National Physical Therapy Examination (NPTE) Practice Exam

What is commonly affected in cases of a herniated disc at the lumbar levels?

1. Diminished knee reflexes

2. Loss of ankle dorsiflexion

3. Loss of pelvic floor control

4. Radiating pain into the upper limb

The correct answer is: Loss of pelvic floor control

In cases of a herniated disc at the lumbar levels, the common outcomes typically include loss of structures related to nerve root compression that exit the lumbar spine and often affect lower extremity functions. The correct response highlights loss of pelvic floor control, which can occur due to impingement of the lower spinal nerve roots that innervate the pelvic floor muscles. This loss of control can manifest as bladder and bowel dysfunction, signaling that the herniation is impacting the sacral nerve roots (often associated with lumbar disc issues). Compression in this area can therefore lead to significant implications on pelvic function, which is paramount when assessing the impact of lumbar herniations. Regarding diminished knee reflexes, while this can occur depending on the specific nerve root affected, it is less directly associated with the lumbar discs compared to pelvic control issues. Loss of ankle dorsiflexion could be observed, but it primarily corresponds with more specific L4-L5 nerve root involvement rather than generalized lumbar disc herniation. Radiating pain into the upper limb is typically associated with cervical disc herniation rather than lumbar issues, underlining the need to correlate symptoms to the anatomical location of the herniation correctly.