NPTE-PT Neuromuscular and Nervous Systems 2 — Questions and Answers
Question 1: A patient presents with foot drop, weakness of ankle dorsiflexion, and sensory loss over the dorsum of the foot. Which nerve is most likely injured?
- Tibial nerve
- Common peroneal nerve (Correct answer)
- Sural nerve
- Saphenous nerve
Correct answer: Common peroneal nerve
The common peroneal nerve innervates the muscles responsible for ankle dorsiflexion and eversion, and provides sensation to the dorsum of the foot.
Question 2: Which reflex arc component is responsible for detecting changes in muscle length?
- Golgi tendon organ
- Muscle spindle (Correct answer)
- Pacinian corpuscle
- Ruffini ending
Correct answer: Muscle spindle
Muscle spindles (intrafusal fibers) are stretch-sensitive receptors that detect changes in muscle length and rate of length change.
Question 3: A patient recovering from a stroke demonstrates hyperreflexia and increased muscle tone in the right upper extremity. Which descending pathway is most likely damaged?
- Rubrospinal tract
- Vestibulospinal tract
- Corticospinal tract (Correct answer)
- Reticulospinal tract
Correct answer: Corticospinal tract
Damage to the corticospinal (pyramidal) tract causes upper motor neuron signs including hyperreflexia, spasticity, and increased muscle tone.
Question 4: Which cranial nerve is tested when a patient is asked to shrug their shoulders against resistance?
- CN IX
- CN X
- CN XI (Correct answer)
- CN XII
Correct answer: CN XI
The accessory nerve (CN XI) innervates the trapezius and sternocleidomastoid muscles, which are tested with shoulder shrugging and head rotation.
Question 5: During gait analysis, a patient shows excessive lateral trunk lean toward the stance leg. This compensatory strategy is most likely due to weakness of which muscle?
- Gluteus maximus
- Gluteus medius (Correct answer)
- Tensor fascia latae
- Piriformis
Correct answer: Gluteus medius
Gluteus medius weakness causes the Trendelenburg gait, where the trunk leans toward the weak side to shift the center of mass and reduce the hip abductor moment demand.
Question 6: A patient with a C6 spinal cord injury would retain which of the following motor functions?
- Finger flexion
- Elbow extension
- Wrist extension (Correct answer)
- Hand intrinsic muscle control
Correct answer: Wrist extension
The C6 myotome includes wrist extensors (extensor carpi radialis), which remain intact in a C6 complete spinal cord injury.
Question 7: Which term describes the phenomenon where repeated stimulation of a reflex leads to a diminished response over time?
- Sensitization
- Facilitation
- Habituation (Correct answer)
- Irradiation
Correct answer: Habituation
Habituation is the progressive decrease in reflex response amplitude with repeated, non-noxious stimulation of the same pathway.
NPTE-PT Neuromuscular and Nervous Systems 2
A patient presents with foot drop, weakness of ankle dorsiflexion, and sensory loss over the dorsum of the foot.
Which nerve is most likely injured?