NCS STUDY WITH VERIFIED
SOLUTIONS
PDMS-2 - Correct Answers -Peabody Developmental Motor Scales 2nd edition
Norm and criterion referenced
examines gross and fine motor skills of children 0-6 years
6 subtests:
1. primitive reflexes (if <12 mo)
2. stationary
3. locomotion
4. object manipulation
5. grasping
6. visual motor integration
provides standard score, percentiles, age equivalents
Dysmetria - Correct Answers -Inability to coordinate movement resulting in an
undershoot or overshoot of the intended position of a limb or eye. (inability to judge
distance or scale) Dysfuncntion of the cerebellum. Increases with multi-joint mvmts
because more interaction forces (find through finger to nose and heel to shin tests)
Impairments with cerebellar dx - Correct Answers -impaired prediction, impaired
adaptability, impaired precision
Balance with Anterior Cerebellar lesion - Correct Answers -high frequency, low
amplitude sway, improves with vision
Balance with vestibulocerebellar lesion - Correct Answers -low frequency, high
amplitude sway. Does NOT improve with vision
Hypermetria - Correct Answers -overshooting due to correction on an initial
understimation in limb inertia
Hypometria - Correct Answers -undershooting due to a correction on an initial
underestimation in limb inertia
Effect of impaired saccades on gait - Correct Answers -Saccades are important for
visual sampling which affects foot placement and turning. Impaired saccades leads to
,impaired foot placement, turning, slower gait velocity (errors in foot placement leads to
need for corrective steps which slows gait velocity)
Scale for Assessment and Rating of Ataxia (SARA) - Correct Answers -higher is worse!
0-40
8 subscales: gait, balance, speech disturbance, dysmetria. Scores range from 0 (no
ataxia) to 40 (severe ataxia) MDC under 3.5, MCID not established, moderately
responsive to change, excellent validity
International Cooperative Ataxia Rating Scale (ICARS) - Correct Answers -19 items with
4 subscales: dysarthria and occulomotor disorders, limb ataxia, postural and gait
disturbances. 0-100 scale with 100 = very severe. MDC 11.8, MCID not established.
Adequate validity and responsiveness
Ataxia severity by stroke locations - Correct Answers -SCA stroke > impairment than
PICA stroke
EMG response to external perturbation in cerebellar dysfunction - Correct Answers -
Larger in amplitude and longer in duration (excessive/ineffective corrections)
Pattern of weakness: cortex lesion - Correct Answers -contralateral face and body
Pattern of weakness: Brainstem - Correct Answers -ipsilateral face, contralateral body
(common but can depend on location) lesion involving facial nerves causes ipsilateral
face, involing motor tracks for contralateral body
Pattern of weakness: spinal cord - Correct Answers -level of lesion and below
Pattern of weakness: polyneuropathy - Correct Answers -distal > proximal (stocking
glove)
Pattern of weakness: neuromuscular junction - Correct Answers -patchy, face is
common (eg:myasthenia gravis, ptosis, weakness around mouth)
Pattern of weakness: myopathy - Correct Answers -proximal more common than distal
Pattern of sensory loss: central distribution - Correct Answers -homonculupous body
regions, selective loss of certain modalities (eg: pain and temp), loss of higher order
(eg: sterognosis, graphesthesia etc. )
Pattern of sensory loss: peripheral distribution - Correct Answers -Dermatome if from
nerve root, peripheral nerve distribution, stocking glove for polyneuropathy
Cerebellar Symptoms - Correct Answers -dysmetria, disdiadochokinesia,
hyper/hypometria, nystagmus (at rest, direction changing), dysarthria, ataxia (ataxia is
,usually cerebellar but can sometimes be sensory from profound loss of sensation =
sensory ataxia)
Symtpms of Basal Ganglia dysfunction - Correct Answers -Bradykinesia (slow mvmt),
hypokinesia (small mvmt), athetosis/chorea, tremor, dystonia (involuntary sustained
position usually in specific muscle)
Apraxia - Correct Answers -Inability to perform skilled
tasks that cannot be explained by weakness, sensory loss, or ataxia (cortical
involvement)
Tabes Dorsalis - Correct Answers -also known as syphilitic myelopathy, is a slow
degeneration (specifically, demyelination) of the neural tracts primarily in the dorsal
columns (posterior columns) of the spinal cord (the portion closest to the back of the
body) & dorsal roots.
