Motor Examination

Question 1

Primary impairments can affect what?

Answer 1

• motor
• sensory/perceptual
• cognitive/behavioral systems

Question 2

What are secodonary impairments?

Answer 2

Not a direct result of nervous system lesion
develops as a result of the orignal problem

Question 3

What does a motor examination consist of?

Answer 3

• muscle strength
• muscle tone
• voluntary movement

Question 4

Why would muscles be hypertrophied?

Answer 4

Due to overuse or specific to some neurlogic disorders

Question 5

Why would muscles be atrophied?

Answer 5

secondary to weakness, inactivity, or tissue destruction

Question 6

What does asymmetry in muscle size suggest?

Answer 6

unilateral problem such as mononeuropathy or stroke

Question 7

What does bilateral changes in muscle size suggest?

Answer 7

Associated with systemtic disorder such as MS or Parkinson’s disease

Question 8

What are the components of motor examination? (6)

Answer 8

• muscle bulk
• muscle tone
• selective motor control
• muscle strength
• muscle endurance
• motor coordination

Question 9

Muscles that look flat or concave indicate what?

Answer 9

Muscle atrophy

Question 10

How do hypotonic muscles feel?

Answer 10

soft and flabby

Question 11

How do hypertonic muscles feel?

Answer 11

Taut and harder than normal

Question 12

What test has this purpose?

• muscles are inspected for bulk and fasciculations and when inidcated palpated for tenderness, consistency, and contractures
• looking for disparity in muscle size

Answer 12

Muscle bulk

Question 13

In muscle bulk test more severe atrophy indicates what?

Answer 13

LMN lesion (nuerogenic atrophy)

Question 14

In muscle bulk test less severe atrophy indicates what?

Answer 14

UMN lesion or disuse

Question 15

Muscle tone examination consists of what two things?

Answer 15

Resting posture and passive motion testing

Question 16

In muscle tone examination passive motion testing reveal what type of information?

Answer 16

Responsiveness of muscles to stretch

Question 17

What do these following factors influence?

• volitional effort and movement
• anxiexy and pain
• position and interaction of tonic reflexes
• medications
• general health
• ambient temperature
• state of CNS arousal or altertness

Answer 17

Factors influencing the state of muscle tone

Question 18

Why is the optimal positioning of muscle tone supine?

Answer 18

Test should be examined when there is absence of voluntary control

Question 19

What is the following tonic neck reflex called?

Head rotation to the right or left resulting in limbs on the nose side extend and the limbs on the skull side to flex

Answer 19

asymmetric tonic neck reflex

Question 20

What is the following tonic neck reflex called?

Flexion of the upper limbs and extension of the lower limbs when neck is flexed and the opposite pattern in the limbs when the neck is extended

Answer 20

Symmetric tonic reflex

Question 21

What is the following tonic neck reflex called?

tilting the head back or forward

Answer 21

Tonic labyrinthine reflex

Question 22

In tonic labyrinthine reflex what happens when the head is titled backwards

Answer 22

Causes flexion of the upper limbs and extension of the lower limbs

Question 23

In tonic labyrinthine reflex what happens when the head is tilted forward

Answer 23

Elicits extension of the upper limbs and flexion of the lower limbs

Question 24

Where should the hand placement of testing ROM and muscle tone be?

Answer 24

Bony prominences and avoid contact with muscles

Question 25

What position are spastic lower extremities held in when in supine position?

Answer 25

Held in extension, adduction with PF, and inversion

Question 26

When in supine if lower limbs appear floppy and lifeless (abducted and ER) what does this indicate?

Answer 26

Hyptonicity

Question 27

How is muscle tone tested?

Answer 27

Passively elongated the target muscle at both slow and fast velocities

Question 28

What do hypertonic muscle tone limbs feel like?

Answer 28

stiff and resistant to movement

Question 29

What do flaccid muscle tone limbs feel like?

Answer 29

heavy and unresponsive

Question 30

In a spastic limb resistance may be near normal when slowly moved but what happens when limb is moved faster

Answer 30

Resistance increases

Question 31

# What type of muscle resistance to passive elongation is this? complete absence of resistance to elongation

Answer 31

Flaccid

Question 32

# What type of muscle resistance to passive elongation is this? decreased resistance to elongation

Answer 32

Hyptonia

Question 33

# What type of muscle resistance to passive elongation is this? mild and appropriate resistance to elongation

Answer 33

Normal

Question 34

# What type of muscle resistance to passive elongation is this? - increased resistance to elongation with faster stretch - more predominant on one side of the effected joints - both agnoists/antagonists - more obvious toward end range when muscle is on max stretch

Answer 34

Spastic hypertonia

Question 35

# What type of muscle resistance to passive elongation is this? - increases resistance to elongation that does not increase with slow or faster stretch - present both sides of the joint thorughout the range - cogwheel or leadpipe

Answer 35

Rigid hypertonia

Question 36

What is the interpretation of resting muscle tone testing

Answer 36

- differentiates between UMN and LMN - Help differentiate between hypertonia, normal, and hyptonia

Question 37

What is the interpretation of rigidity testing?

Answer 37

- feeling constant resistance of speed and direction - cogwheel rigidty and leadpipe rigidity

Question 38

# What rigidity testing interpretation is the following? tension in a muscle that gives way in little jerks when the muscle is passivley stretched

Answer 38

Cogwheel rigidity

Question 39

# What rigidity testing interpretation is the following? 'smooth' rigidy in flexion & extension that continues through the entire end range of a stretched muscle

Answer 39

Lead pipe rigidity

Question 40

# What is this scale? used to assess muscle spasticity in pt with lesions of the CNS and is commonly used in many rehab facilites

Answer 40

Modified Ashworth Scale

Question 41

# What test is the following an interpretation of? - higher the number on the MAS the greater the degree of spasticity - excessive resistance to velocity-dependent stretch may be a sign of UMN

Answer 41

Modifed Ashworth Scale

Question 42

Pt with UMN lesions may have impaired what?

Answer 42

Selective movement

Question 43

# What type of selective motor control movement is this? voluntarily activiating only the intended specific muscle groups without any extraneous or unintended movements at releated joints

Answer 43

Isolated movement

Question 44

# What type of selective motor control movement is this? ability of the pt to move the target joint through very small fragements of the avaiable range

Answer 44

Fractionated movement

Question 45

# What is the following a defintion of? smooth, steady and flowing continuously withouth disruptions, jerks, spurts or starts throughout entire range of AROM

Answer 45

Conrolled movement

Question 46

What is it called when a pt has an inability to isolate movement at a joint?

Answer 46

Abnormal muscle synergy

Question 47

What is the interpretation of UE & LE sidelying synergy test

Answer 47

Degree of impaired selective movement

Question 48

What is the interpretatin of UE myotomes (list C5-T1 actions)

Answer 48

- weakness may indicated spinal nerve root lesion at specific nerve root levels - C5: Elbow flexion - C6: Wrist extension - C7: Elbow Extension - C8: Finger Flexion - T1: Finger Abduction

Question 49

What is the interpretation of LE mytomes? (list L2-S1 actions)

Answer 49

- Weakness may indicate spinal nerve root lesion at specific spinal nerve root levels - L2: Hip Flexion - L3: Knee Extension - L4: Ankle DF - L5: Great Toe Extension - S1: Planter Flexion

Question 50

# What is the following a defintion of? capacity of a muscle to sustain forces or to generate forces repeatedly over time

Answer 50

Muscle endurance

Question 51

# What is the following a defintion of? decline in muscle performance resulting from prolonged or sustainted use of the target muscle group

Answer 51

muscle fatigue