KL ASET PRRP QUESTIONS EXAMS AND
CORRECT ANSWERS
When discussing the effectiveness of testing, there are some terms that describe the
quality of a test in identifying a disorder. Match the term with its definition:
Protocol should be: - Answer Efficient
Few false positives - Answer Specific
Few false negatives - Answer Sensitive
Same results on repeat testing - Answer Reliable
Unaffected by factors such as temperature - Answer Resistant
Combining the results of 3 CTS tests into one number ___________, according to Dr
Lawrence Robinson. - Answer improves reliability and sensitivity
The combined sensory index or "CSI" has a sensitivity of ______ and a specificity of _____
according to Dr Lawrence Robinson. - Answer 83%, 95%
When comparing the median and radial conduction to the thumb after stimulating at the
wrist with a distance of 10 cm, the normal median - radial difference should be _____ -
Answer less than or equal to 0.5 msce
When performing all 3 sensory tests for CTS (Median Ulnar Ring Finger Antidromic,
Median-Radial Thumb Antidromic, Median-Ulnar Mid palmar Orthrodromic), the
predicted specificity of the tests equals 99.9% when ________. - Answer 3 out of 3 tests
are abnormal
When you stimulate midpalmar orthodromic conduction the response is: - Answer a
CNAP (Compound Nerve Action Potential) with some antidromic motor as well
The CSI is a combination of three sensory conduction comparisons.Median - radial
sensory latency difference to the thumbat 10cm (thumbdiff),Median - ulnar sensory
latency difference to the ringfinger at 14cm (ringdiff),Median -ulnar sensory latency
difference across thepalm at 8cm (palmdiff).CSI = palmdiff + ringdiff +
thumbdiffLawrence Robinson, MD - Answer True
In Carpal Tunnel Release surgery the percent of patients stating that post surgery they
have "total relief" is 97% - Answer False/50%
In patients presenting with suspected CTS, motor conduction should be routinely
performed because it is commonly the only abnormality. - Answer False
Occupational risks for CTS include those occupations where workers use high force
highly repetitive movements, such as Grinders, Butchers, Grocery Store Workers,
,Frozen Food Factory Workers, and Platers. - Answer True
There are least 3 good CNAP tests for CTS.1. Palm to Wrist Median-Ulnar Comparison2.
Wrist to Ring Finger Median-Ulnar Comparison3. Wrist to Thumb Median-Radial
Comparison - Answer True
In proximal median neuropathy, studies of the median nerve will most likely reveal: -
Answer Slow conduction velocity at the wrist/elbow segment
Which answer is associated with carpal tunnel syndrome? - Answer Phalen's maneuver
A patient with a symptomatic CTS will describe numbness and tingling in the hand but
the ____ is usually spared. - Answer 5th digit, or little finger
As it passes into the forearm the median nerve runs between _______ before giving off
muscular branches to the PT, Flexor carpi radialis (FCR), Flexor digitorum sublimis
(FDS) and in some individuals the palmaris longus muscles. - Answer the two heads of
the pronator teres
Sometimes confused with CTS, these conditions have similar symptoms. (Select all that
apply) - Answer C6-7 root lesions
Lesions of the Brachial Plexus
Lesions of the proximal median nerve
The electrophysiologic evaluation of a patient with suspected CTS includes which of the
following? (Select all that apply) - Answer 1. If a coexisting polyneuropathy is present,
ensuring that any median slowing at the wrist is out of proportion to the slowing
expected from the polyneuropathy alone
2. Excluding brachial plexopathy predominately affecting the median nerve fibers
3. Demonstrating focal slowing or conduction block of median never fibers across the
carpal tunnel
4. Excluding cervical radiculopathy especially C6-7
CTS is usually bilateral both clinically and in testing but the dominant hand is usually
worse. - Answer True
Women are affected by CTS more than men. - Answer True
Non-occupational risks for CTS include: (Select all that apply) - Answer Hypothyroidism
Pregnancy
Obesity
Diabetes
,Affects all branches of the ulnar nerve, including the proximal and distal deep palmar
motor and the superficial branches which contain the sensory fibers and motor
