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Neurological Assessment Guide: Orthopedic Diagnostic Chart

Comprehensive guide for diagnosing neurological levels, muscle power, and reflexes. Explore nerve root lesions, sensory evaluation, and upper extremity muscle testing. Visualize muscle grading, sensation, and reflex patterns.

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Neurological Assessment Guide: Orthopedic Diagnostic Chart

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  1. Orthopaedic Neurology Diagnostic Guide to Neurological Levels

  2. Motor Power • Interruption of the nerve root causes denervation and paralysis of its myotome. • Pressure on a nerve root can cause a decrease in muscle strength. • Muscle testing is utilized to evaluate whether or not a lesion is present and to what degree it is effecting the muscle strength.

  3. Muscle Grading Chart • Muscle gradations • 5 – normal • 4 – good • 3 – fair • 2 – poor • 1 – trace • 0 - zero • Description. • Complete range of motion against gravity with full resistance. • Complete range of motion against gravity with some resistance. • Complete range of motion against gravity. • Complete range of motion with gravity eliminated. • Evidence of slight contractility. No joint motion. • No evidence of contractility.

  4. Sensation • Pathology to the cord or nerve root results in loss of light touch, followed by loss of sensation of pain. • During recovery from nerve root injury, sensation of pain returns before light touch.

  5. Sensation • The 2 sensations are tested separately, light touch with a cotton swab, pain with pinpricks. • Pinwheels can be utilized to evaluate sensation. • Results can be recorded on a dermatome chart as normal, hyperesthetic (increased), hypoesthetic (decreased), dyesthetic (altered), or anesthetic (absent).

  6. Reflex • Interruption in the basic reflex arc results in the loss of reflex, while pressures on the nerve root itself may decrease its intensity (hyporeflexia). • Interruption of the upper motor neuron’s regulatory control results in a hyperactive nerve (hyperreflexia). • Reflexes should be reported as normal, increased, or decreased utilizing bilateral comparison.

  7. Stretch Reflex Arc

  8. Nerve Root Lesions by Neurologic Level

  9. Evaluation of Nerve Root Lesions Upper Extremity

  10. Cervical Spine • C5 is the 1st significant contribution to the brachial plexus. • C1-4 are difficult to test; However, C4 is the major innervation to the diaphragm (via the phrenic nerve).

  11. The Cervical Spine

  12. Deltoid & Supraspinatous

  13. Elbow Flexion and Extension

  14. Biceps Brachii & Brachialis

  15. Functions of the Biceps

  16. Muscle Test for the Biceps

  17. Biceps Reflex Test

  18. Memory Trick

  19. Muscle Test Shoulder Abduction

  20. Sensory Distribution C5

  21. Wrist Extension and Flexion

  22. Extensor Carpi Ulnaris (Left), Extensor Carpi Radialis (Right)

  23. Muscle Test Wrist Extension

  24. Brachioradialis Reflex Test

  25. Memory Trick

  26. Triceps Brachii

  27. Walking With a Crutch Utilizes the Triceps Muscle

  28. Muscle Test Wrist Flexors

  29. Flexor Carpi Radialis (Left), Flexor Carpi Ulnaris (Right)

  30. Finger Extension and Flexion

  31. Extensor Digitorum

  32. Muscle Test Finger Extension

  33. Triceps Reflex Test

  34. Flexor Digitorum Superficialis (Left), and Profundus (Right)

  35. Lumbricales

  36. Muscle Test Finger Flexors

  37. Memory Trick

  38. Finger Abduction and Adduction

  39. Muscle Test Finger Abduction

  40. Muscle Test Finger Adduction

  41. Summary of Muscle Testing for the Upper Extremity

  42. Summary of Reflex Testing for the Upper Extremity

  43. Summary of Sensation for the Upper Extremity

  44. Cervical Vertebrae and Nerve Roots

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