reflex & palpation
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Questions and Answers

Which reflex is tested by striking the patellar tendon directly?

  • Lateral hamstring
  • Patellar (correct)
  • Posterior tibial
  • Medial hamstring

    • Which position can be used to test the Achilles reflex?

  • Kneeling
  • Sitting
  • Supine lying
  • Prone (correct)

    • What should the examiner ensure before testing the Achilles reflex?

  • Patient's knee is flexed
  • Patient's plantar flexors are relaxed
  • Patient's dorsiflexors are relaxed (correct)
  • Patient's ankle is dorsiflexed

    • Which reflex is tested by tapping the thumbnail over the appropriate tendon?

    <p>Hamstring</p> Signup and view all the answers

    What may cause the reflexes to be absent soon after exercise?

    <p>Neurogenic intermittent claudication</p> Signup and view all the answers

    When should the reflexes be tested if neurogenic intermittent claudication is suspected?

    <p>Immediately after exercise</p> Signup and view all the answers

    Which area is located between the ASIS and the symphysis pubis?

    <p>Inguinal area</p> Signup and view all the answers

    What is palpated by the examiner when moving posteriorly from the ASIS?

    <p>Iliac crest</p> Signup and view all the answers

    What is the caudal portion of the sacral canal called?

    <p>Sacral hiatus</p> Signup and view all the answers

    Which structure is palpated for symptoms of a hernia, abscess, infection, or other pathological conditions?

    <p>Inguinal area</p> Signup and view all the answers

    What is the level of the S2 spinous process?

    <p>Line joining the two PSISs</p> Signup and view all the answers

    What should the examiner do to properly palpate the coccyx?

    <p>Insert the index finger into the anus</p> Signup and view all the answers

    Which reflex occurs in males only?

    <p>Superficial cremasteric reflex</p> Signup and view all the answers

    What does a negative test result of the superficial cremasteric reflex indicate?

    <p>Normal situation</p> Signup and view all the answers

    What does a unilateral absence of the superficial abdominal reflex suggest?

    <p>Lower motor neuron lesion from T7 to L2</p> Signup and view all the answers

    What does a normal result of the superficial anal reflex indicate?

    <p>Normal situation</p> Signup and view all the answers

    Which muscle should be palpated for potential pathology, and where is it located?

    <p>Piriformis muscle, located between the PSIS of the pelvis and the greater trochanter of the femur</p> Signup and view all the answers

    Which view should the examiner use to assess the shape of the vertebrae and disc spaces?

    <p>Anteroposterior view</p> Signup and view all the answers

    What does the presence of the Babinski or Oppenheim tests indicate?

    <p>Possible presence of disease or upper motor neuron lesion</p> Signup and view all the answers

    What should the examiner check if neurological symptoms are found?

    <p>Both A and B</p> Signup and view all the answers

    What does the presence of a bamboo spine indicate?

    <p>Ankylosing spondylitis</p> Signup and view all the answers

    What percentage of the population has lumbarization of S1?

    <p>2% to 8%</p> Signup and view all the answers

    What condition occurs in 6% to 10% of the population and is characterized by incomplete fusion of the vertebrae?

    <p>Spina bifida occulta</p> Signup and view all the answers

    What does the presence of traction spurs indicate in the lumbar intervertebral segment?

    <p>Spinal instability</p> Signup and view all the answers

    Which movement is used to test for hypomobility or hypermobility of the spine?

    <p>Flexion</p> Signup and view all the answers

    Which movement is used to test for hypomobility or hypermobility of the spine in a prone position?

    <p>Extension</p> Signup and view all the answers

    Which movement is used to test for hypomobility or hypermobility of the spine with the patient's leg rotated upward?

    <p>Side flexion</p> Signup and view all the answers

    What are the movements sometimes called passive accessory intervertebral movements (PAIVMs)?

    <p>Extension, side flexion, and rotation</p> Signup and view all the answers

    Which movement involves applying pressure through the thumbs to push the vertebrae anteriorly?

    <p>Central vertebral pressure</p> Signup and view all the answers

    Which movement involves applying pressure to the muscles overlying the lamina or the transverse process of the lumbar vertebra?

