Card Set Information
What is neurological examinations testing?
What are your dermatomes?
C3,4 and 5 supply the diaphragm (the large muscle between the chest and the belly that we use to breath).
C5 also supplies the shoulder muscles and the muscle that we use to bend our elbow .
C6 is for bending the wrist back.
C7 is for straightening the elbow.
C8 bends the fingers.
T1 spreads the fingers.
T1 –T12 supplies the chest wall & abdominal muscles.
L2 bends the hip.
L3 straightens the knee.
L4 pulls the foot up.
L5 wiggles the toes.
S1 pulls the foot down.
S3,4 and 5 supply the bladder. bowel and sex organs and the anal and other pelvic muscles.
What is the order of neurological examinations?
- screening test
- sensation- light touch, pin prick
- power- isometric strength test (mm @ mid range & try break the contraction), considr pain and wasting
- reflexes- test reflex arc
What are the levels of reflex grading?
- absent, fading, normal, exaggerated, clonus (spasticity)
- ensure you compare to the other side
What are neurodynamic test?
Mobility of nerve tissue
is placing a nerve on tension and seein if it reproduces thepts pain
- SLR- eg torn hammie- fibrosis, mm spasm- piriformis
+ve test diff pian, compare ROM to other side and see where P comes on
- buldge disc, narrowing of spinal cannal
Where do disc buldges usually occur?
L4, L5, S1
How do you do a sensations test?
using a cotton ball- moving around in circles up and down the limb
Also foot and hand run down the fingers/ toes
Usually 2 or 3 levels are affected
If loss sensation pin prick only that area and map out area of loss sensation
How do you test the power of the lumbar spine?
Pain can affect myotome strength
Pt does the movement and then you try to move it
L2- hip flexors- hold @ 90 degrees against ur resistance
L3- quads- pt knee on towel- hold straight leg
L4- DF/ IN- do separate and both feet together- compare side
L5- EHL- big toe
S1- evertors, PF in standing- walk on toes for quick screen- otherwise in supine
S2- toe flex- bend toes over fingers
What are the clearing tests?
What are the relfexes of the lower limb and what nerve root do they test?
- knee jerk- L4
- ankle jerk- S1
Perform a knee jerk
- over patella tendon
- in gap
- if pt resisting preoccupy them
perform an ankle jerk
- achilles tendon
- small DF
With testing of sensation etc if pt presents with numbness is foot do entire limb