Deep Tendon Reflex Grades - Correct Answers -0 Absent (abnormal)
1+ diminished
2+ Average
3+ Brisker than average, but not necessarily pathological
4+ Very brisk, hyperactive, may include clonus
(1+ or 3+ not necessarily abnormal unless big difference bilaterally or between UE and
LEs
LMN signs and symptoms - Correct Answers -atrophy, fasiculations, stocking glove
sensory loss
DTR: Biceps - Correct Answers -C5 (C6), tap biceps tendon, normal is elbow flexion
DTR: Brachioradialis - Correct Answers -C6 (C7) palpate muscle and tap belly or
tendon, elbow flexion
DTR: Triceps - Correct Answers -C& (C8) tap triceps tendon at elbow, elbow extension
DTR: Patella - Correct Answers -(L3) L4
DTR: Achilles - Correct Answers -S1 (S2) tap with ankle in DF, response is PF
Babinski sign - Correct Answers -swipe across bottom of the foot in a J shape with
handle of hammer, positive is toe extension in adults (UMNL sign) (normal is nothing)
Hoffmans Relfex - Correct Answers -quick stretch to distal phalanx of middle finger, + is
abduction/flexion of other fingers (UMNL sign) normal is no mvmt
Myotome: Biceps - Correct Answers -C5
, Myotome: Triceps - Correct Answers -C7
Myotome: wrist extensors - Correct Answers -C6
Myotome: Finger Flexors - Correct Answers -C8 (have them curl fingers and you opose)
Myotome: Finger Abduction - Correct Answers -T1
Myotome: Hip Flexor - Correct Answers -L2
Myotome: Knee extensor - Correct Answers -L3
Myotome: Dorsiflexion - Correct Answers -L4
Myotome: Great Toe Extension - Correct Answers -L5
Myotome: Plantarflexion - Correct Answers -S1
Cranial Nerve I - Correct Answers -olfactory: attaches at telencephalon (cerebrum) exits
from cribriform plate of ethmoid, Injured if cribriform plate breaks.
Cranial Nerve II - Correct Answers -optic: attaches at diencephalon via optic chiasm,
exists optic canal of sphenoid bone. Check vision and check peripheral vision for field
cuts (pupil constriction is CN II for sensory component and III for motor component),
myelinated CNS tracts, susceptible to demyelinating conditions such as MS. Some
fibers decussate to the other side of brain so clinical s/s can depend on specific site of
location
Cranial Nerve III - Correct Answers -Occulotmotor:somatic, visceral motor, cilliary
muscle, (pupil constriction is CN II for sensory component and III for motor component)
check: is there ptosis, ROM with H, diplopia, near point convergence
Cranial Nerve IV - Correct Answers -Trochlear: internal rotation, adduction, used for
reading. Ask them to lok interomedially, the invovled eye will drift up
Cranial Nerve V - Correct Answers -Trigeminal:
V1: opthalmic n. sensory of skin of face, mucous membranes. (attaches at pons, exits
through superior orbital fissure)
V2: Maxillary n. sensory to skin of upper jaw. Attaches at midbrain, exits foramen
rotundum.
V3: Mandibular nerve. mixed. muscles of mastication and sensation of lower jaw
(attaches to pons, exits foramen ovale)
(quick touch through the 3 branches and bite down look for symmetry. Can also test
cornea reflex)
SOLUTIONS
PDMS-2 - Correct Answers -Peabody Developmental Motor Scales 2nd edition
Norm and criterion referenced
examines gross and fine motor skills of children 0-6 years
6 subtests:
1. primitive reflexes (if <12 mo)
2. stationary
3. locomotion
4. object manipulation
5. grasping
6. visual motor integration
provides standard score, percentiles, age equivalents
Dysmetria - Correct Answers -Inability to coordinate movement resulting in an
undershoot or overshoot of the intended position of a limb or eye. (inability to judge
distance or scale) Dysfuncntion of the cerebellum. Increases with multi-joint mvmts
because more interaction forces (find through finger to nose and heel to shin tests)
Impairments with cerebellar dx - Correct Answers -impaired prediction, impaired
adaptability, impaired precision
Balance with Anterior Cerebellar lesion - Correct Answers -high frequency, low
amplitude sway, improves with vision
Balance with vestibulocerebellar lesion - Correct Answers -low frequency, high
amplitude sway. Does NOT improve with vision
Hypermetria - Correct Answers -overshooting due to correction on an initial
understimation in limb inertia
Hypometria - Correct Answers -undershooting due to a correction on an initial
underestimation in limb inertia
Effect of impaired saccades on gait - Correct Answers -Saccades are important for
visual sampling which affects foot placement and turning. Impaired saccades leads to
,impaired foot placement, turning, slower gait velocity (errors in foot placement leads to
need for corrective steps which slows gait velocity)
Scale for Assessment and Rating of Ataxia (SARA) - Correct Answers -higher is worse!
0-40
8 subscales: gait, balance, speech disturbance, dysmetria. Scores range from 0 (no
ataxia) to 40 (severe ataxia) MDC under 3.5, MCID not established, moderately
responsive to change, excellent validity
International Cooperative Ataxia Rating Scale (ICARS) - Correct Answers -19 items with
4 subscales: dysarthria and occulomotor disorders, limb ataxia, postural and gait
disturbances. 0-100 scale with 100 = very severe. MDC 11.8, MCID not established.
