LE Mobility/Neuro functional testing

Question 1

What segments are being tested when asking pt to perform heel walking? (Opposite of toe walking)

Answer 1

L4-L5

Question 2

What segments are being tested when asking the pt to perform toe walking?

Answer 2

S1

Question 3

What segments are being tested when asking pt to perform a SLR?

May also be used to test for what?

Answer 3

Upper Extremity:

C5- shoulder abduction.
C6– Elbow flexion Wrist extension
C7 – Elbow extension
C8 – Thumb Extension and wrist ulnar deviation
T1 – Finger abduction

Lower Extremity:

L2 – Hip flexion*****
L3 – Knee extension
L4 – Ankle dorsiflexion
L5 – Big toe extension
S1 – Ankle plantarflexion[4]

Question 4

Resistive testing for hip flexion corresponds to L?-L?

Answer 4

L1-L2

Question 5

Resistive testing for [ knee extension ] corresponds to L?-L?

Answer 5

L3-L4

Question 6

Resistive testing for [ ankle DF ] corresponds to L?-L?

Answer 6

L4-L5 (same for heel walking)

Question 7

Resistive testing for [ Great toe extension ] corresponds to L?

Answer 7

L5

Question 8

Resistive testing for [ Ankle PF ] corresponds to what nerve root

Answer 8

S1 (same for toe walking)

Question 9

Reflex testing @ patella corresponds to L?

Answer 9

L4 (Rectus Fem = knee extension)

Question 10

Reflex testing at Achilles corresponds to S?

Answer 10

S1 (Gastroc = PF = toe walk)

Question 11

Dermatome level of anterior thigh corresponds to L?

Answer 11

L2 (prox thigh)

L3 - hand width above knee

Question 12

Dermatome level of [ Middle 3rd of anterior thigh ] corresponds to L?

Answer 12

L3 (mid 3rd)

Question 13

Dermatome level of [ Patella, Medial Malleolus of ankle] corresponds to L?

Answer 13

L4 (extensor reflex testing @ patella)

Question 14

Dermatome level of [ Dorsum of foot, fibular head] corresponds to L?

Answer 14

L5 (dorsiflexors)

Question 15

Dermatome testing level of [lateral + plantar aspect of foot] corresponds to S?

Answer 15

S1

Question 16

Dermatome level of [Medial posterior thigh] corresponds to S?

Answer 16

S2

Question 17

Dermatome level of [Perianal area] corresponds to S?

Answer 17

S3-5

Question 18

The lumbar plexus is formed from nerve roots X-X; innervates the ___ and ___ (areas of body) muscles of the body and the dermatomes of the ______ Leg and foot. The largest and most important branches are the ___ and ___ nerves.

Answer 18

Roots: lower thoracic and lumbar ventral nerve roots (T12 to L5)

Innervates: Medial + Anterior mm of body

Dermatomes: Medial leg and foot

Most important nerves: Obturator + Femoral

Question 19

The sacral plexus roots come via S1-S4; directly supplies ____ mm and, via sciatic nerve, innervates MM of ____ and ___.

Answer 19

Directly supplies glutes;

Sciatic supplies mm of posterior thigh + lower leg

Question 20

What nerve spawns form L5?

Answer 20

Peroneal Nerve

Question 21

Roots implicated in foot drop?

Answer 21

Foot drop is commonly caused by radiculopathy of the L5 nerve root. Sometimes, radiculopathy from L4 and/or S1 may also cause foot drop.

Question 22

L4-S3 spinal nerve roots provides motor and sensory innervation to most of the ????

AKA? Divides into?

Answer 22

posterior leg and foot

AKA sciatic nerve

divides into the tibial and common peroneal (fibular) branches

Question 23

innervates the sartorius, pectineus, quadriceps femoris, and iliacus muscle of the iliopsoas. It receives nerve supply by the nerve roots L2 through L4,

Answer 23

Femoral nerve

Question 24

Common nerve injury during medial LE trauma or pelvic surgery? deficiencies?

Answer 24

Obturator nerve damage

decreased hip ADD and MR

Question 25

Function of Femoral Nerve and Common mode of injury?

Answer 25

Femoral = Hip flexion + knee extension common injury = pelvic fx

Question 26

Lateral LE injury fibular fx may damage what nerve and cause what deficiencies?

Answer 26

Common Peroneal Nerve PED - Peroneal damage leads to loss of Eversion and DF deficiency with Dorsum loss of sensation

Question 27

Tibial nerve injury results in? common mode of injury?

Answer 27

Bakers cyst behind knee or knee trauma TIP - Tibial nerve damage leads to loss of INversion and PF, with loss at the TIP of the heel (s1)

Question 28

Superior gluteus nerve damage results in what? Where does this nerve pass?

Answer 28

Trendelenberg gt on opposite side only nerve to pass through the sciatic notch *above* the piriformis muscle

Question 29

Inferior glute nerve is most commonly injured by? deficiency in?

Answer 29

Posterior hip dislocation deficiency in hip extension

Question 30

LE MYOTOME TESTING ``` L1-2 ? L3-4? L4? L5? S1? ```

Answer 30

Lower Extremity: ``` L1-2 – Hip flexion L3 – Knee extension L4 – Ankle dorsiflexion L5 – Big toe extension S1 – Ankle plantarflexion ```