Exam 1: Motor system examination Flashcards
Where are the voluntary motor impulses located in the brain?
in the cerebral motor cortex, located primarily in the motor cortex of the frontal lobe on the pre central gyrus
What is the mapped out presentation of the motor cortex called?
motor homunclulus
What are the three areas of muscle integrity that are assessed for the purposes of neurological evaluation?
strength, tone, and volume
What is muscle twitch (discrete and palpable contractions)?
Muscle fasciulation
Fasculations are due to denervated muscle fibers. T/F
True
If fasciculations are not seen by the naked eye by can be demonstrated electromyographically, what are they called?
fibrillations
What is the force exerted in changing positions?
kinetic
What is the force exerted in resulting movement?
static
Antigravity muscles, those that hold the body the in quadruped position, up against gravity, are not stronger than their antagonists. T/F
False. They ARE stronger
What part of the muscle strength grading systems is complete paralysis?
0/5
What part of the muscle strength grading system is a twitch of movement (0-10% of normal movement)?
1/5
What part of the muscle strength grading system is a moderate to severe paresis (active movement is gravity is eliminated) and 11-25% of normal movement?
2/5
What part of the muscle strength grading system is a moderate paresis (active movement against gravity) and 23-50% of normal movement?
3/5
What part of the muscle strength grading system is mild paresis (active movement against gravity and resistance) and 51-75% of normal movement?
4/5
What part of the muscle strength grading system is normal (76-100%)?
5/5
What is the segmental innervation and peripheral nerve for supraspinatus?
S: C(4)-5-6 (primarily 5)
P: suprascapular
What is the segmental innervation and peripheral nerve for the deltoid?
S: C5/6 (primarily 5)
P: axillary
What is the segmental innervation and peripheral nerve for the biceps?
S: C5/6 (primarily 5)
P: musculocutaneous
What is the segmental innervation and peripheral nerve for the brachioradialis?
S: C5/6 (primarily 5)
P: radial
What is the segmental innervation and peripheral nerve for wrist extension?
S: C6/7/8 (primarily 6)
P: radial
What is the segmental innervation and peripheral nerve for the triceps?
S: C6/7/8 (T1) (primarily 7)
P: Radial
What is the segmental innervation and peripheral nerve for wrist flexion?
S: C6/7/8 (T1) (primarily 7)
P: Median/ulnar
What is the segmental innervation and peripheral nerve for finger extension?
S: C6/7/8 (primarily 7)
P: radial
What is the segmental innervation and peripheral nerve for finger flexion?
S: C7/8, T1 (primarily 8)
P: median/ulnar
What is the segmental innervation and peripheral nerve for finger abduction?
S: C8/T1 (primarily T1)
P: ulnar
What is the segmental innervation and peripheral nerve for finger adduction?
S: C8-T1 (primarily T1)
P: Ulnar
If muscle tone is increased, what could that suggest?
UMNL
If muscle tone is decreased, what could that suggest?
LMNL
What is an increased muscular resistance felt by the examiner during quick joint movement, which then quickly fades away?
Spasticity
What is clasped knife?
tension at first, followed by a decrease in that tension as the joint is opened (spasticity)
What is spasticity associated with?
cortical or pyramidal pathway lesion (UMNL)
What is an involuntary muscular resistance felt when moving a resisting joint and persists as the joint is moved through its entire ROM?
rigidity
“Gooseneck rigidity”
What is rigidity associated with?
lesions of extrapyramidal pathways (UMNL)
What is hypotonia usually indicative of?
neurological damage at the level of there reflex arc (LMNL)
Cerebellar disease DOES NOT cause diffused hypotonia. T/F
FALSE. It can
What is something that may occur following acute, sever UMN damage in either the brain of spinal cord?
neural shock
Neural shock is not related to vascular shock. T/F
True
What is loss of normal neurological function is like reductions in tone, stretch reflexes, strength and volume?
Deficit phenomenon
What do lower motor neurons produce?
Deficit phenomenon
What are exaggerations or perversions of normal neurological functions and are due to a loss of cortical inhibition?
Release phenomenon
Hyper-refelxia, hypertonia, and pathological reflexes would be an example what type of phenomenon?
Release phenomenon
What are UMNL indicative of?
release phenomenon
Explain tone or tonis.
- reflex phenomenon
- afferent and efferent components
- gamma efferents stimulates intramural fibers of muscle spindles and afferent impulses go to anterior horn of spinal cord to initiate contraction by relfex action of alpha motor neurons
What is the segmental innervation and peripheral nerve for the biceps reflex?
S: C5/6 (primarily C5)
P: Músculocutaneous
What is the segmental innervation and peripheral nerve for the brachioradialis reflex?
S: C5/6 (primarily 6)
P: radial
What is the segmental innervation and peripheral nerve for the triceps reflex?
S: C6/7/8 T1 (primarily 7)
P: radial
What is the segmental innervation and peripheral nerve for finger flexion reflex?
S: C7/8, T1 (primly 8)
P: median, ulnar
What is the reflex grading system called?
wexler scale
What does a 0 on the reflex grading system mean?
absent with reinforcement
What does a +1 on the reflex grading system mean?
hypoactive with reinforcement
What does a +2 on the reflex grading system mean?
normal (may use sluggish or brisk)
What does a +3 on the reflex grading system mean?
hyperactive
What does a +4 on the reflex grading system mean?
hyperactive with transient or sustained clonus
What is the method of jendrassik?
distracting the patient while performing the reflex, such as clinching fists or flexing toes
