Clin Assess Ch. 17 Nervous System (Deep Tendon Reflexes, Dermatomes, LOA arousal techniques, + scale for grading muscle strength)

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Spinal segment DTR for ankle reflex is?

S1

Spinal segment DTR for knee reflex is?

L2,L3,L4

Spinal segment DTR for supinator (brachioradialis) reflex is?

C5, C6

Spinal segment DTR for biceps is?

C5, C6

Spinal segment DTR for tripceps reflex is

C6, C7

Spinal segment DTR for upper abdominal reflex is?

T8,T9,T10

Spinal segment DTR for lower abdominal reflex is?

T10, T11, T12

Spinal segment DTR for plantar response is?

L5, S1

Spinal segment DTR for anal reflex is?

S2, S3, S4

On Scale for Grading Muscle Strength: No muscular contraction detected is?

0

On Scale for Grading Muscle Strength: A barely detectable flicker or trace of contraction is?

1

On Scale for Grading Muscle Strength: Active movement of the body part with gravity eliminated is?

2

On Scale for Grading Muscle Strength: Active movement against gravity is?

3

On Scale for Grading Muscle Strength: Active movement against gravity and some RESISTANCE is?

4

On Scale for Grading Muscle Strength: Active movement against full resistance without evident fatigue. This is normal muscle strength is?

5

Dermatome for front of neck is?

C3

Dermatome for nipples is?

T4

Dermatome for Umbilicus is?

T10

Dermatome for thumb is?

C6

Dermatome for Ring finger and pinky?

C8

Dermatome for knee is?

L4

Scale for Grading DTR Reflexes: very brisk, hyperactive, with clonus

grade 4+

Scale for Grading DTR Reflexes: brisker than average, possibly but not necessarily indicative of disease

grade 3+

Scale for Grading DTR Reflexes: Average, normal

grade 2+

Scale for Grading DTR Reflexes: Somewhat diminished, low normal

grade 1+

Scale for Grading DTR Reflexes: no response

grade 0

LOA Arousal Technique: speak to the pt. in normal tone/voice. Pt. opens their eyes, looks at you, and responds fully and appropriately to stimuli. What level is this?

Alert

LOA Arousal Technique: speak to the pt. in loud voice. What level is this?

Lethargy--pt. appears drowsy but opens the eyes and looks at you, respond to questions, and then falls asleep.

LOA Arousal Technique: shake the patient gently as if awakening a sleeper

Obtundation--pt. opens the eyes, looks at you but responds slowly and is somewhat confused. Alertness and interest in the environment are decreased.

LOA Arousal Technique: Apply painful stimulus. For example, pinch the tendon, rub the sternum, or roll a pencil across a nail bed.

Stupor--pt arouses from sleep only after painful stimuli. Verbal responses are slow or even absent. The patient lapses into an unresponsive state when the stimulus ceases. There is minimal awareness of self or the environment

LOA Arousal Technique: Apply repeated painful stimuli

Coma--comatose pt. remains unarousable with eyes closed. There is no evident response to inner need or external stimuli

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