Examination Of The Motor System (handout based) Flashcards
steadiness and verticality of the standing posture
Station
Initial inspection of Body Contours, Posture and Gait
- Motor examination begins the moment the patient walks into your clinic
- Have the patient undress
- Determine the patient’s gestalt, somatotype or body build
- Inspect the size and contour of muscles
Walking is also known as
Gait
muscles are strongest when tested from the shortest position
Length - strength principle
muscles which support the standing posture against collapse by pull of gravity
Anti - gravity muscle principle
Grading of strength testing
0 - No contraction
1 - A flicker or trace of contraction
2 - Active movement with gravity eliminated
3 - Active movement against gravity
4 - Active movement againstgravity and moderate resistance
5 - Normal power
Muscular resistance apart from gravity or joint disease the examiner feels when manipulating a patient’s resting joint
Muscle Tone
Muscle tone is due to:
- Elasticity of the muscle
* Number and rate of motor discharges
Initial catch or resistance and then a yielding when the examiner manipulates the patient’s resting extremity
Spasticity
Increased muscular resistance felt throughout the entire range of movement when the examiner slowly manipulates a patient’s resting joint
Rigidity
Resistance equal in degree and range that the patient presents to the examiner as he tries to move a part in any direction
Paratonia
Decreased resistance
Flaccidity
Increased range of motion of the joint movement (i.e hyperextensible knees or flaccid heel cords)
Flaccidity
Grading of MSR (muscle stretch reflex)
0 - Areflexia
1 - Hyporeflexia
2 and 3 - Normal
4 and 4+ - Hypereflexia
Superficial (plantar) Reflexes: Move an object along the lateral side of the foot
chaddock
Superficial (plantar) Reflexes: Squeeze hard on the Achilles tendon
Schaeffer
Superficial (plantar) Reflexes: Press your knuckles on the patient’s shin and move them down
Oppenheim
Superficial (plantar) Reflexes: Squeeze the calf muscles momentarily
Gordon
Superficial (plantar) Reflexes: Make multiple light pinpricks on the dorsolateral surface of the foot
Bing
Superficial (plantar) Reflexes: Pull on the 4thtoe outward and downward for a brief time and release suddenly
Gonda, Stransky
Paralyzes movements in hemiplegic, quadriplegic distribution, not individual muscles
UMN Lesion
Atrophy of disuse
UMN Lesion
Hyperactive MSRs; (+)Clonus, Clasp-knife spasticity; (+) Extensor Toe Sign
UMN Lesion
Paralyzes individual muscles or sets of muscles in root or peripheral nerve distribution
LMN Lesion
Atrophy of denervation
LMN Lesion
Hypoactive MSRs; Hypotonia; (+) Fasciculationsand Fibrillations
LMN Lesion
Are sensorimotor functions that are lost after a neurologic lesion (i.e. loss of movement, loss of vision)
Deficit phenomenon
Are sensorimotor functions that become increased or first emerge after a neurologic lesion (i.e. hyperactive MSRs, Babinski sign); The lesion has interrupted inhibitory connections
Release phenomenon
rhythmic oscillations of a body part
Tremor
incessant, random, quick movement
Chorea
slow, writhing movement of fingers and extremities
Athetosis
prolonged slow, alternating contraction and relaxation of agonist and antagonist muscles
Dystonia
violent flinging movements of one half of the body
Hemiballismus
quick, lightning-fast movements of face and upper extremties
Ticks
