UL MOTOR EXAM

Question 0

Tone?

Answer 0

Clonus (UMN)
Increased (UMN) or normal tone…no such as thing as “lower.”

Cogwheel rigidity (Parkinson’s tenor superimposed on increased tone!)

Question 1

Inspection?

Answer 1

Wasting (LMN lesion)
Fasciculations, flick muscle (LMN)

Tremors (resting)

Well?

Question 2

Power?

Answer 2

Shoulder abduction (C5)
Elbow flexion (C6) 
Elbow extension (C6) 
Wrist extension (C7) 
Wrist flexion 
Finger extension (C7) 
Finger flexion (C8) 
Spread finger (T1) 

Grade

• 5: against resistance
• 4: weak resistance
• 3: against gravity
• 2: gravity removed, side to side
• 1: flicker of muscle contraction
• 0: nothing

Question 3

Reflexes?

Answer 3

Biceps (C5/C6)
Supinator (C5/C6)
Triceps (C6/C7)

+ flicker (LMN)
++ normal
+++ exaggerated (UMN)

Question 4

Co-ordination?

Answer 4

Finger-nose -> intention tremor (cerebellar lesion), past-pointing (dysmetria) -> cerebellar lesion

Dysdiadokinesis -> cerebellar lesion

Question 5

Sensation?

Answer 5

LT
PAIN

Test distally, only if abnormal move up

• PROPRIOCEPTION
• VIBRATION
• TEMPERATURE