Exam Structure and Neurological Exam Key Terms

Vocabulary flashcards covering exam structure, neurological signs, reflexes, and common clinical assessment terms.

Yellow Flags

Indicates a finding that requires some additional attention and follow-up, and may warrant a referral to a specialist.

Red Flags

A red flag is a finding that is clearly outside of the scope of expertise of the therapist, and appropriate care for the patient is dependent on coordination with another health care professional.

Subjective

History, systems review, yellow and red flags; the patient’s basic information and symptoms.

Objective

Observation, Range of Motion, Strength (MMT and Functional Strength Testing), Sensation, Palpation, Provocative Tests, Clearing Tests, DTRs, Pathologic Reflexes, and Special Tests.

Assessment

Refinement of working hypothesis into 1 or more specific problems/dysfunctions supported by collaborative information.

Plan

Measurable steps designed to accomplish the goal, including the classic exercise prescription: specificity, frequency, duration, and intensity.

Deep Tendon Reflexes (DTRs)

Reflex tests used to evaluate the reflex arc (e.g., depressed or elevated reflexes).

Babinski Reflex

Pathologic reflex; stroking the lateral foot toward the ball of the foot; a positive result indicates an upper motor neuron problem.

Hoffman Sign

Flick of the distal middle finger toward the nail; in an UMN lesion, the thumb and index finger may form an “O”.

Upper Motor Neuron Signs

Weakness (spastic), hyperreflexia, pathologic reflexes, altered or loss of voluntary motion, with little to no true muscle atrophy.

Lower Motor Neuron Signs

Weakness (flaccid), hyporeflexia, rapid muscle atrophy, fasciculations/fibrillations, and no pathologic reflexes.

Biceps Brachii Reflex (C5-6)

Elbow flexion reflex tested at C5-6.

Brachioradialis Reflex (C5-6)

Forearm flexion/supination reflex tested at C5-6.

Triceps Brachii Reflex (C6-8)

Elbow extension reflex tested at C6-7-8.

Patellar Tendon Reflex (L2-4)

Knee extension reflex tested at L2-4.

Hamstring Reflex (L5-S1-2)

Knee flexion reflex tested at L5-S1-2.

Achilles Tendon Reflex (L5-S1-2)

Ankle plantarflexion reflex tested at L5-S1-2.

Mechanism of Injury

The event or force that caused the injury; helps in diagnostic reasoning.

Age

Patient’s age; used to inform differential diagnosis and risk.

Gender

Patient’s gender; relevant to prevalence and risk for certain conditions.

Ethnic Makeup

Ethnicity; some conditions are more prevalent in specific ethnic groups.

Morphology

Body type/body build; used in assessment of condition risk or presentation.

Family History

Medical conditions in family that may influence patient risk.

Past Medical History

Prior illnesses, injuries, and health problems.

Medications

Current medications that may affect diagnosis or treatment.

Training History

Pre-injury training or activity history relevant to rehab and prognosis.

Subjective: Yellow Flags Examples

Pain patterns not fitting a dermatome, pain disproportionate to exam, pain of unknown origin, night pain, etc.

Objective: Clearing Tests

Tests performed to clear (rule out) issues in the region above and below the tested area.

Objective: Provocative Tests

Tests that provoke symptoms to aid diagnosis (often annotated with asterisk in notes).

Objective: Special Tests

Additional tests used to identify specific dysfunctions.