Week 2 nuero lab - motor testing

Myotome assessment

• How do you record?

intact, diminished, absent

Diminished: unilateral difference, can’t hold position

Myotome assessment

• UE

• LE

DTR - biceps

DTR - brachiorad

DTR - Triceps

DTR- quad

DTR - achilles

Reflexes grading

Superficial cutaneous reflexes

• Document:

• Tests integrity of:

• Abnormal response indicates:

normal or abnormal

polysynaptic reflexes

UMN/corticospinal tract involvement

Plantar/Babinski reflex

• Level:

• Technique:

• Normal:

• Abnormal:

Chaddock or Oppenheim sign

• Level:

• Technique:

• Normal:

• Abnormal:

Abdominal reflex upper & lower

• Level:

• Technique:

• Normal:

• Abnormal:

Hoffman sign

• Level:

• Technique:

• Normal:

• Abnormal:

Tone & spasticity Assessment

• How to perform

• Positive in flexion vs extension

Hypertonicity

• Spasticity vs rigidity

• Which is velocity dependent

• What does each indicate?

Spasticity - velocity dependent - UMN lesion

Rigidity - at rest - basal ganglia

Modified Ashworth Scale

• measures what?

• Grades

Coordination Assessment

• 3 areas to screen before performing coordination assessment

Cognition, sensory, strength

1. Can they see

2. Can they follow directions

3. What is normal AROM & strengths

5 main areas to focus when conducting a coordination exam are?

ability to alternate movement

synergies - abnormal - broken into parts

fixation - hold limb in certain position

accuracy - getting to target

balance

What is it called when tremor is increasing near the target

intention tremor

Make sure what before starting?

check cognition and make sure back is supported

Poor accuracy is called

over or under shooting is called

dysmetria

movement broken into components is called

dyssynergia

inability to maintain starting position indicates

impaired fixation/limb holding

impaired synergy is called

dyssynergia

impaired rapid alternation is called

difficulty rapidly reversing or sequencing movement is called?

difficulty rapidly reversing movement is called

dysdiadochokinesia

failure of antagonist to appropriately check the movement indicates?

positive rebound phenomenon (punch themselves)

Dysmetria

• Undershooting is called?

• Overshooting is called?

hypometria

hypermetria

Rhythmic oscillation while holding the posture may reveal a?

postural tremor

What is being asses for

• finger-to-nose

• finger-to-therapist-finger

• finger-to-finger

Movement accuracy

Movement composition

Fixation/limb holding

What is being tested for

• alternate nose-to-finger

Reciprocal motion

movement accuracy

movement composition

fixation/limb holding

What is being tested for

• Finger opposition

• Mass grasp

Reciprocal motion

movement composition

What is being tested for

• Pronation/supination

Reciprocal motion

movement composition

fixation/limb holding

What is being tested for

• rebound test

movement composition (synergy)

fixation/limb control

What is being tested for

• hand tapping

• foot tapping

Reciprocal motion

movement composition

What is being tested for

• Pointing/past pointing

movement accuracy

movement composition

fixation/limb holding

What is being tested for

• alternate heel-to-knee/heel-to-toe

• Toe-to-examiners finger

• heel-on-shin

• drawing a circle/figure 8

movement accuracy

movement composition

What is being tested for

• fixation/position holding

fixation/limb holding