Orthopedics and Neurology DX 612
Homework # 2
Orthopaedic Neurology
1. Signs of a UMNL include:
a. Muscle atrophy
b. Reduced sensory function
c. Hypesthesia
d. Grade 1 DTR
2. A space-occupying lesion impinging on the posterior columns might cause one of
the following:
a. Anesthesia
b. Motor weakness
c. Hypesthesia
d. Complete loss of light touch
3. Signs of a LMNL include:
a. Destruction of the anterior horn cells
b. Complete loss of light touch
c. Muscle atrophy and motor weakness
d. Babinski sign present
4. Evaluation of the integrity of the neurologic levels depends on a knowledge of the
following
a. Dermatomes
b. Myotomes
c. Reflexes
d. All of the above
5. Spastic paralysis would occur with the following condition:
a. LMNL
b. All UMNL
c. Poliomyelitis
d. Post-CVA
6. Motor testing evaluates function of the following:
a. Myotatic reflex
b. Post-central gyrus
c. Spinothalamic tract
d. Anterior horn cells
7. Motor testing should be performed when a patient presents with the following
condition:
a. Low back pain
b. Neck pain
c. Headaches
d. All of the above
8. How often should motor testing be performed in a chiropractic office?
a. Once per month
b. Initial evaluation
c. Every visit
d. When indicated
Dr. James J Lehman
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2/15/2007
Orthopedics and Neurology DX 612
Homework # 2
Orthopaedic Neurology
9. Why would follow-up motor testing be indicated when a patient presents with a
motor deficit?
a. Monitor response to care
b. Placate insurance carrier
c. Demonstrate pelvic obliquity
d. Determine function of anterior spinothalamic tract
10. Pain and temperature neural impulses traverse along which tracts?
a. Lateral spinothalamic tract
b. Anterior spinothalamic tract
c. Column of Goll
d. Column of Burdach
11. Sensory evaluation of the upper extremity involves the following nerve roots:
a. C 5, C 6, C7, and C8
b. C5 – T 2
c. C 4 – T1
d. All of the above
12. Motor evaluation of the C 5 nerve root involves DTR examination of the
following:
a. Triceps
b. Biceps
c. Brachioradialis
d. All of the above
13. Upper motor neuron lesions may involve the following structures:
a. Anterior nerve root
b. Peripheral nerve
c. Anterior horn motor cells
d. All of the above
14. Myotatic reflexes involve the following neurological structures:
a. Pre-central gyrus, motor cortex, corticospinal tract
b. Posterior columns, internuncial fibers, posterior spinal nerve root
c. Posterior and anterior spinal nerve roots, internuncial fibers
d. All of the above
15. A grade 2+ DTR is considered to be:
a. WNL
b. Exaggerated
c. Reduced
d. Abnormal
Dr. James J Lehman
Page 2
2/15/2007
Orthopedics and Neurology DX 612
Homework # 2
Orthopaedic Neurology
16. Which tendon should be stimulated in order to test the L 5 nerve root level?
a. Hamstring
b. Lateral hamstring
c. Medial hamstring
d. All of the above
17. The medial hamstring tendon(s) include:
a. Long head of the biceps femoris
b. Semitendinosis
c. Semimembranosus
d. All of the above
18. The neural innervation of the infrapatellar tendon is derived from which nerve
root?
a. L3
b. L2
c. L5
d. L4
19. The presence of the Babinski sign signifies which of the following neurological
conditions?
a. Majestic fanning of the toes
b. An extension of the large toe
c. A lower motor neuron lesion
d. An upper motor neuron lesion
20. Beevor’s sign presents with spinal cord or nerve root neurapraxia at the following
spinal levels:
a. T9
b. T10
c. T11
d. T7-12
21. The determination of involved neurologic levels applies to the evaluation of the
following:
a. Developmental anomalies
b. Spinal injuries
c. Herniated intervertebral discs
d. Cord pathologies
e. Osteoarthritis
f. All of the above
22. A muscle grade (motor) of 2 indicates one of the following:
a. Complete range of motion against gravity with full resistance
b. Complete range of motion with gravity eliminated
c. Complete range of motion with gravity
d. No evidence of contractility
Dr. James J Lehman
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2/15/2007
Orthopedics and Neurology DX 612
Homework # 2
Orthopaedic Neurology
23. The pyramidal motor system is a two-neuron system with axons that commence at
the following sites within the brain and spinal cord:
a. Posterior columns and the corticospinal tract
b. Lateral corticospinal and ventral corticospinal tracts
c. Primary motor cortex and anterior horn cells
d. Anterior horn and the posterior horn of the spinal cord
24. Please select the motor innervation for the abduction of the shoulder:
a. C4 axillary nerve
b. C5 suprascapular nerve
c. C6 axillary nerve
d. C5 axillary nerve
25. The neural innervation of the biceps tendon is:
a. C5 radial nerve
b. C5 musculocutaneous nerve
c. C7 musculocutaneous nerve
d. C6 radial nerve
26. Since wrist extension involves the radial nerve innervation and the median nerve
innervates wrist flexion, which spinal nerve level is responsible for finger
extension?
a. C4
b. C5
c. C6
d. C7
27. The purest area to test sensation of the C8 dermatome is:
a. Index finger
b. Thumb
c. Medial aspect of the last digit of the hand
d. Ulnar side of the little finger
28. Which interossei muscles abduct the fingers?
a. Palmar
b. Medial
c. Lateral
d. Dorsal
29. The interossei muscles responsible for adduction and are innervated by ulnar
nerve. Which spinal nerve root(s) innervate these muscles?
a. T1 & T2
b. C8 & T1
c. T1
d. C8
Dr. James J Lehman
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2/15/2007
Orthopedics and Neurology DX 612
Homework # 2
Orthopaedic Neurology
30. Which cervical orthopedic test may either provoke or ameliorate pain?
a. Cervical compression
b. Jackson’s
c. Cervical distraction
d. Valsalva’s
31. When is a pathologic reflex expected to occur?
a. Lower motor neuron lesion
b. Space occupying lesion in anterior horn of spinal cord
c. Poliomyelitis
d. First 6 months of life
32. Nerve root impingement may cause the following:
a. Increased DTR
b. Spastic paralysis
c. Grade of 5+ DTR
d. Grade of 4/5 motor
33. Please explain why it is reasonable to perform evaluation of the neurologic levels.
34. Please explain how you would perform an evaluation of the neurologic levels.
List the different systems to be examined and the methods.
35. Describe the differences between a Lower Motor Neuron Lesion and an Upper
Motor Neuron Lesion. List at least 4 findings for each type of lesion.
Dr. James J Lehman
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2/15/2007