer 2

CNS = upper motor neurons

PNS = lower motor neurons

Question 3

Reflex - CNS Role

Answer 3

should normally put a slight inhibition on the reflex so the motion isn’t exaggerated

Question 4

Reflex - PNS Role

Answer 4

innervates muscle by relaying sensation to the motor neuron

if not operating correctly, there would be reduced response

Question 5

Pattern recognition - Dermatomes

Answer 5

peripheral nerve sensory distribution

Question 6

Pattern recognition - Myotomes

Answer 6

peripheral nerve muscle innervations

Question 7

Clinical testing of myotomes - Weakness

Answer 7

Looking for
1) weakness in muscles predominantly innervated by specific spinal nerves

2) pattern of weakness representative of a specific spinal nerve

Question 8

Myotomes Chart - Shoulder Shrug

Answer 8

C2 , C3, C4

Question 9

Myotomes Chart - Shoulder abduction

Answer 9

C5

Question 10

Myotomes Chart - Elbow flexion

Answer 10

C6

Question 11

Myotomes Chart - Wrist extension

Answer 11

C6

Question 12

Myotomes Chart - Elbow extension

Answer 12

C7

Question 13

Myotomes Chart - Thumb extension

Answer 13

C8

Question 14

Myotomes Chart - Finger abduction

Answer 14

T1

Question 15

Myotomes Chart - Hip flexion

Answer 15

L1 , L2

Question 16

Myotomes Chart - Knee extension

Answer 16

L3 , L4

Question 17

Myotomes Chart - Dorsiflexion

Answer 17

L4 , L5

Question 18

Myotomes Chart - Great toe extension

Answer 18

L5

Question 19

Myotomes Chart - Plantarflexion

Answer 19

S1

Question 20

Muscle Impairment - Reasons

Answer 20

Peripheral nerve involvement → Spinal, Peripheral

CNS function → Motor control, Central inhibition

Disuse

Injury/mechanical stresses

Disease

Ischemia

Question 21

Central inhibition

Answer 21

active nervous process arising in the CNS and leading to the suppression/prevention of excitation

Question 22

Muscle Impairment - Clinical Signs

Answer 22

Weakness

Decreased control

Muscle atrophy

Pain/tenderness/cramping

Question 23

Muscle Impairment - Clinical Assessment

Answer 23

Sensory Testing

Muscle Testing

Question 24

Sensory testing (muscle impairment)

Answer 24

Looking for:

dermatomal distribution of symptoms

peripheral nerve cutaneous distribution of symptoms

other patterns (like stroke)

Question 25

Muscle testing (muscle impairment)

Answer 25

Looking for: myotomal pattern of weakness weakness associated with a peripheral nerve weakness NOT representative of a neurologic pattern

Question 26

Symptoms of peripheral circulatory impairment

Answer 26

Changes in skin color quality Pain (ischemic/general) Swelling Absent or decreased pulse

Question 27

Digestive system

Answer 27

Alimentary canal/nutrition Referred pain → often experience pain in other seemingly unrelated areas (EX: pain down the arm, pain around scapula, etc)

Question 28

2 Point Discrimination

Answer 28

the ability to discern that two nearby objects touching the skin are truly two distinct points, not one usually used with a sharp item during a neuro exam

Question 29

Barognosis

Answer 29

ability to evaluate the weight of objects by holding/lifting them