One carpal spasm question-please guess

CRNA1982 · Nov 11, 2011

The answer is B

thinkertdm · Nov 11, 2011

Technically, it's not a "Babinski reflex". It's a plantar reflex, and it's a Babinski sign when the toes curl up. It can be a sign of a central nervous system lesion, or can be a normal variant in a small portion of people.

cindyloowho · Nov 11, 2011

B. They might have low calcium and a positive Chvostek's sign could help solidify that concern, although trousseau sign is usually a better indicator of low calcium than Chvostek's, but I do digress. Or, they may just have a hypersensitive trousseau's sign :-)

Kooky Korky, BSN, RN · Nov 11, 2011

B

Or they might have c spine issues.

Meriwhen, ASN, BSN, MSN, RN · Nov 11, 2011

I also vote B, with a glass of milk

austin14 · Nov 11, 2011

its b because of low calcium levels. just had a question like this in my med-surg class

CRNA1982 · Nov 11, 2011

B
Or they might have c spine issues.

Not sure I understand? Can you elaborate?

Blackcat99 · Nov 11, 2011

Thanks to everyone.:heartbeat I really appreciate your help. This last question had been driving me crazy.

Now I know the answer is B. :yeah:

morte, LPN, LVN · Nov 11, 2011

Not sure I understand? Can you elaborate?

i'm thinkin, she's thinkin, an irritated nerve in the C-spine contributing to the carpal spasm??

CRNA1982 · Nov 11, 2011

I can't say I have ever seen a pt. with a carpal spasm secondary to C-spine nerve impingement. Usually they present with paresthesias (numbness/tingling in upper extremities)

Esme12, ASN, BSN, RN · Nov 11, 2011

symptoms

[color=#0645ad]petechia which appear as on-off spots, then later become confluent, and appear as purpura (larger bruised areas, usually in dependent regions of the body).
[color=#ba0000]oral, perioral and acral paresthesias, tingling or 'pins and needles' sensation in and around the mouth and lips, and in the extremities of the hands and feet. this is often the earliest symptom of hypocalcaemia.
[color=#ba0000]carpopedal and generalized tetany (medical sign), (unrelieved and strong contractions of the hands, and in the large muscles of the rest of the body) are seen.
latent tetany
- [color=#0645ad]trousseau sign of latent tetany (eliciting [color=#0645ad]carpal spasm by inflating the [color=#0645ad]blood pressure cuff and maintaining the cuff pressure above [color=#0645ad]systolic)
- [color=#0645ad]chvostek's sign (tapping of the inferior portion of the [color=#0645ad]zygoma will produce facial spasms)[color=#0645ad][1]
[*]tendon reflexes are hyperactive

http://en.wikipedia.org/wiki/hypocalcaemia

http://www.umm.edu/ency/article/003194.htm

carpopedal spasm, which was reproducible by inflating a blood-pressure cuff placed on the patient's arm. chvostek's sign, the twitching of the circumoral muscles with tapping lightly over the facial nerve, was also present ....

http://www.nejm.org/doi/full/10.1056/nejmicm074227

babinskis reflex

reflexes are predictable, uncontrollable responses to a certain type of stimulation.

babinski's reflex is one of the reflexes that occurs in infants. it is normal in children up to 2 years old, but it disappears as the child gets older and the nervous system becomes more developed. it may disappear as early as 12 months.

the presence of a babinski's reflex after age 2 is a sign of damage to the nerve paths connecting the spinal cord and the brain (the corticospinal tract). this tract runs down both sides of the spinal cord. a babinski's reflex can occur on one side or on both sides of the body.

an abnormal babinski's reflex can be temporary or permanent.

the plantar reflex is a [color=#0645ad]reflex elicited when the sole of the foot is stimulated with a blunt instrument. the reflex can take one of two forms. in normal adults the plantar reflex causes a downward response of the [color=#0645ad]hallux ([color=#0645ad]flexion). an upward response ([color=#0645ad]extension) of the [color=#0645ad]hallux is known as babinski response, babinski sign, or koch sign, named after [color=#0645ad]joseph babinski (1857–1932), a [color=#0645ad]french [color=#0645ad][1] [color=#0645ad]neurologist of [color=#0645ad]polish origin. the presence of the babinski sign can identify [color=#0645ad]disease of the [color=#0645ad]spinal cord and [color=#0645ad]brain in adults, and also exists as a [color=#0645ad]primitive reflex in [color=#0645ad]infants.[color=#0645ad][2]

[color=#0645ad][http://en.wikipedia.org/wiki/plantar_reflex

http://www.youtube.com/watch?v=c_5_xfjxt4g&feature=related