    <p>Unilateral vertebral pressure</p> Signup and view all the answers

    Which reflex is tested by striking the patellar tendon directly?

    <p>Patellar reflex</p> Signup and view all the answers

    Which reflex may be tested in prone, sitting, or kneeling position?

    <p>Achilles reflex</p> Signup and view all the answers

    What should the examiner ensure before testing the Achilles reflex?

    <p>The patient's dorsiflexors are relaxed</p> Signup and view all the answers

    When should the reflexes be tested if neurogenic intermittent claudication is suspected?

    <p>Immediately after exercise</p> Signup and view all the answers

    Which reflex is tested by tapping the thumbnail over the appropriate tendon?

    <p>Medial hamstring reflex</p> Signup and view all the answers

    What does the presence of traction spurs indicate in the lumbar intervertebral segment?

    <p>Hypermobility</p> Signup and view all the answers

    Which reflex occurs in males only?

    <p>Superficial cremasteric reflex</p> Signup and view all the answers

    What does a unilateral absence of the superficial cremasteric reflex suggest?

    <p>A lower motor neuron lesion between L1 and L2</p> Signup and view all the answers

    What does the absence of the superficial abdominal reflex indicate?

    <p>An upper motor neuron lesion</p> Signup and view all the answers

    What is the purpose of the Babinski or Oppenheim tests?

    <p>To determine upper motor neuron lesions or pyramidal tract disease</p> Signup and view all the answers

    What should the examiner do if neurological symptoms are found during the examination?

    <p>Check the dermatome patterns of the nerve roots</p> Signup and view all the answers

    How should the examiner test for sensation in the lower limbs?

    <p>By running relaxed hands over the back, abdomen, and lower limbs</p> Signup and view all the answers

    Which movement should the examiner use to test for hypomobility or hypermobility of the spine with the patient's leg rotated upward?

    <p>Lateral flexion</p> Signup and view all the answers

    What does a unilateral absence of the superficial abdominal reflex suggest?

    <p>Spinal cord injury</p> Signup and view all the answers

    What should the examiner ensure before testing the Achilles reflex?

    <p>The patient's foot is dorsiflexed</p> Signup and view all the answers

    What does a negative test result of the superficial cremasteric reflex indicate?

    <p>Sciatic nerve impingement</p> Signup and view all the answers

    What does the presence of the Babinski or Oppenheim tests indicate?

    <p>Upper motor neuron lesion</p> Signup and view all the answers

    Which structure is palpated for symptoms of a hernia, abscess, infection, or other pathological conditions?

    <p>Greater trochanter of the femur</p> Signup and view all the answers

    Which movement is used to test for hypomobility or hypermobility of the spine in a prone position?

    <p>Extension</p> Signup and view all the answers

    What is the level of the L4 spinous process?

    <p>Between L3 and L4</p> Signup and view all the answers

    What is the purpose of posteroanterior central vertebral pressure (PACVP)?

    <p>To push the vertebrae anteriorly</p> Signup and view all the answers

    What is the purpose of posteroanterior unilateral vertebral pressure (PAUVP)?

    <p>To apply lateral springing pressure</p> Signup and view all the answers

    What is the purpose of transverse vertebral pressure (TVP)?

    <p>To rotate the vertebrae</p> Signup and view all the answers

    What should be noted during palpation of the lumbar spine?

    <p>All of the above</p> Signup and view all the answers

    Which area should the examiner palpate to assess for symptoms of a hernia, abscess, infection, or other pathological conditions?

    <p>Left upper quadrant</p> Signup and view all the answers

    What is the caudal portion of the sacral canal called?

    <p>Sacral hiatus</p> Signup and view all the answers

    Which structure should the examiner palpate by moving along the iliac crest and palpating for signs of pathology?

    <p>Iliac crest</p> Signup and view all the answers

    What is the level of the S2 spinous process?

    <p>Line joining the two PSISs</p> Signup and view all the answers

    What is the proper way to palpate the coccyx?

    <p>Insert the index finger into the anus</p> Signup and view all the answers

    Which structure is palpated between the ASIS and the symphysis pubis?

    <p>Inguinal area</p> Signup and view all the answers

    Which reflex is tested by tapping the tendon directly with a reflex hammer?

