Examination Of The Motor System (handout based) Flashcards Preview

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Initial inspection of Body Contours, Posture and Gait

* Motor examination begins the moment the patient walks into your clinic
* Have the patient undress
* Determine the patient’s gestalt, somatotype or body build
* Inspect the size and contour of muscles

1

steadiness and verticality of the standing posture

Station

2

Walking is also known as

Gait

3

muscles are strongest when tested from the shortest position

Length - strength principle

4

muscles which support the standing posture against collapse by pull of gravity

Anti - gravity muscle principle

5

Grading of strength testing

0 - No contraction
1 - A flicker or trace of contraction
2 - Active movement with gravity eliminated
3 - Active movement against gravity
4 - Active movement againstgravity and moderate resistance
5 - Normal power

6

Muscular resistance apart from gravity or joint disease the examiner feels when manipulating a patient’s resting joint

Muscle Tone

7

Muscle tone is due to:

* Elasticity of the muscle
* Number and rate of motor discharges

8

Initial catch or resistance and then a yielding when the examiner manipulates the patient’s resting extremity

Spasticity

9

Increased muscular resistance felt throughout the entire range of movement when the examiner slowly manipulates a patient’s resting joint

Rigidity

10

Resistance equal in degree and range that the patient presents to the examiner as he tries to move a part in any direction

Paratonia

11

Decreased resistance

Flaccidity

12

Increased range of motion of the joint movement (i.e hyperextensible knees or flaccid heel cords)

Flaccidity

13

Grading of MSR (muscle stretch reflex)

0 - Areflexia
1 - Hyporeflexia
2 and 3 - Normal
4 and 4+ - Hypereflexia

14

Superficial (plantar) Reflexes: Move an object along the lateral side of the foot

chaddock

15

Superficial (plantar) Reflexes: Squeeze hard on the Achilles tendon

Schaeffer

16

Superficial (plantar) Reflexes: Press your knuckles on the patient’s shin and move them down

Oppenheim

17

Superficial (plantar) Reflexes: Squeeze the calf muscles momentarily

Gordon

18

Superficial (plantar) Reflexes: Make multiple light pinpricks on the dorsolateral surface of the foot

Bing

19

Superficial (plantar) Reflexes: Pull on the 4thtoe outward and downward for a brief time and release suddenly

Gonda, Stransky

20

Paralyzes movements in hemiplegic, quadriplegic distribution, not individual muscles

UMN Lesion

21

Atrophy of disuse

UMN Lesion

22

Hyperactive MSRs; (+)Clonus, Clasp-knife spasticity; (+) Extensor Toe Sign

UMN Lesion

23

Paralyzes individual muscles or sets of muscles in root or peripheral nerve distribution

LMN Lesion

24

Atrophy of denervation

LMN Lesion

25

Hypoactive MSRs; Hypotonia; (+) Fasciculationsand Fibrillations

LMN Lesion

26

Are sensorimotor functions that are lost after a neurologic lesion (i.e. loss of movement, loss of vision)

Deficit phenomenon

27

Are sensorimotor functions that become increased or first emerge after a neurologic lesion (i.e. hyperactive MSRs, Babinski sign); The lesion has interrupted inhibitory connections

Release phenomenon

28

rhythmic oscillations of a body part

Tremor

29

incessant, random, quick movement

Chorea

30

slow, writhing movement of fingers and extremities

Athetosis

31

prolonged slow, alternating contraction and relaxation of agonist and antagonist muscles

Dystonia

32

violent flinging movements of one half of the body

Hemiballismus

33

quick, lightning-fast movements of face and upper extremties

Ticks