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DPT 752 - Neurological Rehab I > Motor Examination > Flashcards

Motor Examination Flashcards

1
Q

What are the signs of an UMN lesion?

A

Hemiplegia/hemiparesis, spastic hypertonia, hyperreflexia, clonus, Babinski sign.

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2
Q

What are the signs of an LMN lesion?

A

Paralysis/paresis, reduced tone/flaccidity, atrophy, hyporeflexia, fasciculations.

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3
Q

What is the difference between AROM and PROM?

A

AROM is active range of motion performed by the patient, PROM is passive range of motion tested by the examiner.

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4
Q

What does severe muscle atrophy indicate?

A

A lower motor neuron lesion.

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5
Q

What is hypertonia and its types?

A

Increased resistance to passive stretch, includes rigidity (basal ganglia) and spasticity (UMN).

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6
Q

What does mild muscle atrophy indicate?

A

An upper motor neuron lesion or disuse.

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7
Q

What is the purpose of a dynamometer in muscle strength testing?

A

To measure the force output of muscles objectively.

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8
Q

What is a quick screen for myotomes?

A

A bilateral upper extremity (U/E) quick screen.

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9
Q

What does hypertonia suggest if found during an examination?

A

It may indicate a lesion in the upper motor neurons or basal ganglia.

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10
Q

What does hypotonia suggest if found during an examination?

A

It may indicate a cerebellum or lower motor neuron lesion.

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11
Q

What is the difference between rigidity and spasticity?

A
  • Rigidity involves increased resistance regardless of speed or direction (basal ganglia)
  • Spasticity involves velocity-dependent resistance (UMN).
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12
Q

What is the clasp knife phenomenon?

A

A type of spasticity where there is a sudden decrease in resistance during rapid movement.

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13
Q

What is decorticate rigidity?

A
  • Spasticity of antigravity muscles, causing flexion of the upper and extension lower extremities.
  • Has a GCS motor response score of 3 and 10% of pts don’t gain functional independence
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14
Q

What is decerebrate rigidity?

A
  • Spasticity of the antigravity (extensor) muscles of the entire body. Extension of upper extremity and lower extremity.
  • Equates to 2 points for Best Motor Response on Glascow Coma Scale. 35-45% of people don’t gain funtional independence
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15
Q

What is the arm dropping test?

A

A test where the arm is dropped to observe for normal muscle tone or abnormalities.

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16
Q

What is the arm drop and pendulum test used to assess?

A

A test used to assess muscle tone by observing the swinging motion of a limb.

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17
Q

How is the pronator drift test performed?

A

Hold UE in supination with 90 degrees of shoulder flexion and elbow extension for 15-30 seconds, observe for pronation or dropping.

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18
Q

What indicates hypertonic limbs during passive motion testing?

A

Stiff and resistant to movement.

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19
Q

What indicates flaccid limbs during passive motion testing?

A

Heavy and unresponsive to movement.

20
Q

What is the grading scale for deep tendon reflexes?

A
  • 0 = absent
  • 1+ = slight
  • 2+ = normal
  • 3+ = brisk
  • 4+ = very brisk
21
Q

What is the significance of testing for clonus?

A

To detect rhythmic involuntary contractions associated with reflexes.

22
Q

What is a positive Babinski sign?

A

Great toe extension and toe splaying in response to stroking the sole.

23
Q

What does severe atrophy indicate?

A

A lower motor neuron lesion.

24
Q

What does mild atrophy indicate?

A

An upper motor neuron lesion or disuse.

25
Q

What is the significance of the arm dropping test?

A

To assess muscle tone by observing the reaction of the arm when dropped.

26
Q

What is the procedure for testing deep tendon reflexes at the biceps?

A

Test at C5-C6 nerve root level.

27
Q

What is the procedure for testing deep tendon reflexes at the brachioradialis?

A

Test at C6-C7 nerve root level.

28
Q

What is the procedure for testing deep tendon reflexes at the triceps?

A

Test at C6-C7-C8 nerve root level.

29
Q

What is the procedure for testing deep tendon reflexes at the patella?

A

Test at L3-L4 nerve root level.

30
Q

What is the procedure for testing deep tendon reflexes at the Achilles?

A

Test at S1-S2 nerve root level.

31
Q

What is the purpose of goniometry?

A

To measure the range of motion in joints.

32
Q

What is the modified Ashworth scale used for?

A

To measure spasticity in patients.

33
Q

What is clonus and how is it tested?

A

A rhythmic involuntary contraction, tested by rapidly and forcefully moving the joint to end-range.

34
Q

How is passive motion testing performed?

A

The therapist supports and moves the limb, assessing resistance and responsiveness.

35
Q

What is the significance of muscle tone observation?

A

To differentiate between normal, hypertonic, and hypotonic muscle states.

36
Q

What are the common locations for deep tendon reflex testing?

A

Biceps, brachioradialis, triceps, patella, Achilles.

37
Q

How are reflexes graded on a scale of 0-4+?

A

0 = absent, 1+ = slight, 2+ = normal, 3+ = brisk, 4+ = very brisk.

38
Q

What is a superficial reflex?

A

A reflex elicited by gentle stimulation of the skin.

39
Q

What does increased resistance in passive motion indicate?

A

Hypertonia or spasticity.

40
Q

What does decreased resistance in passive motion indicate?

A

Hypotonia or flaccidity.

41
Q

What is the significance of varying speed in passive motion testing?

A

To determine the presence and extent of spasticity.

42
Q

What does a positive clonus test indicate?

A

UMN lesion and associated spasticity.

43
Q

What is the procedure for testing the plantar reflex?

A

Stroke along the lateral side of the sole, moving from heel to the ball of the foot, curving medially across the metatarsal heads.

44
Q

What hypertonia is velocity dependent, with faster velocity you will have more resistance and with slower velocity you will have less resistance; also directional dependent?

A

spastic

45
Q

What hypertonia has both sides being tighter and is not velocity or directional dependent?

A

rigidity

46
Q

what is the rigidity with continued catch and release throughout ROM? (tremor superimposed on rigidity)

A

cogwheel

47
Q

What is the rigidity that has an uniform increase in tone?

A

lead-pipe

DPT 752 - Neurological Rehab I (22 decks)

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