Term
| Examination of the motor system tests what? |
|
Definition
| the integrity of the UMN pathways from layer 5 pyramidal neurons to spinal cord and then the LMN-lower motor neuron to muscle connections. |
|
|
Term
|
Definition
-A specific pattern of arm and leg weakness
-Arm is held in flexion with marked weakness of extensors of fingers, wrist and shoulder
-Hand and fingers tightly clenched with increased tone |
|
|
Term
|
Definition
-There is specific weakness of hip flexion and ankle dorsiflexion a pattern known as “UMN weakness”
-There is a swinging outwards of the leg
-There is hyperreflexia, clonus and upgoing plantar response |
|
|
Term
|
Definition
-A specific pattern of arm and leg weakness depending upon the level of spinal cord or brain injury
-Both legs appear stiff and there is toe walking (“spastic diplegia”)
-Walking appears slow and stiff and difficult and steps are small |
|
|
Term
|
Definition
-There is specific weakness of hip flexion and ankle dorsiflexion a pattern known as “UMN weakness”
-There is hyperreflexia, clonus and upgoing plantar responses bilaterally |
|
|
Term
|
Definition
-A specific pattern of LMN leg weakness
-Arm swing is normal
-If you listen you can hear the foot slapping the floor
-Patient picks up foot with conscious effort to avoid tripping over it by lifting up proximal leg |
|
|
Term
|
Definition
-There is specific weakness of ankle dorsiflexion usually from root or peripheral nerve lesion (sciatic vs. peroneal nerve) and there is “FOOT DROP”
-There is hyporeflexia, decreased tone and inspection may show atrophy/fasciculations |
|
|
Term
|
Definition
-A specific pattern of walking problem
-Patient has problem getting out of chair and finding center of gravity to start walking and will take very small steps as if feet are stuck to ground |
|
|
Term
|
Definition
-Exam will usually show cognitive impairments and there may be frontal release signs and there may be bilateral signs of CVA with
-There is hyperreflexia, clonus and upgoing plantar response but with minimal weakness seen |
|
|
Term
|
Definition
Look at muscles for:
Look for symmetry
Loss of bulk
Atrophy
fasciculations |
|
|
Term
|
Definition
-You can often feel a flaccid weak muscle before you examine it
-Inspect and palpate the bulk of hypothenar and thenar hand muscles
-Palpation often informs you whether there is increased, normal or decreased tone present |
|
|
Term
|
Definition
5 normal
4 against resistance
3 against gravity
2 not against gravity
1 trace
0 |
|
|
Term
|
Definition
-Examine pt in neutral sitting position or relaxed in bed
-usually confirmatory
-Young adults and kids have brisker reflexes and a couple of beats of clonus ok
-Asymmetry very helpful in localization
-dropped reflex to assist dx of isolated radiculopathy |
|
|
Term
|
Definition
-LMN will be in distribution of one nerve (eg ulnar nerve), root or plexus or more widespread as with ALS
-There will be more atrophy
-There may be fasciculations
-There is weakness in distribution of atrophy |
|
|
Term
|
Definition
-Reflexes are depressed or absent
-There may or may not be sensory loss
-Plantar response will be flexor
-Clonus is absent |
|
|
Term
|
Definition
-Look for UMN pattern of gait
-Inspection will suggest increased tone and only mild atrophy
-Clonus is present |
|
|
Term
|
Definition
-Strength testing will show UMN pattern of weakness (finger extensors and hip flexors and ankle dorsiflexors)
-Reflexes are hyperreflexic and plantar responses are extensor |
|
|
