Physical Therapy Evaluation Tool (PEAT) 4 Practice Exam

Cauda equina syndrome is a neurologic emergency caused by compression of the sacral nerve roots, which can disrupt sensation in the perineal region. Saddle anesthesia, or numbness in the area that would contact a saddle (the perineum, buttocks, and inner thighs), directly reflects involvement of the S2–S5 nerve roots and is a hallmark of this condition. It often accompanies or precedes bowel or bladder dysfunction, and together they signal a urgent need for rapid imaging and specialist evaluation to prevent irreversible deficits. The other signs don’t indicate CES: dull thigh sensation isn’t specific to the saddle region; intermittent claudication points to vascular claudication rather than neural compression; and local ankle swelling suggests edema or a vascular/soft tissue issue rather than cauda equina involvement.