CLINICAL SKILLS OSCE S5 - MOTOR EXAM (UL)

Question 1

Inspection

Answer 1

• expose arms, inspect bulk
• chorea? tremor? fasciculations?
• stretch out arms at shoulder height (bradykinesia)
• stretch out arms, supinate hands, close eyes (pronator drift - UMN lesion)

Question 2

Tone

Answer 2

• relax your arms for me please
• I shall feel for hypo/hypertonia
• wrist flex/extension
• wrist pronate/supinate
• wrist rotation
• increase velocity on wrist rotation to elicit cog wheel spasticity
• lead pipe rigidity?

Question 3

Power

Answer 3

(Provide resistance)
- Shoulder abduction C5
- Elbow flexion C6
- Elbow extension C7
- Wrist flexion and extension (C6, C7)
- Grip fingers C8 and T1

Question 4

Reflex

Answer 4

• Clench teeth
• Bicep reflex
• Normal/hyporeflexive/hypereflexive
• Observe for clonus