MSK L1

Question 1

what does myotomes test?

Answer 1

assess spinal nerve root vs peripheral nerve function

not assessing specific muscle function

Question 2

how often should you repeat myotome test if suspect weakness noted

Answer 2

3+

Question 3

procedure to assess dermatomes ?

Answer 3

explain
give reference
close eyes with hands resting on knees

Question 4

what questions to ask for dermatome testing?

Answer 4

tell when you feel
where
was it same as face

Question 5

cervical compression and distraction what are you asking Pt?

Answer 5

are symptoms better, worse, same
symptom location

Question 6

biceps C5-C6

Answer 6

biceps contraction

Question 7

brachioradialis C5-C6

Answer 7

elbow flexion w/ w/o forearm pronation

Question 8

triceps C7-C8

Answer 8

elbow extension

Question 9

hoffman + findings

Answer 9

thumb adducts and opposes, remaining fingers flex

Question 10

babinski +

Answer 10

great toe extension w/ fanning of toes 2-5

Question 11

babinski -

Answer 11

slight flex of all toes

Question 12

what is a + Lhermitte phenomenon

Answer 12

shocklike sensation radiates down spinal column into UE and sometimes LE

Question 13

neuroprovocation testing

Answer 13

assess sensitivity of spinal nerve roots and peripheral nerves to movement and tension created by trunk and extremities

Question 14

what side to test nerves

Answer 14

good first

Question 15

neurodynamic mobilizations - nerve glides

glides

Answer 15

Alternating on:off positions

Question 16

neurodynamic mobilizations -
tensioners

Answer 16

Oscillatory
Alternating on:on and off:off positions

Question 17

neurodynamic mobilizations -

stretches

Answer 17

Sustained
Find sensitized position and hold for 10-15 seconds (3-5 reps)

Question 18

Slump test

Answer 18

Pt positioned in long sitting or sitting:
Hips and knees flexed
Hands behind back

PT askes pt to slump into slouched posture and drop chin to chest

PT askes pt to perform the following sequential movements as tolerated:
Straighten involved knee –> ankle DF

PT then overpressures cervical flexion and ankle DF if necessary

Pt is asked about presence of or Δ’s in symptoms at each new position

Pt does not progress to the next position if symptoms ↑

PT records sensitized position and joint angle if appropriate for re-assessment following tx

Question 19

nerve glides: slump

Answer 19

Pt is seated and then moves limb into sensitizing position (on) while simultaneously extending cervical spine (off)

Then pt reverses position, flexing c-spine (on) while simultaneously flexing the knee and, if appropriate PF ankle (off)

Question 20

slump nerve glide dosage

Answer 20

Glides (oscillatory): moving back and forth b/t positions for 2-3 sets of 10-20 reps

Question 21

slump nerve stretches dosage

Answer 21

Stretches: find sensitizing position, once gentle stretch is felt hold that position 10-15 sec for 3-5 reps

Question 22

how long can nerve stretches be held for?

Answer 22

30-60 secs

Question 23

nerve glides benefits

Answer 23

slump stretching may be beneficial in short term for improving disability, pain, centralizing symptoms

Question 24

Neuroprovocation Tests: ULTT 1 (Median n.) procedure

Answer 24

Pt supine and PT stands on ipsilateral side

PT performs the following movements passively and sequentially:
C-spine neutral → shoulder depression → GH abduction → wrist/finger extension, forearm supination → GH ER → elbow extension → C-spine contralateral side bending

Question 25

nerve glide median nerve procedure

Answer 25

Pt starts seated w/ c-spine in neutral and shoulder held at 90º abduction w/ elbow flexed to 90º Pt then extends fingers, wrist and elbow into sensitizing position (on) while simultaneously side bending head towards affected side (off) Then pt reverses position, flexing wrist and elbow (off) while simultaneously side bending head away from affected side (on)

Question 26

Neuroprovocation Tests: ULTT 2 (Radial n.) procedure

Answer 26

Pt supine and PT stands on ipsilateral side C-spine neutral → shoulder depression → GH abduction → GH IR → wrist/finger flexion, forearm pronation → elbow extension → C-spine contralateral side bending

Question 27

nerve glide radial nerve

Answer 27

Pt starts seated or standing w/ c-spine in neutral and shoulder held near their side w/ elbow extended Pt flexes fingers and wrist then abducts the shoulder into sensitizing position (on) while simultaneously side bending head towards affected side (off) Then pt reverses position, extends fingers and wrist (off) while simultaneously side bending head away from affected side (on)

Question 28

Neuroprovocation Tests: ULTT 3 (Ulnar n.) procedure

Answer 28

Pt supine and PT stands on ipsilateral side C-spine neutral → shoulder depression → GH abduction → GH ER → forearm pronation, wrist/finger extension → elbow flexion → C-spine contralateral side bending

Question 29

nerve glides ulnar nerve procedure

Answer 29

Pt starts seated w/ c-spine in neutral and shoulder held at 90º abduction w/ elbow flexed to 90º Pt extends fingers and wrist then flexes elbow towards face into sensitizing position (on) while simultaneously side bending head towards affected side (off) Then pt reverses position, flexes fingers and wrist (off) while simultaneously side bending head away from affected side towards neutral (on)

Question 30

median nerve is associated with what spinal root?

Answer 30

C6

Question 31

radial n is associated with what spinal root?

Answer 31

C7

Question 32

ulnar n is associated with what spinal root?

Answer 32

C8

Question 33

when do you do ROS?

Answer 33

before eval not diagnostic! its screening *checking all systems

Question 34

patient reports numbness and tingling in thumb and index finger (palmar) which nerve structures?

Answer 34

median nerve C6

Question 35

if you test dermatomes and only the hand is affected what structure is affected?

Answer 35

median n. b/c C6 goes up the hand

Question 36

what ROS should be done on everyone?

Answer 36

general health

Question 37

when should GU be looked at?

Answer 37

typically refers to back or lower. not for UE!

Question 38

when should GI looked at?

Answer 38

indigestion can go to neck. diaphragm touches organs pain after eating? if no --> not GI

Question 39

UE AROM

Answer 39

shoulder: flex, abd IR/ER elbow/forearm: flex/ext pro/sup wrist/hand: flex/ext RD/UD open/close *OP should be followed if AROM not painful!

Question 40

when to use tensioners?

Answer 40

use when glides no longer elicit symptoms OR less irritable

Question 41

does stretches elongate the nerve?

Answer 41

no! build tolerance to stress

Question 42

when to do ULTT 1

Answer 42

screening median symptoms

Question 43

how to dose median nerve glides

Answer 43

2x10 high irritability = less reps

Question 44

when to do ULTT 2 test?

Answer 44

ULTT 1 was + (trying to prove cervical radic) radial nerve symptoms (paralysis back hand)

Question 45

when to do ULTT3

Answer 45

ulnar nerve symptoms