National Physical Therapy Examination (NPTE) Practice Exam

A patient with stenosis at the C7-T1 level is likely to exhibit which signs?

1. Weak biceps, normal biceps reflex, paresthesia in the thumb and index finger

2. Weak deltoid, diminished biceps reflex, paresthesia along the lateral upper extremity

3. Weak thumb extensors and adductors, normal triceps reflex, paresthesia in the little finger

4. Weak triceps, diminished triceps reflex, paresthesia in the index, middle, and ring fingers

The correct answer is: Weak thumb extensors and adductors, normal triceps reflex, paresthesia in the little finger

A patient with stenosis at the C7-T1 level typically exhibits signs associated with the involvement of the lower cervical spine segments, particularly the C8 nerve root. This anatomy becomes critical in understanding the neurological deficits that might arise. Focusing on option C, weakness in the thumb extensors and adductors indicates a dysfunction in the musculature innervated by the C8/T1 segments, specifically affecting the intrinsic muscles of the hand such as the abductor pollicis and the adductor pollicis. The normal triceps reflex also aligns with the fact that the triceps are primarily innervated by the C7 nerve root, while C8 and T1 mainly contribute to the hand function rather than elbow extension. Paresthesia in the little finger can occur due to the involvement of the ulnar nerve, which arises from the C8 and T1 nerve roots. Thus, when there's stenosis at the C7-T1 level, symptoms often manifest where the ulnar nerve supplies sensation, correlating with the clinical finding of paresthesia in the little finger. This understanding of nerve root involvement, muscle weakness, reflex assessment, and sensory distribution is essential to assessing and diagnosing conditions related to cervical spine stenosis