innervation to the palmaris brevis. - Answer Proximal canal lesion
Affects all ulnar-innervated hand muscles, including the hypothenar muscles, with the
exception of the palmaris brevis; the superficial branch containing the sensory fibers
and motor innervation to the palmaris brevis is not affected. - Answer Proximal deep
palmar motor lesion
If the patient has classic symptoms for ulnar neuropathy at the elbow, but the routine
NCS is normal. What other studies can be done to document possible UNE? (Select all
that apply.) - Answer Sensory or mixed NCS across the elbow
Repeat motor studies recording from the FDI
In ulnar neuropathy at the elbow, there is slowing of CV across the elbow. What else
might be seen in nerve conduction studies? (Select all that apply.) - Answer Abnormal
dorsal ulnar cutaneous SNAP and Reduced ulnar SNAP amplitude
In ulnar neuropathy at the wrist (UNW), which lesion affects all branches of the ulnar
nerve including proximal and distal deep palmar motor and sensory branches? - Answer
Proximal canal lesion
In ulnar neuropathy at the wrist (UNW), which lesion affects all ulnar-innervated hand
muscles, including the hypothenar muscles? The sensory branch is not affected. -
Answer Proximal deep palmar motor lesion
The most common ulnar nerve injury or compression is at the: - Answer Elbow
The ulnar nerve is essentially derived from the: - Answer Lower trunk, medial cord
When evaluating UNW and recording from the FDI, reduced CMAP amplitudes can be
seen in (check all that apply): - Answer Proximal deep palmar motor lesion
Distal deep palmar motor lesion
Proximal canal lesion
Which clinical or electrophysiologic abnormality is NOT consistent with UNW? - Answer
Abnormal dorsal ulnar cutaneous sensory study
Which is the BEST answer regarding ulnar neuropathy at the elbow? - Answer Motor
deficits greater than sensory
There are least 3 good CNAP tests for CTS.1. Palm to Wrist Median-Ulnar Comparison2.
Wrist to Ring Finger Median-Ulnar Comparison3. Wrist to Thumb Median-Radial
Comparison - Answer True
Innervated by the posterior interosseous nerve (C7, C8), which is a continuation of the
deep branch of the radial nerve. The radial nerve is a branch of the posterior cord of the
, brachial plexus. - Answer Abductor pollicis longus
receives innervation from the median nerve. In most limbs there is only one branch to
the FCR. It arises from the lateral epicondyle of the humerus and adjacent areas -
Answer The flexor carpi radialis (FCR)
muscle of the posterior forearm present in humans and other animals. It extends the
medial four digits of the hand. Extensor digitorum is innervated by the posterior
interosseous nerve, which is a branch of the radial nerve. - Answer Extensor digitorum
(communis)
According to the textbook by Preston & Shapiro, the radial CMAP recording muscle of
choice is: - Answer Extensor indicis (proprius)
The radial nerve receives innervation from: - Answer Upper, middle and lower trunk
The most common radial neuropathy is: - Answer At the spiral groove
The superficial radial nerve supplies sensation to: - Answer The lateral dorsum of the
hand
Which answer below does NOT represent radial neuropathy at the Spiral Groove? -
Answer Diminished triceps tendon reflex
Which muscle below is NOT innervated by the radial nerve? - Answer Flexor carpi
radialis
The radial nerve bifurcates into two separate nerves: The____ and ___. - Answer
superficial radial nerve (sensory), and posterior interosseous nerve (motor)
The following are possible entrapment sites for the radial nerve (select all that apply) -
Answer 1. Spiral groove: Saturday night palsy is most common
2. Forearm - Posterior interosseous syndrome
3. Axilla - Prolonged compression
4. Wrist - superficial
Radial neuropathy in the axilla has the following clinical deficits except for - Answer
abnormal deltoid strength
Superficial Radial Sensory Neuropathy is derived from radial nerve in region ofelbow
from distal third of forearm, it runs subcutaneously near the radius. - Answer True
In addition to the rare entrapment of the lateral antebrachial cutaneous nerve, it is more
often studied to evaluate: - Answer Lateral cord and/or upper trunk plexopathies
The Spinal Accessory nerve is a pure motor nerve with no cutaneous fibers. - Answer
