Examining motor fxn Flashcards
In what kind of brain lesions will you observe low tone?
LMN = nerve roots and peripheral injury UMN = with initial spinal shock for SCI or stroke, but then transitions to high tone
A hyperactive tendon response indicates what lesion?
UMN
A score of 2 on the MAS means what?
2 = more marked increase in muscle tone through most of ROM, affected part easily moved
1 = slight increase in tone, minimal resistance at end of ROM 1+ = slight increase in muscle tone, minimal resistance through less than half ROM 3 = considerable increase in tone, passive movement difficult 4 = rigid
Is rigidity velocity dependent?
no
In SCI, what kind of DTRs would you expect?
hyperreflexic
What kind of CNS disorder has lead-pipe rigidity?
parkinsonism -> can be cogwheel or ratchet-like resistance to movement
If a patient is ataxic, what could the location of the lesion be?
cerebellum
Compare/contrast dysmetria/dysdiadochokinesia
dysdiadochokinesia = inability to perform rapidly alternating movements
dysmetria = unable to judge distance/range of a movement
How do you test dysmetria?
finger to nose then pencil
How do you test dysdiadochokinesia?
try to pronate/supinate quickly with one hand in the palm of another
Do people with a cerebrellar lesion/stroke have spasm?
no not typically
With stroke, what is the location of the lesion in the brain? (think cortex/tracts)
cerebral cortex corticospinal tracts
What do voluntary movements with stroke look like?
dyssynergic = abnormal timing/coactivation/activation, fatigueability
What do voluntary movements with parkinson’s look like?
bradykinesia/akinesia (lack of spontaneous and automatic movements)
Rigidity is associated with what CNS disorder?
parkinson’s
A patient you’re seeing has increased tone and sustained posturing in rigid extension of all four limbs and trunk/neck. What would you call this?
decerebrate
- for lesions between superior colliculus and vestibular nucleus
A patient has increased tone and has sustained posturing of the limbs in flexion and LEs in extension - what is this called?
decorticate
Your patient has prolonged, severe spasms of muscles during your session, causing them to throw their head, back, and heels into extension, while their arms and hands are rigidly flexed. What could be going on?
opisthotonos - seen in severe meningitis, tetanus, epilepsy
Is Guillian-Barre a LMN or UMN issue?
LMN
What kind of lesion produces rapid, focal, severe muscle wasting?
LMN (neurogenic atrophy)
- UMN is variable disuse atrophy
What would a 2+ on the reflex scoring scale indicate?
2+ = visible movement of extremities
0 = absent 1+ = tone change, no visible movement of extr 3+ = exaggerated, full movement 4+ = oligatory and sustained movement, lasting for >30s
Do we typically see proximal or distal muscle weakness with neuropathies?
distal (proximal with myopathies)
What’s the typical pattern of spasticity at the hip?
extended, IR, adducted (scissoring)
What type of sitting posture is associated with spasticity?
sacral sitting