Pain Eval Lab

Question 1

Tibial n

Answer 1

DF/EV

Question 2

Sural N

Answer 2

DF/ INV

Question 3

Fibular N

Answer 3

PF/INV

Question 4

Median N

Answer 4

Stabilize Scap
Forearm supination
shoulder abd to 90
W/F/TH Ext
Shoulder ER
Elbow Ext

Question 5

Radial N

Answer 5

Scapular depression
elbow extension
shoulder IR
Forearm pronation
W/Th/F Flexion/UD
Shoulder Abd

Question 6

Ulner N

Answer 6

W/F ext
Forearm pro
elbow flex
scap depression
shoulder ER
Shoulder abd

Question 7

Median N palpation

Answer 7

• mid humerus: abd shoulder to 90, med n is just under biceps on ant-med aspect of arm
• elbow: med to biceps tendon in cubital fossa
• carpal tunnel: very deep so we use indirect palpation –> slowly apply pressure over tunnel

Question 8

Radial N Palpation

Answer 8

• upper arm: 90 shoulder abd and ER, just distal to axilla
• distal humerus: 3-4 finger widths distal to deltoid tuberosity - runs oblique
• lateral forearm: just proximal to styloid process - 3-4 finger width prox along radial aspect of radius
• anatomical snuffbox: come up from dorsal aspect and push dorso radially

Question 9

Ulnar N palpation

Answer 9

• mid hum: 90 abd, 90 ER - post to biceps and med n on medial hum
• elbow: cubital tunnel - prox and distal to tunnel
• Guyon canal - start at pisiform, move still and toward little finger - press Doral and try rolling over - just med to hamate

Question 10

sciatic n palpation - prone

Answer 10

• 1/2 way between isch tub and greater troch - nerve in bottom 1/3 of that line - deep
• wont typically feel nerve but may illicit symptoms

Question 11

tibial n palpation

Answer 11

• supine, flexed hip/knee to 90
• popliteal fossa between ST and biceps tendon
• superficial

Question 12

fibular n palpation

Answer 12

• just med to BF
• superficial fibular - ankle PF/INV - can see on dorsum of foot
• deep fib - webspace of big toe ew

Question 13

sural n palpation

Answer 13

• one hand width above lat Mal
• one CM below lat Mal - palpate perpendicular to bottom of foot

Question 14

laterality testing

Answer 14

a) Form of motor imagery – pt. imagines left hand in orientation of left had stimuli

b) Implicit motor imagery – patient is unaware of imagined movement

c) Activates cortical (prefrontal) network involved in limb representation and preparation for movement

d) Does NOT activate motor cortices

Question 15

limb laterality testing

Answer 15

use affected body part or part nearby on the homunculus

Question 16

spine laterality testing

Answer 16

use pictures of R/L rotation

Question 17

How to do 2PD Testing

Answer 17

Start below threshold and increase 2 mm
- enough pressure to blanch the skin
- 3-5 ascending/descending trials at the same region

Question 18

PPT technique

Answer 18

the flat, circular rubber tip of the plunger is placed perpendicular to the subject’s skin and pressure steadily applied until the subject reports that the pain threshold (or pain tolerance) is perceived

Question 19

how much pressure for PPT

Answer 19

• pressure is applied at a uniform rate of 1 kg/sec

Question 20

normative data PPT

Answer 20

a) abnormal when the pressure pain threshold of a certain site was at least 2 kg/cm2 lower than opposite
site, was lower than the normal value, or was not >3 kg/cm2.

b) PPT of less than 29.42 N/cm2 should be considered as a clinically relevant indicator of pathological hypersensitivity