True
CORRECT ANSWERS
When discussing the effectiveness of testing, there are some terms that describe the
quality of a test in identifying a disorder. Match the term with its definition:
Protocol should be: - Answer Efficient
Few false positives - Answer Specific
Few false negatives - Answer Sensitive
Same results on repeat testing - Answer Reliable
Unaffected by factors such as temperature - Answer Resistant
Combining the results of 3 CTS tests into one number ___________, according to Dr
Lawrence Robinson. - Answer improves reliability and sensitivity
The combined sensory index or "CSI" has a sensitivity of ______ and a specificity of _____
according to Dr Lawrence Robinson. - Answer 83%, 95%
When comparing the median and radial conduction to the thumb after stimulating at the
wrist with a distance of 10 cm, the normal median - radial difference should be _____ -
Answer less than or equal to 0.5 msce
When performing all 3 sensory tests for CTS (Median Ulnar Ring Finger Antidromic,
Median-Radial Thumb Antidromic, Median-Ulnar Mid palmar Orthrodromic), the
predicted specificity of the tests equals 99.9% when ________. - Answer 3 out of 3 tests
are abnormal
When you stimulate midpalmar orthodromic conduction the response is: - Answer a
CNAP (Compound Nerve Action Potential) with some antidromic motor as well
The CSI is a combination of three sensory conduction comparisons.Median - radial
sensory latency difference to the thumbat 10cm (thumbdiff),Median - ulnar sensory
latency difference to the ringfinger at 14cm (ringdiff),Median -ulnar sensory latency
difference across thepalm at 8cm (palmdiff).CSI = palmdiff + ringdiff +
thumbdiffLawrence Robinson, MD - Answer True
In Carpal Tunnel Release surgery the percent of patients stating that post surgery they
have "total relief" is 97% - Answer False/50%
In patients presenting with suspected CTS, motor conduction should be routinely
performed because it is commonly the only abnormality. - Answer False
Occupational risks for CTS include those occupations where workers use high force
highly repetitive movements, such as Grinders, Butchers, Grocery Store Workers,
,Frozen Food Factory Workers, and Platers. - Answer True
There are least 3 good CNAP tests for CTS.1. Palm to Wrist Median-Ulnar Comparison2.
Wrist to Ring Finger Median-Ulnar Comparison3. Wrist to Thumb Median-Radial
Comparison - Answer True
In proximal median neuropathy, studies of the median nerve will most likely reveal: -
Answer Slow conduction velocity at the wrist/elbow segment
Which answer is associated with carpal tunnel syndrome? - Answer Phalen's maneuver
A patient with a symptomatic CTS will describe numbness and tingling in the hand but
the ____ is usually spared. - Answer 5th digit, or little finger
As it passes into the forearm the median nerve runs between _______ before giving off
muscular branches to the PT, Flexor carpi radialis (FCR), Flexor digitorum sublimis
(FDS) and in some individuals the palmaris longus muscles. - Answer the two heads of
the pronator teres
Sometimes confused with CTS, these conditions have similar symptoms. (Select all that
apply) - Answer C6-7 root lesions
Lesions of the Brachial Plexus
Lesions of the proximal median nerve
The electrophysiologic evaluation of a patient with suspected CTS includes which of the
following? (Select all that apply) - Answer 1. If a coexisting polyneuropathy is present,
ensuring that any median slowing at the wrist is out of proportion to the slowing
expected from the polyneuropathy alone
2. Excluding brachial plexopathy predominately affecting the median nerve fibers
3. Demonstrating focal slowing or conduction block of median never fibers across the
carpal tunnel
4. Excluding cervical radiculopathy especially C6-7
CTS is usually bilateral both clinically and in testing but the dominant hand is usually
worse. - Answer True
Women are affected by CTS more than men. - Answer True
Non-occupational risks for CTS include: (Select all that apply) - Answer Hypothyroidism
Pregnancy
Obesity
Diabetes
,Affects all branches of the ulnar nerve, including the proximal and distal deep palmar
motor and the superficial branches which contain the sensory fibers and motor
innervation to the palmaris brevis. - Answer Proximal canal lesion
