Assuming a cervical disk herniation at C6, which finding would be most typical on examination?

• A. Impaired triceps reflex
• B. Diminished wrist extensor strength
• C. Diminished sensation along the medial arm and forearm
• D. Paresthesias in the index, long, and ring fingers

Answer: (B)

Cervical radiculopathy patterns follow the specific nerve root’s motor, sensory, and reflex distribution. A disk herniation at C6 most directly compresses the C6 root, so the exam should show weakness in muscles that C6 powers, particularly the wrist extensors (extensor carpi radialis longus and brevis). This is why diminished wrist extensor strength is the most typical finding.

In contrast, the triceps reflex is primarily C7–C8, so impairment there would point away from a C6 lesion. Sensory loss for a C6 issue would be in the lateral forearm and thumb rather than along the medial arm or multiple finger dermatomes. Paresthesias involving index, middle, and ring fingers would span several dermatomes, not reflect a single-root C6 pattern.