NPTE-PT Neuromuscular System Examination 1 — Questions and Answers
Question 1: Which test assesses the integrity of the corticospinal tract by stroking the lateral plantar surface of the foot?
- Babinski sign (Correct answer)
- Clonus test
- Romberg test
- Hoffman sign
Correct answer: Babinski sign
The Babinski sign is elicited by stroking the lateral plantar surface, with an abnormal response (dorsiflexion of the great toe and fanning of the others) indicating upper motor neuron dysfunction.
Question 2: A patient presents with impaired vibration sense and proprioception but intact pain and temperature sensation. Which spinal cord pathway is most likely affected?
- Dorsal columns (Correct answer)
- Lateral spinothalamic tract
- Anterior spinothalamic tract
- Corticospinal tract
Correct answer: Dorsal columns
The dorsal columns (posterior funiculi) carry vibration and proprioception, while the lateral spinothalamic tract carries pain and temperature.
Question 3: During examination, a physical therapist notes that a patient cannot perform rapid alternating movements with the hand. This finding is called:
- Dysdiadochokinesia (Correct answer)
- Dysmetria
- Ataxia
- Tremor
Correct answer: Dysdiadochokinesia
Dysdiadochokinesia is the inability to perform rapid alternating movements and is a classic sign of cerebellar dysfunction.
Question 4: Which cranial nerve is tested by assessing the patient's ability to shrug shoulders against resistance?
- CN XI (Spinal Accessory) (Correct answer)
- CN X (Vagus)
- CN XII (Hypoglossal)
- CN VII (Facial)
Correct answer: CN XI (Spinal Accessory)
Cranial nerve XI (spinal accessory) innervates the trapezius and sternocleidomastoid, both tested by shoulder shrug and head rotation against resistance.
Question 5: A patient with a C5 spinal cord injury would be expected to retain which of the following motor functions?
- Shoulder abduction and elbow flexion (Correct answer)
- Wrist extension only
- Full hand grip
- Elbow extension
Correct answer: Shoulder abduction and elbow flexion
C5 innervates the deltoid and biceps, so shoulder abduction and elbow flexion are preserved at this level of injury.
Question 6: Which test is used to assess the integrity of the cerebellum by having the patient stand with feet together and eyes closed?
- Romberg test (Correct answer)
- Fukuda stepping test
- Finger-nose test
- Heel-shin test
Correct answer: Romberg test
The Romberg test assesses proprioception and vestibular function; a positive result (increased sway with eyes closed) indicates sensory ataxia, often pointing to posterior column or cerebellar involvement.
NPTE-PT Neuromuscular System Examination 1
Which test assesses the integrity of the corticospinal tract by stroking the lateral plantar surface of the foot?