Motor and sensory exam (+gait) Flashcards

1
Q

What are the steps in the motor exam?

A

1) Upper limb tone
2) Upper limb power
3) Upper limb reflexes
4) Lower limb tone and clonus
5) Lower limb power
6) Lower limb reflexes
7) Abdominal reflexes

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2
Q

What are the steps in the exam to test coordination?

A

1) Finger-nose coordination
2) Heel-shin coordination
3) Dysdiadochokinesis
4) Drift
5) Romberg’s test

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3
Q

What are the steps to test gait?

A

1) Normal walk and turn
2) Heel-toe tightrope walking
3) Tip toes
4) On heels
5) Squat down and rise up

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4
Q

What are the steps to test sensory function?

A

1) Test light touch
2) Pain perception
3) Finger proprioception
4) Proprioception of hallux
5) Proprioception of joint position
6) Vibration sense

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5
Q

How do you test upper limb tone?

A

Hold hand as if going to shake it

Supinate and pronate forearm, flex and extend elbow, roll the wrist

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6
Q

What movements do you test the upper limb power for?

A
Finger extension and flexion
Finger abduction
Opposition and abduction of thumb
Wrist flexion and extension
Elbow flexion and extension
Shoulder abduction and adduction
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7
Q

What are the upper limb reflexes you test?

A

Biceps, triceps, supinator, finger jerk

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8
Q

How do you test lower limb tone?

A

Roll the knee sideways and backwards

Flex and extend the knee

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9
Q

How do you test for clonus in the the lower limb?

A

Sharply dorsiflex foot, bend knee, hip externally rotated

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10
Q

What movements do you test for power in the lower limb?

A
Hip flexion/extension
Knee extension/flexion
Hip abduction and adduction
Extension of the big toe
Eversion/Inversion
Dorsi/plantarflexion
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11
Q

What lower limb reflexes do you test?

A

Knee, ankle, plantar

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12
Q

How do you test the achilles/ankle reflex?

A

Foot slightly dorsiflexed, hip externally rotated, knee bent

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13
Q

How do you try to elicit a deep reflex?

A

Reinforce by clenching teeth or grasp fingers

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14
Q

How do you test abdominal reflexes?

A

Draw a blunt object over the four quadrants

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15
Q

How do you test finger-nose coordination?

A

Repeatedly touch nose and examiners finger
Repeat with eyes closed
Move finger side to side/up and down

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16
Q

How do you test heel-shin coordination

A

Run heel down front of opposite leg

Repeat with eyes closed

17
Q

How do you test for dysdiadochokinesis?

A

Put the back of the hand on the other

Repeatedly pronate/supinate

18
Q

How do you test for drift?

A

Close eyes and extend arms

19
Q

How do you perform Romberg’s test?

A

Stand with feet together and arms closed (be ready to catch)

20
Q

How do you test light touch, perception of pain, perception of vibration?

A

Light touch: cotton wool
Pain: Neurotips
Vibration: 128Hz tuning fork on bony points

21
Q

How do you test finger/hallux proprioception?

A

Stabilise proximal interphalangeal joint and move phalanx up and down
Ask them to identify up/down with eyes closed

22
Q

How do you test proprioception of joint position?

A

Ask patient to touch the digit of one hand with another with eyes closed
Move limb into position and ask them to mimic the position on the opposite side