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Peripheral Nervous System and Neurologic Exam - Question 4

Topic: Anatomy

Created on Sunday, August 15 2010 by jdmiles

Last modified on Sunday, August 15 2010.

A patient presents with weakness. Which of the following physical exam findings is suggestive of a lesion within the peripheral nervous system?

 
        A) Paralysis in all muscles below the navel, with normal strength above the navel
 
        B) Unilateral upper and lower extremity weakness
 
        C) Brisk reflexes
 
        D) Flaccid tone
 

 


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This question was created on August 15, 2010 by jdmiles.
This question was last modified on August 15, 2010.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ANSWERS AND EXPLANATIONS




A) Paralysis in all muscles below the navel, with normal strength above the navel

This answer is incorrect.


Loss of strength in all muscles below (caudal to) a specific level is suggestive of a spinal cord lesion, not a peripheral nervous system lesion.  (See References)

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B) Unilateral upper and lower extremity weakness

This answer is incorrect.


Weakness on one side of the body (that is, unilateral weakness or hemiparesis) suggests a central nervous system etiology.  (See References)

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C) Brisk reflexes

This answer is incorrect.


Brisk reflexes suggest a central nervous system etiology.  (See References)

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D) Flaccid tone

This answer is correct.


Peripheral nervous system lesions that result in weakness will often also result in flaccid tone. Note that flaccid tone can also be seen in central nervous system lesions, especially in the acute phase. However, none of the other options are characteristic of peripheral nervous system disorders.  (See References)

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References:

1. Preston, D.C., and Shapiro, B.E. (2005). Electromyography and Neuromuscular Disorders: Clinical-Electrophysiologic Correlations, 2nd Edition. Elsevier, Philadelphia. Chapter 2.(ISBN:075067492X)Advertising:
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anatomy
Peripheral Nervous System and Neurologic Exam - Question 4
Question ID: 10081504
Question written by J. Douglas Miles, (C) 2006-2009, all rights reserved.
Created: 08/15/2010
Modified: 08/15/2010
Estimated Permutations: 0

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