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3 NERVOUS SYSTEM > PRACTICAL: Motor System EXAMINATION > Flashcards

PRACTICAL: Motor System EXAMINATION Flashcards

1
Q

Motor System Examination POINTS
🧠⚡The:ABCDEFG ⚡

A
  1. Tone Assessment
  2. Attitude of the limb
  3. Bulk of the muscle
  4. CoorDination
  5. Examination of POWER
  6. reFlexes
  7. Gait
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2
Q

Attitude
Define

A

Position of the limb which it adopts when the patient is in RESTING POSITION

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3
Q

Attitude of UPPER LIMB IN HEMIPLAGIA

A
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4
Q

Lower LIMB Attitude in HEMIPLEGIA

A

⭐ EXTENDED at HIP and Knee
⭐ Externally Rotated at HIP
⭐ FOOT INVERTED
⭐ PLANTAR FLEXED

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5
Q

Erb’s Paralysis

A
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6
Q

PARAPLEGIA ATTITUDE

A
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7
Q

PLEGIAs

A
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8
Q

Wasting is considered if

⭐ Reduction in Dominant Extremity

⭐ Reduction in Non-Dominant Extremity

A

Wasting is considered if

⭐ Reduction in Dominant Extremity
> 1cm

⭐ Reduction in Non-Dominant Extremity
> 2cm

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9
Q

Measurements of circumference is done at
🧠⚡Paties: ₹18 ⚡

A

⭐ 10cm below OLECRONON
⭐ 10cm above MEDIAL EPICONDYLE of HUMERUS
⭐ 18cm ABOVE the PATELLA
⭐ 10cm BELOW the TIBIAL TUBEROSITY

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10
Q

Pseudo-HYPERTROPHY
Cause?
6 CAUSES

A

⭐ ⭐ INCREASED FAT IN MUSCLE
CAUSES:
1. DUCHENE’S MUSCULAR DYSTROPHY
2. BECKER’S MUSCULAR DYSTROPHY
3. HOFFMAN DISEASE
4. KOCHER-DEBRE-SEMELAIGNE Syndrome
5. MYOTONIA CONGENITA: THOMSEN’S DISEASE
6. STORAGE DISORDERS
7. Juvenile SMA Type 2: KUGELBERG WELANDER DISEASE

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11
Q

Hypothyroidism
➕
Pseudo-HYPERTROPHY
In Adults?
🧠⚡ MAN is adult⚡
In Children?
🧠⚡KOCH in malyalam = Child ⚡

A
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12
Q

Kocher Syndrome
Synonyms

A

⭐ Kocher-Debre-Semelaigne Syndrome
⭐ Infantile HERCULES Syndrome

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13
Q

True MUSCULAR HYPERTROPHY

A

Exercise

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14
Q

Localised MUSCLE SWELLING
HAMo TRC

A

⭐ HEMORRHAGE in the muscle
⭐ MYOSITIS OSSIFICANS
⭐ ABSCESS
⭐ TUMOR
⭐ RUPTURE of Muscle
⭐ CYST (CYSTICERCOSIS)

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15
Q

Generalized MUSCLE WASTING
Seen in
🧠⚡MAT²CH- Aids ⚡

A
  1. Malignancy
  2. Cachexia
  3. TB
  4. Thyrotoxicosis
  5. Addison’s Disease
  6. HIV/AIDS
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16
Q

PROXIMAL MUSCLE WASTING
Seen in

A

⭐ MOTOR NEURON DISEASE
⭐ MUSCULAR DYSTROPHY
⭐ INFLAMMATORY MYOPATHIES: Polymyositis, etc
⭐ PLEXOPATHIES
⭐ AXILLARY NEUROPATHY (LARGE FIBER NEUROPATHY)

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17
Q

Inflammatory MYOPATHIES

A

⭐ Polymyositis
⭐ Dermatomyositis
⭐ Inclusion Body MYOSITIS
⭐ Autoimmune NECROTIZING MYOPATHIES (AINM)

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18
Q

DISTAL MUSCLE WASTING
Seen in:

A

⭐ ANTERIOR HORN CELL DISEASE: Polio, MND
⭐ Syringomyelia, Intramedullary tumours
⭐ Small Fibe Peripheral POLYNEUROPATHY
⭐ Myotonic DYSTROPHY
⭐ Plexopathies: Lower Brachial Plexus injuries
⭐ Arthritis: Rheumatoid
⭐ Disuse ATROPHY

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19
Q

HAND MUSCLE WASTING

A
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20
Q

SPLIT HAND SIGN
Seen in

A

AMYOTROPIC LATERAL SCLEROSIS

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21
Q

TONE
Define

A

⭐ RESISTANCE FELT DURING PASSIVE JOINT MOVEMENT

⭐ Partial state of Contraction of the muscle at REST which is demonstrated by RESISTAMCE OFFERED BY MUSCLE TO Passive Movement across the joint

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22
Q

TONE assessment is done in

A

⭐ UPPER LIMB (Wrist and Elbow joint)

⭐ LOWER LIMB (KNEE and ANKLE joint)

23
Q

⭐ TONE of BICEPS is assessed during

⭐ TONE of TRICEPS is assessed during

A

⭐ TONE of BICEPS is assessed during
✨ EXTENSION

⭐ TONE of TRICEPS is assessed during
✨ FLEXION

24
Q

Tone is dependent on

A

VELOCITY-DEPENDENT

25
Q

Tone of the muscle is DUE TO:

A

⭐ Integrity of REFLEX ARC
⭐ LOW FREQUENCY and ASYNCHRONOUS Discharge of GAMMA- MOTOR NEURONS