Affects all ulnar-innervated hand muscles, including the hypothenar muscles, with the
exception of the palmaris brevis; the superficial branch containing the sensory fibers
and motor innervation to the palmaris brevis is not affected. - Answer Proximal deep
palmar motor lesion
If the patient has classic symptoms for ulnar neuropathy at the elbow, but the routine
NCS is normal. What other studies can be done to document possible UNE? (Select all
that apply.) - Answer Sensory or mixed NCS across the elbow
Repeat motor studies recording from the FDI
In ulnar neuropathy at the elbow, there is slowing of CV across the elbow. What else
might be seen in nerve conduction studies? (Select all that apply.) - Answer Abnormal
dorsal ulnar cutaneous SNAP and Reduced ulnar SNAP amplitude
In ulnar neuropathy at the wrist (UNW), which lesion affects all branches of the ulnar
nerve including proximal and distal deep palmar motor and sensory branches? - Answer
Proximal canal lesion
In ulnar neuropathy at the wrist (UNW), which lesion affects all ulnar-innervated hand
muscles, including the hypothenar muscles? The sensory branch is not affected. -
Answer Proximal deep palmar motor lesion
The most common ulnar nerve injury or compression is at the: - Answer Elbow
The ulnar nerve is essentially derived from the: - Answer Lower trunk, medial cord
When evaluating UNW and recording from the FDI, reduced CMAP amplitudes can be
seen in (check all that apply): - Answer Proximal deep palmar motor lesion
Distal deep palmar motor lesion
Proximal canal lesion
Which clinical or electrophysiologic abnormality is NOT consistent with UNW? - Answer
Abnormal dorsal ulnar cutaneous sensory study
Which is the BEST answer regarding ulnar neuropathy at the elbow? - Answer Motor
deficits greater than sensory
There are least 3 good CNAP tests for CTS.1. Palm to Wrist Median-Ulnar Comparison2.
Wrist to Ring Finger Median-Ulnar Comparison3. Wrist to Thumb Median-Radial
Comparison - Answer True
Innervated by the posterior interosseous nerve (C7, C8), which is a continuation of the
deep branch of the radial nerve. The radial nerve is a branch of the posterior cord of the
, brachial plexus. - Answer Abductor pollicis longus
receives innervation from the median nerve. In most limbs there is only one branch to
the FCR. It arises from the lateral epicondyle of the humerus and adjacent areas -
Answer The flexor carpi radialis (FCR)
muscle of the posterior forearm present in humans and other animals. It extends the
medial four digits of the hand. Extensor digitorum is innervated by the posterior
interosseous nerve, which is a branch of the radial nerve. - Answer Extensor digitorum
(communis)
According to the textbook by Preston & Shapiro, the radial CMAP recording muscle of
choice is: - Answer Extensor indicis (proprius)
The radial nerve receives innervation from: - Answer Upper, middle and lower trunk
The most common radial neuropathy is: - Answer At the spiral groove
The superficial radial nerve supplies sensation to: - Answer The lateral dorsum of the
hand
Which answer below does NOT represent radial neuropathy at the Spiral Groove? -
Answer Diminished triceps tendon reflex
Which muscle below is NOT innervated by the radial nerve? - Answer Flexor carpi
radialis
The radial nerve bifurcates into two separate nerves: The____ and ___. - Answer
superficial radial nerve (sensory), and posterior interosseous nerve (motor)
The following are possible entrapment sites for the radial nerve (select all that apply) -
Answer 1. Spiral groove: Saturday night palsy is most common
2. Forearm - Posterior interosseous syndrome
3. Axilla - Prolonged compression
4. Wrist - superficial
Radial neuropathy in the axilla has the following clinical deficits except for - Answer
abnormal deltoid strength
Superficial Radial Sensory Neuropathy is derived from radial nerve in region ofelbow
from distal third of forearm, it runs subcutaneously near the radius. - Answer True
In addition to the rare entrapment of the lateral antebrachial cutaneous nerve, it is more
often studied to evaluate: - Answer Lateral cord and/or upper trunk plexopathies
The Spinal Accessory nerve is a pure motor nerve with no cutaneous fibers. - Answer
True