Adequate validity and responsiveness
Ataxia severity by stroke locations - Correct Answers -SCA stroke > impairment than
PICA stroke
EMG response to external perturbation in cerebellar dysfunction - Correct Answers -
Larger in amplitude and longer in duration (excessive/ineffective corrections)
Pattern of weakness: cortex lesion - Correct Answers -contralateral face and body
Pattern of weakness: Brainstem - Correct Answers -ipsilateral face, contralateral body
(common but can depend on location) lesion involving facial nerves causes ipsilateral
face, involing motor tracks for contralateral body
Pattern of weakness: spinal cord - Correct Answers -level of lesion and below
Pattern of weakness: polyneuropathy - Correct Answers -distal > proximal (stocking
glove)
Pattern of weakness: neuromuscular junction - Correct Answers -patchy, face is
common (eg:myasthenia gravis, ptosis, weakness around mouth)
Pattern of weakness: myopathy - Correct Answers -proximal more common than distal
Pattern of sensory loss: central distribution - Correct Answers -homonculupous body
regions, selective loss of certain modalities (eg: pain and temp), loss of higher order
(eg: sterognosis, graphesthesia etc. )
Pattern of sensory loss: peripheral distribution - Correct Answers -Dermatome if from
nerve root, peripheral nerve distribution, stocking glove for polyneuropathy
Cerebellar Symptoms - Correct Answers -dysmetria, disdiadochokinesia,
hyper/hypometria, nystagmus (at rest, direction changing), dysarthria, ataxia (ataxia is
,usually cerebellar but can sometimes be sensory from profound loss of sensation =
sensory ataxia)
Symtpms of Basal Ganglia dysfunction - Correct Answers -Bradykinesia (slow mvmt),
hypokinesia (small mvmt), athetosis/chorea, tremor, dystonia (involuntary sustained
position usually in specific muscle)
Apraxia - Correct Answers -Inability to perform skilled
tasks that cannot be explained by weakness, sensory loss, or ataxia (cortical
involvement)
Tabes Dorsalis - Correct Answers -also known as syphilitic myelopathy, is a slow
degeneration (specifically, demyelination) of the neural tracts primarily in the dorsal
columns (posterior columns) of the spinal cord (the portion closest to the back of the
body) & dorsal roots.
Deep Tendon Reflex Grades - Correct Answers -0 Absent (abnormal)
1+ diminished
2+ Average
3+ Brisker than average, but not necessarily pathological
4+ Very brisk, hyperactive, may include clonus
(1+ or 3+ not necessarily abnormal unless big difference bilaterally or between UE and
LEs
LMN signs and symptoms - Correct Answers -atrophy, fasiculations, stocking glove
sensory loss
DTR: Biceps - Correct Answers -C5 (C6), tap biceps tendon, normal is elbow flexion
DTR: Brachioradialis - Correct Answers -C6 (C7) palpate muscle and tap belly or
tendon, elbow flexion
DTR: Triceps - Correct Answers -C& (C8) tap triceps tendon at elbow, elbow extension
DTR: Patella - Correct Answers -(L3) L4
DTR: Achilles - Correct Answers -S1 (S2) tap with ankle in DF, response is PF
Babinski sign - Correct Answers -swipe across bottom of the foot in a J shape with
handle of hammer, positive is toe extension in adults (UMNL sign) (normal is nothing)
Hoffmans Relfex - Correct Answers -quick stretch to distal phalanx of middle finger, + is
abduction/flexion of other fingers (UMNL sign) normal is no mvmt
Myotome: Biceps - Correct Answers -C5
, Myotome: Triceps - Correct Answers -C7
Myotome: wrist extensors - Correct Answers -C6
Myotome: Finger Flexors - Correct Answers -C8 (have them curl fingers and you opose)
Myotome: Finger Abduction - Correct Answers -T1
Myotome: Hip Flexor - Correct Answers -L2
Myotome: Knee extensor - Correct Answers -L3
Myotome: Dorsiflexion - Correct Answers -L4
Myotome: Great Toe Extension - Correct Answers -L5
Myotome: Plantarflexion - Correct Answers -S1
Cranial Nerve I - Correct Answers -olfactory: attaches at telencephalon (cerebrum) exits
from cribriform plate of ethmoid, Injured if cribriform plate breaks.
Cranial Nerve II - Correct Answers -optic: attaches at diencephalon via optic chiasm,
exists optic canal of sphenoid bone. Check vision and check peripheral vision for field
cuts (pupil constriction is CN II for sensory component and III for motor component),
myelinated CNS tracts, susceptible to demyelinating conditions such as MS. Some
fibers decussate to the other side of brain so clinical s/s can depend on specific site of
location
Cranial Nerve III - Correct Answers -Occulotmotor:somatic, visceral motor, cilliary
muscle, (pupil constriction is CN II for sensory component and III for motor component)
check: is there ptosis, ROM with H, diplopia, near point convergence
Cranial Nerve IV - Correct Answers -Trochlear: internal rotation, adduction, used for
reading. Ask them to lok interomedially, the invovled eye will drift up
Cranial Nerve V - Correct Answers -Trigeminal:
V1: opthalmic n. sensory of skin of face, mucous membranes. (attaches at pons, exits
through superior orbital fissure)
V2: Maxillary n. sensory to skin of upper jaw. Attaches at midbrain, exits foramen
rotundum.
V3: Mandibular nerve. mixed. muscles of mastication and sensation of lower jaw
(attaches to pons, exits foramen ovale)
(quick touch through the 3 branches and bite down look for symmetry. Can also test
cornea reflex)
