Sensory Exam

Question 1

Tools to assess vibration?

Answer 1

1128-Hz tuning fork

Question 2

Apply both vibrating and non-vibrating fork to pt start ____________ and move ____________

Answer 2

Distally; proximally

Question 3

UE locations (5)

Answer 3

1. Distal phalanx of finger
2. Ulnar styloid process
3. Olecranon process
4. Acromion process
5. Cervical spinous process C7

Question 4

LE locations (5)

Answer 4

1. Distal phalanx great toe
2. Medial malleolus
3. Patella
4. ASIS
5. Lumbar spinous process

Question 5

Where is the toe grasped for proprioception testing?

Answer 5

Minimal contact on sides of toe above DIP joint

Question 6

How is proprioception of the toe performed?

Answer 6

Bilaterally, start with large ROM and work your way smaller. Start distal, work to proximal joints with impairment

Question 7

What does the Romberg test test?

Answer 7

Proprioception

Question 8

What is indicated if the pt is unable to perform test with eyes open?

Answer 8

cerebellum issues

Question 9

What is indicated if the pt is unable to perform test with eyes closed?

Answer 9

proprioceptive issues

Question 10

What is deep tendon reflex also known as?

Answer 10

Myotatic or muscle stretch reflexes

Question 11

True or false: Deep Tendon Reflexes assess both the afferent and efferent components of spinal nerve

Answer 11

TRUE!

Question 12

3 critical components of DTR:

Answer 12

1. Patient must be relaxed
2. Must be efficient using reflex hammer (assertive but not aggressive swing of hammer)
3. Use reinforcement techniques if pt cannot relax (LE: Jendrassik maneuver; UE: squeeze knees together)

Question 13

List the grades of deep tendon reflex

Answer 13

0. No response
1+ Minimal response
2+ Normal response
3+ Brisk response
4+ Hyperactive response (associated with clonus)

Question 14

DTR C5 (muscle; stimulation sight; response)

Answer 14

Biceps; Biceps tendon; elbow flexion

Question 15

DTR C6 (muscle; stimulation sight; response)

Answer 15

Brachioradialis; Brachioradialis tendon (prossima to radial styloid); elbow flexion

Question 16

DTR C7 (muscle; stimulation sight; response)

Answer 16

Triceps; Triceps tendon (proximal to olecranon process); elbow extension

Question 17

DTR L2,3,4 (muscle; stimulation sight; response)

Answer 17

Quadriceps; Patellar tendon (btwn patella & tibial tub); knee extension

Question 18

DTR L5, S1 (muscle; stimulation sight; response)

Answer 18

Achilles, achilles tendon; ankle plantar flexion

Question 19

Do cutaneous reflexes asses UMN or LMN lesions?

Answer 19

UMN lesions (lesions of the neural pathway that are above the anterior horn cell OR motor nuclei of the cranial n.

Question 20

What does absence of abdominal reflex indicate?

Answer 20

Lesion of UMN from T6 to L1 depending on level of absence

Question 21

What is a negative Babinski? Positive?

Answer 21

Negative- toes curl in

Positive- toes splay out

Question 22

What is a negative Hoffman? Positive?

Answer 22

Negative- no reaction to stimulus

Positive- Reflex flexion of distal phalanx of thumb and index finger

Question 23

What are the 5 elements of coordination test?

Answer 23

1. Heel to shin
2. Heel to contralateral knee
3. Finger to nose
4. Rapid alternating pronation/ supination of wrist
5. Matching to finger position