Motor Check Study Resources

MOTOR CHECK 1. Observation 2. Assessment of agility 3. voluntary movement 4. Assessment of muscle status MUSCLE ATROPHY • Neurogenic Atrophy - AHC lesion - Infranuclear lesions • Myogenic Atrophy • Artogenic Atrophy • Disuse Atrophy CHANGES IN SHAPES - Paralysis & Atrophy - Pyramidal cortex lesions - Congenital hemiatrophy • Winged Scapula trapezius + serratus anterior • Drop Hand • Drop Foot • Monkey Hand • Claw Hands • Claw Foot MUSCLE HYPERTROPHY • Pure Hypertrophy • Pseudohypertrophy FACICULATIONS • Spontaneous Fasciculations – Irritation/degeneration of AHC neurons – Irritation/degeneration of motoneuron axons – Fatigue/mental tension • Fasciculations During Movement • Myoclonia a. certain families b. infectious disease HARD MUSCLE CONSISTENCY • Hard Muscles: a. Spasm d. Rigidity b. Muscle pathology e. Contracture c. Spasticity • Flabby Muscles • LMN lesions can be in the axons or in the motor plate MUSCLE PRESSURE PAIN MUSCLE TONE • 'Head drop' test • 'Arm swing' test • Test shaking your hands • 'Drop arm' test • The limb swaying test according to Wartenberg • 'Falling limb' test MUSCLE STRENGTH MMT REFLEX EXAMINATION • Masseter reflex • Biceps Brachial Tendon Reflex (C.5-6) • Radial Periosteum Reflex (C.5-6) • Triceps Reflex (C.6-7-8) • Ulnar Periosteum Reflex (C.8, T.1) • Pectoral Reflex (C.5, T.1) • Abdominal Wall Muscle Reflexes: - Upper (T.8-9) – Middle (T.9-10) – Bottom (T.11-12) • Knee Tendon Reflex (L.2-3-4) • Biceps Femoris Reflex (L.4-5, S.1-2) • Achilles Tendon Reflex • Knee Clonus • Foot Clonus PATHOLOGICAL REFLEXES • Extensor Plantar Response (Babinski) – Chaddock reflex: scratches on the lateral dorsum pedis. – Oppenheim reflex: optimal distal contraction of the tibia. – Gordon reflex: squeezes the calf hard. – Scaeffer reflex: squeezes the Achilles tendon. – Gonda reflex: maximal plantar flexion of the fourth finger. – Bing reflex: prick stimulation of the 5th metatarsal skin. Pathological Reflexes in the Hands – Tromner reflex: pokes the tip of the middle finger, the thumb and other fingers are flexed. – Hoffmann's reflex: middle finger nail scratches, others flex. – Wartenberg reflex: tapping on the second and distal flexor fingers, a flexion movement of the fingers will occur. – Mayer's reflex: bends the middle finger towards the palm. Normal Thumb opposition. If there is no damage to the pyramidal system, then there is no opposition. – Leri reflex: wrist flexes. Normally the elbow will be flexed. If the pyramid is damaged, it will not flex. Pathological Reflexes Mark Regression • Suck Reflex: touching the lips; response to movements of the lips, tongue, jaw such as sucking. • Snout reflex: percussion of the upper lip, contraction of the muscles of the protruding lips. • Holding Reflex: pressing on the palms, hands clenched into fists. • Palmometal reflex: scratching of the thenar part of the palm, muscle contraction m. ipsilateral mentalis and orbicularis oris. • Tonic Neck Reflex: head turned to the side. MILD paralysis • Hand Pronation Test – Signs of pronation according to Strumpell: elbow flexion will cause a pronation movement if there is UMNL. – The hand raising test is like a prayer movement. • Arm Deviation Test: straighten both arms horizontally in front. • Leg position tilted to the side / not symmetrical • Leg Signs According to Barre: face down position, both legs bent. • Wartenberg Knee Test: lie on your back, knees bent. INVOLUNTARY MOVEMENT 1. Tremors – Physiological: healthy people tremor when performing slow agile movements. – Essential Heredofamiliar: usually only found on the arms, sometimes the lips, tongue, head and lower jaw. – Parkinson's disease – Iatrogenic: due to medication/person's own personality – Metabolic: due to toxic metabolic substances. - Cerebell 2. TIC – Benign: habitual (bad) spasms that arise suddenly, quickly, involuntarily and as bursts of muscle contractions. – Gilles De La Tourette: harder than benigna. 3. Spasmus – Idiopathic hemifacialis: lesions in the facial canal – Hemifacialis Post Pareses n. Facialist – Reflector hemifasalis: there is a correlation between the closing of the eyelids due to infection or the corpus alenium in the eyeball 4. Dyskinesia and Dystonia – Choreatic movement – Athetoid movements – Hemibalismus 5. Non-Epileptic myoconia. Involuntary movements that arise suddenly are arrhythmic for a moment and can occur repeatedly. DISCOORDINATIVE MOVEMENTS • When Standing – Cerebellar stance = broad base stance – Romberg test – Decomposition of attitude Normally standing up from sitting, bending the body, bending the knees, standing up straight. • On Running Time • Making Movements: Asymmetry or Dysmetria – Index-nose test – Nose-index-nose test – Finger test – Heel-patella-big toe test – Dysdiadochokinesia test is effective. to make quick movements intermittently. – Test doing attitude – Reflector hemifasalis: there is a correlation between the closing of the eyelids due to infection or the corpus alenium in the eyeball