NMS I OSCE 2

Muscle strength tests:

  • Supraspinatus —> C5 —> suprascapular nerve

  • Deltoid —> C5 —> axillary nerve

  • Biceps —> C5 —> musculocutaneous n

  • Brachioradialis —> C5 —> radial n

  • wrist extension —> C6 —> radial n

  • Triceps —> C7 —> radial n

  • wrist flexion —> C7 —> median/ulnar n

  • finger extension —> C7 —> radial n

  • finger flexion —> C8 —> median/ulnar n

  • finger abduction —> T1 —> ulnar n

  • finger adduction —> T1 —> ulnar n

Deep tendon reflexes:

  • Biceps —> C5 —> musculocutaneous n

  • brachioradialis —> C6 —> radial n

  • triceps —> C7 —> radial n

  • finger flexion —> C8 —> median/ulnar n

Superficial Reflexes:

  • Epigastric abdominal - tests T5-7 and intercostal nerves

    • decreased response of abdominal muscles = lesion of segmental innervation of T5-7 or LMNL of intercostal nerve

  • upper abdominal - tests T7-9 and intercostal nerves

    • decreased response of abdominal muscles = lesion of segmental innervation of T7-9

  • middle abdominal - tests T9-11 and intercostal nerves

    • decreased response of abdominal muscles = lesion of segmental innervation of T9-11

  • lower abdominal - tests T11-12 and intercostal nerves

    • decreased response of abdominal muscles = lesion of segmental innervation of T11-12

  • Plantar reflex - test L4-S2 and tibial nerves

    • Babinski sign = lesion of segmental innervation of L4-S2

Pathological reflexes:

  • Hoffman’s sign - tests corticospinal tract above C5

    • quick pinch with flexion then release

    • if claw hand is illicited = lesion of corticospinal tract above C5

  • Tromner’s sign - tests corticospinal tract above C5

  • Rossolimo’s sign

  • Babinski’s test

  • Chaddock’s sign

  • Oppenheim’s sign

  • Gordon’s sign

  • Schaefer’s sign

Visceral reflexes:

  • Pupillary light reflex - tests CN II & III

  • Accommodation reflex - tests CN III

  • Ciliospinal reflex - tests C8-T2 & CN III (sympathetics)

Cervical tests:

  • cervical range of motion (use inclinometer)

    • flexion - 50-60º considered normal

    • extension - 60-75º considered normal

    • rotation - 80º considered normal

    • lateral bend - 45º considered normal

  • Lhermitte’s

    • passive cervical flexion

Brachial Plexus:

  • Bakody’s test

  • Reverse Bakody’s test (TOS)

  • Bikele’s test

  • Brachial plexus tension test

  • shoulder depressor test

SOL:

  • Valsalva test

  • Dejerine’s test (triad)

  • swallowing test

VBI:

  • Barre-Lieou test

  • Vertebrobasilar functional maneuver

  • DeKleyn’s test

IVF:

  • Foraminal compression test

  • Jackson’s compression test

  • Maximum cervical compression test

  • Spurling’s test

  • Distraction test

Muscle strain/Ligament sprain:

  • O’Donahue’s test

  • Soto-Hall test

Meningitis:

  • Kernig’s sign

  • Brudzinski sign

TOS:

  • Allen’s test

  • Adson’s test (Scalenus Anticus test)

    • hypertrophy of anterior scalene entraps subclavian artery

  • Modified Adson’s test

    • hypertrophy of middle scalene entraps subclavian artery

  • Halstead’s test

  • Allen’s maneuver test

  • Roos’ test

  • Wright’s test

    • hypertrophy of pec minor entraps subclavian artery

  • Costoclavicular (Eden’s) maneuver test

    • entrapment of subclavian artery between clavicle and 1st rib