Neuromuscular: Testing

Question 0

Absent DTR + Same Level Sensory Loss

Answer 0

Lesion within afferent arc of the reflex

In the nerve or dorsal horn

Question 1

Absent DTR

Answer 1

Lesion in the reflex arc itself

Question 2

Absent DTR + Paralysis, Fasciculations, Or Atrophy

Answer 2

Lesion within efferent arc of the reflex

In efferent nerve, anterior horn cells, or both

Question 3

Peripheral Neuropathy And DTRs

Answer 3

Most common reason for absent reflexes
Present with sensory, motor, or mixed impairments
May affect all components of reflex arc
Associated with DM, ETOH, Vit deficiency (pernicious anemia), certain CAs and toxins.

Question 4

Hyperactive DTRs

Answer 4

Interruption of cortical supply to LMN
Result of UMN lesion
Interruption is above reflex arc segment

Question 5

Sensation Testing

Answer 5

1. Superficial
2. Deep
3. Cortical

Question 6

Superficial Sensation Testing

Answer 6

Temperature
Light Touch
Pain

Question 7

Deep Sensation Testing

Answer 7

Proprioception
Kinesthesia
Vibration

Question 8

Cortical Sensation Testing

Answer 8

B Simultaneous Stimulation
Stereognosis
Two-Point Discrimination
Barognosis
Localization of Touch

Question 9

Barognosis

Answer 9

Perceive the weight of different objects in the hand

Question 10

Deep Pain

Answer 10

Squeeze the forearm or calf muscle

Question 11

Graphesthesia

Answer 11

Identify a number or letter drawn on the skin without visual input

Question 12

Kinesthesia

Answer 12

Identify direction and extent of movement of a joint or body part

Question 13

Light Touch

Answer 13

Perceive touch through light pressure or use of a cotton ball

Question 14

Localization

Answer 14

Identify the exact location of light touch on the body using a verbal response or gesturing

Question 15

Proprioception

Answer 15

Identify a static position of an extremity or body part

Question 16

Stereognosis

Answer 16

Identify an object without sight

Question 17

Superficial Pain

Answer 17

Perceive noxious stimulus using a pen cap, paperclip, or pin

Question 18

Temperature

Answer 18

Perceive warm and cold test tubes

Question 19

Two-Point Discrimination

Answer 19

Using a two-point caliper on the skin, identify one or two points without visual input

Question 20

Vibration

Answer 20

Tuning fork

Question 21

ASIA A

Answer 21

Complete

No sensory or motor function

Question 22

ASIA B

Answer 22

Sensory Incomplete

Sensory only preserved below neurological level through S4-5

Question 23

ASIA C

Answer 23

Motor Incomplete

Motor preserved below neurological level, most key muscles < 3/5

Question 24

ASIA D

Answer 24

Motor Incomplete | Most key muscles below neurological level 3/5 or more

Question 25

ASIA E

Answer 25

Normal

Question 26

Motor Level

Answer 26

Most causal key muscles 3/5 or more with superior segment 5/5

Question 27

Sensory Level

Answer 27

Most causal dermatome 2/2 for pin prick and light touch

Question 28

Motor Index Scoring

Answer 28

Test each key muscle 0-5 25 Points total per extremity 100 Points possible total (C5-T1, L2-S1)

Question 29

Hallpike Dix Test

Answer 29

``` Procedure: Patient sits on table Turn patient's head 45 degrees Quickly move patient to supine Neck extended 30 degrees Check for vertigo, nystagmus Return to sitting, assess other side (+) for BPPV on side producing symptoms ```