26
Q

⭐ Rate of GAMMA-MOTOR NEURON Discharge is LOW

⭐ Rate of GAMMA-MOTOR NEURON Discharge is HIGH

A

⭐ HYPOTONIC

⭐ HYPERTONIC

27
Q

TONE OF HIP is checked by

A

Rolling the THIGH Side-to-side

28
Q

Erb’s PARALYSIS
🧠⚡ADIR: Prone ➡️ POSITION OF LIMBS ⚡

A

Policeman Hand Deformity
Adduction ➕ INTERNAL ROTATION ➕ Pronation

29
Q

TONE OF KNEE joint is checked by

A

METHOD1:
Place hands behind the patient’s knee and lift the leg in a sudden motion
⬇️
Observe if HEEL Drags along the BED
⬇️
Represents NORMAL TONE

METHOD 2:
DO FLEXION AND EXTENSION OF THE KNEE JOINT

30
Q

HYPERTONIA OF KNEE is checked by

A

Foot does not make contact with the BED after the maneuver

31
Q

TONE OF WRIST is checked by

A

Do Flexion and Extension at WRIST JOINT
⬇️
Do Circular Motion of the WRIST

32
Q

TONE OF ELBOW JOINT is checked by

A

⭐ Flexion and Extension
⭐ Supination and Pronation of Forearm

33
Q

TONE OF ARM is checked by

A

⭐ Flexion and Extension of Shoulder Joint
⭐ Adduction and Abduction of Shoulder

34
Q

HYPOTONIA

A
35
Q

Causes of HYPOTONIA

A
  1. LMN Lesion
    -motor side of reflex arc affected
    -sensory side
    -combined motor ➕ sensory
    -lesion of Muscles
    -lesion of NMJ
  2. Stage of NEURONAL SHOCK in UMN lesion
  3. Cerebellar lesions
  4. Chorea
  5. Periodic Paralysis
  6. REM SLEEP
  7. BZD overdose
  8. Neuromuscular blockers
  9. HYPOTHYROIDISM
  10. DOWN Syndrome
  11. HYPERMAGNESEMIA
36
Q

Types of HYPERTONIA
SPASTICITY vs RIGIDITY
🧠⚡ Rigidity has Extra R⚡
🧠⚡ Gamma motor excess common for both ⚡

A
37
Q

Causes of SPASTICITY

A
38
Q

Causes of HYPERTONIA

A
  1. SPASTICITY
  2. Rigidity
  3. TETANUS
  4. SEIZURES (TONIC PHASE)
  5. TETANY
  6. CATATONIA
  7. PARATONIA
    -Geganhalten
    -Mitgehen
  8. Strychnine poisoning
39
Q

Fasiculations vs FIBRILLATION

A

Fasiculations seen in : Motor neuron or Axonal DEGENERATION

FIBRILLATION : Anterior Horn cell diseasea

40
Q

Causes of Fasiculations

A
  1. Amyotrophic Lateral Sclerosis
  2. SMA
  3. Post POLIO Syndrome
  4. HyperThyroidism
  5. Organo phosphorus poisoning
  6. Atropine, Lithium
  7. Mercury
  8. Benign Fasiculations
41
Q

Myotonia
Meaning

A

Muscle contraction continues beyond the period of time required for a particular movement, there is FAILURE of Normal Muscle Relaxation

✨ CONTINUED, INVOLUNTARY MUSCLE CONTRACTION EVEN AFTER CESSATION OF VOLUNTARY EFFORTS

42
Q

MYOTONIA is Best seen in Muscles of

A

Face : continued smiling
Hand : Delay in relaxation of grip

43
Q

Myokymia
Seen in

A

Continuous RIPPLING/VERMICULAR movement of a group of muscle fibers that can be seen in NEUROPATHIES

✨ GBS
✨ Plexopathies
✨ Isaac Syndrome

44
Q

Cause of MYOTONIA

A
  1. Myotonic Dystrophy Type 1 and 2
  2. MYOTONIA Congenita
  3. Paramyotonia Congenita
  4. Hyperkalemic Periodic Paralysis
45
Q

Clasp Knife Phenomena

A

Increased TONE only during the INITIAL PHASE
⬇️
After a point
⬇️
SUDDEN LOSS OF TONE

46
Q

Muscles involved in SPASTICITY

A

Antigravity MUSCLES
⭐ Upper Limb: FLEXORS
⭐ Lower Limb: EXTENSORS

47
Q

SUPINATOR CATCH seen in

A

SPASTICITY
Supination-Pronation of the forearm will reveal it

48
Q

Klumpke’s PARALYSIS
🧠⚡FESs High ⚡
🧠⚡ Klump = clamp = Holding tree⚡

A

Elbow Flexed ➕ Supinated Forearm
➕ U/L HORNER SYNDROME

49
Q

Erb’s Palsy root value

A
50
Q

CATATONIA

A

Altered tone of the muscle in
⭐ B/L FRONTAL LOBE DYSFUNCTION
⭐ DIFFUSE CEREBELLAR DISORDERS

51
Q

Oppositional CATATONIA
(OR)
Gegenhalten

A

Subject involuntarily RESIST PASSIVE MOVEMENTS

52
Q

FACILITATORY PARATONIA
(OR)
MITGEHEN

A

Subject involuntarily assists PASSIVE MOVEMENT

53
Q

Qualitative Assessment of POWER or WEAKNESS by

A

MRC Grading

54
Q

MRC Grading of POWER of Muscle

A

Grade 0- No contraction
Grade 1- Flicker or trace of contraction
Grade 2- Active movement, with gravity eliminated
Grade 3- Active movement against gravity
Grade 4- Active movement against gravity and resistance
Grade 5- Normal power

Grades 4- : movement against slight resistance
Grades 4 :movement against moderate resistance
Grades 4+ :movement against Strong resistance

3 NERVOUS SYSTEM (40 decks)

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