Week 1 Neuro

Question 1

C5 Dermatome

Answer 1

Lateral upper arm

Question 2

C6 Dermatome

Answer 2

Lateral forearm & radial aspect of the hand

Question 3

C7 Dermatome

Answer 3

Middle fingers (3)

Question 4

C8 Dermatome

Answer 4

Ulnar aspect of hand

Question 5

T1 Dermatome

Answer 5

Medial forearm

Question 6

Components of orthopedic tests for nerve roots

Answer 6

Light touch - lightly brush skin (eyes closed, unaffected area first)
Pain (Nociception) - sharp/dull (dull is the control)
Vibration - tuning fork (Posterior Column. Start at most distal joint and move proximally as needed)
Reflex - Upper Motor Neuron, Lower Motor Neuron
Motor - muscle testing

Question 7

What reflex(es) are checked to test C5 nerve root?

Answer 7

Bicep (musculocutaneous nerve)

Question 8

What reflex(es) are checked to test C6 nerve root?

Answer 8

Brachioradialis (radial n.)

Question 9

What reflex(es) are checked to test C7 nerve root?

Answer 9

Triceps (radial n.)

Question 10

Grading scale for reflexes (0-4)

Answer 10

0/4 - areflexia, no contraction
1+/4 - hyporeflexia, trace response m/b normal if equal bilaterally
2+/4 - Normal
3+/4 - m/b hyperreflexia or normal if equal bilaterally
4+/4 hyperreflexia, sustained clonus

Question 11

Tricks if a DTR is difficult to elicit (4)

Answer 11

1. Close eyes
2. Stretch muscle slightly
3. Contract muscle slightly
4. Jendrassik maneuver (have them clench their teeth at the exact moment of impact)

Question 12

Hoffman’s Pathologic Reflex

Answer 12

UMN lesion indicated if clawing results from a flick of the extended middle finger nail. (Thumb & pinky flexion)

Question 13

Dynamic Hoffman’s

Answer 13

Same thing with added cervical flexion/extension

Question 14

What to remember when muscle testing?

Answer 14

If it scores 3 or below it's a nerve issue & must confirm with other tests. *Cross only 1 joint!* And don't compress the muscle being tested. 
Test bilaterally
Slow load & unload
5-10 sec
Multiple tests
Max contraction

Question 15

C5 Muscle Testing

Answer 15

Deltoid (axillary n.)

Question 16

C6 Muscle Testing

Answer 16

Biceps (musculocutaneous n.)
Wrist extensors (radial n.)

Question 17

C7 Muscle Testing

Answer 17

Triceps (radial n.)
Wrist flexors (median/ulnar n.)
Finger extensors (ulnar/median n.)

Question 18

C8 Muscle Testing

Answer 18

Finger flexors (ulnar/median n.)

Question 19

T1 Muscle Testing

Answer 19

Finger abductor/adductors (ulnar n.)

Question 20

Muscle(Motor) Testing Grading Scale 0-5

Answer 20

0/5 - no evidence of muscle contraction
1/5 - slight contraction, no joint motion, can’t complete ROM even with gravity eliminated
2/5 - completes ROM with gravity eliminated but cannot move against gravity
3/5 - completes ROM against gravity but without resistance
4/5 - completes ROM against gravity and light resistance
5/5 - completes ROM against gravity and full resistance