    <p>Patellar reflex</p> Signup and view all the answers

    In which position can the Achilles reflex be tested?

    <p>All of the above</p> Signup and view all the answers

    What is the proper position of the knee to test the patellar reflex?

    <p>30° flexion in supine lying</p> Signup and view all the answers

    How should the ankle be positioned to test the Achilles reflex?

    <p>Slightly dorsiflexed</p> Signup and view all the answers

    What should the examiner do to ensure the patient's dorsiflexors are relaxed before testing the Achilles reflex?

    <p>Passively dorsiflex the foot</p> Signup and view all the answers

    Which reflex is tested by tapping the thumbnail over the appropriate tendon?

    <p>Medial hamstring reflex</p> Signup and view all the answers

    Which reflex is used to test for an upper motor neuron lesion in males only?

    <p>Superficial cremasteric reflex</p> Signup and view all the answers

    What does a unilateral absence of the superficial cremasteric reflex suggest?

    <p>A lower motor neuron lesion between L1 and L2</p> Signup and view all the answers

    Which superficial reflex indicates an upper motor neuron lesion when absent?

    <p>Superficial abdominal reflex</p> Signup and view all the answers

    What does the absence or reduction of the superficial cremasteric reflex bilaterally suggest?

    <p>An upper motor neuron lesion</p> Signup and view all the answers

    Which reflex should the examiner perform to determine upper motor neuron lesions or pyramidal tract disease?

    <p>Pathological reflex tests (e.g., Babinski or Oppenheim tests)</p> Signup and view all the answers

    When should the examiner check the dermatome patterns of the nerve roots and the peripheral sensory distribution of the peripheral nerves?

    <p>If neurological symptoms are found</p> Signup and view all the answers

    Which muscle is often easier to palpate if the hip is flexed to 90°?

    <p>Piriformis muscle</p> Signup and view all the answers

    What is the percentage of the population that experiences lumbarization of S1?

    <p>2% to 8%</p> Signup and view all the answers

    What anomaly occurs in 3% to 6% of the population, making the L4–L5 level the first mobile segment rather than L5–S1?

    <p>Sacralization of L5</p> Signup and view all the answers

    What is the percentage of the population that experiences sacralization of L5?

    <p>3% to 6%</p> Signup and view all the answers

    What is the percentage of the population that experiences spina bifida occulta?

    <p>6% to 10%</p> Signup and view all the answers

    What is the percentage of the population that experiences spondylosis or spondylolisthesis?

    <p>2% to 4%</p> Signup and view all the answers

    Which structure is palpated between the ASIS and the symphysis pubis?

    <p>The inguinal area</p> Signup and view all the answers

    Which structure is found in the left upper quadrant?

    <p>The spleen</p> Signup and view all the answers

    Which structure is palpated by moving posteriorly from the ASIS?

    <p>The iliac crest</p> Signup and view all the answers

    Which structure is palpated by pushing both thumbs down onto the superior aspect of the pubic bones?

    <p>The symphysis pubis</p> Signup and view all the answers

    Which structure is palpated by moving laterally 2 to 3 cm from the spinous processes?

    <p>The lumbar facet joints</p> Signup and view all the answers

    Which structure requires a rectal examination to be properly palpated?

    <p>The coccyx</p> Signup and view all the answers

    Which movement is used to test for hypomobility or hypermobility of the spine with the patient's leg rotated upward?

    <p>Side flexion</p> Signup and view all the answers

    What is the purpose of posteroanterior central vertebral pressure (PACVP)?

    <p>To test for hypomobility or hypermobility of the spine</p> Signup and view all the answers

    Which movement involves applying pressure to the muscles overlying the lamina or the transverse process of the lumbar vertebra?

    <p>Posteroanterior unilateral vertebral pressure (PAUVP)</p> Signup and view all the answers

    What is the purpose of transverse vertebral pressure (TVP)?

    <p>To palpate for potential pathology in the lumbar spine</p> Signup and view all the answers

    Which structure is palpated at the level of the L3-L4 disc space?

    <p>Umbilicus</p> Signup and view all the answers

    What should the examiner ensure before testing the Achilles reflex?

    <p>There is no hip pathology</p> Signup and view all the answers

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