Motor Exam

Question 1

Muscle strength quick screen

Answer 1

Resist abduction, adduction, flexion and extension at the shoulder, elbow, fingers, hip and ankle
Resist flexion and extension at elbow and knee

Question 2

Pronator Drift

Answer 2

Patient flexes both shoulders to 90 degrees, extends elbows and fully supinates both forearms and closes eyes.
Inability to maintain this position for 30 seconds, with gradual pronation and downward drift of one arm = UMN lesion

Question 3

What does more severe atrophy indicate?

Answer 3

LMN lesion

Question 4

What does less severe atrophy indicate?

Answer 4

UMN lesion or disuse

Question 5

Rigidity:

Answer 5

Excessive resistance that not does not vary with the speed of the stretch

Question 6

PROM:

Answer 6

Passively flex and extend patient’s elbow, wrist, knee, ankle and neck

Question 7

Modified Ashworth Scale 0:

Answer 7

no increase in muscle tone

Question 8

Modified Ashworth Scale 1:

Answer 8

slight increase in muscle tone, manifested by a catch or by minimal resistance as the end of ROM when the affected part(s) is moved in flexion or extension

Question 9

Modified Ashworth Scale 1+

Answer 9

slight increase in muscle tone, manifested by a catch, followed by minimal resistance throughout the remainder (less than half) of ROM

Question 10

Modified Ashworth Scale 2

Answer 10

more marked increase in muscle tone through most or ROM, but affected parts easily moved

Question 11

Modified Ashworth Scale 3

Answer 11

considerable increase in muscle tone, passive movement difficult

Question 12

Modified Ashworth Scale 4

Answer 12

affected parts rigid in flexion or extension

Question 13

Babinski sign present:

Answer 13

Babinski’s sign is present if the great toe extends, other toes may spread apart

Question 14

Location of touch:

Answer 14

DCML

Question 15

Tactile thresholds:

Answer 15

dermatone, peripheral nerve

Question 16

Two point discrimination:

Answer 16

DCML

Question 17

Bilateral Simultaneous Touch

Answer 17

a lesion in the parietal lobe contralateral to the side of the body where sensory extinction occurs.

Question 18

Graphesthesia:

Answer 18

this indicates a lesion in the contralateral parietal cortex or adjacent white matter.

Question 19

Joint Movement and Joint position

Answer 19

Errors indicate dysfunction in the peripheral nerves, spinal cord, brainstem, or cerebrum.

Question 20

Vibration:

Answer 20

large, Aβ peripheral nerve fibers and the dorsal column/medial lemniscus neurons.

Question 21

Stereognosis:

Answer 21

lesion in the contralateral parietal cortex or adjacent white matter

Question 22

Sharp prickling pain

Answer 22

lateral pain system

Question 23

Romberg test pass/fail:

Answer 23

Moving arms or feet
Opening eyes
Beginning to fall or requiring assistance

Question 24

Sensory ataxia romberg:

Answer 24

the person is able to maintain balance with EO for 30s but balance is impaired with EC

Question 25

Sharpened Romberg:

Answer 25

Same as Romberg, but with one foot in front of the other foot

Question 26

Phasic Stretch Reflex 0:

Answer 26

absent despite reinforcement

Question 27

Phasic Stretch Reflex 1+:

Answer 27

slight reflex, present but depressed, low normal

Question 28

Phasic Stretch Reflex 2+:

Answer 28

normal typical reflex

Question 29

Phasic Stretch Reflex 3+

Answer 29

brisk reflex, possibly but not necessarily abnormal

Question 30

Phasic Stretch Reflex 4+

Answer 30

very brisk, abnormal, clonus