Neurology Book



Motor Exam

Aka: Motor Exam, Strength Grading, Muscle Strength, Myotomes, Motor Nerve, Motor Root, Motor Neurons, Motor Strength, Rapid Extremity Motor Exam
  1. See Also
    1. Upper Motor Neuron Lesion
    2. Lower Motor Neuron Lesion
  2. Types
    1. Upper Motor Neuron Lesion (everything is UP - tone, reflexes, toes)
      1. Muscle group weakness (not complete paralysis) and minimal muscle atrophy
      2. Increased muscle tone ("Clasp-knife" spasticity)
      3. Hyperreflexia with or without Clonus
      4. Babinski reflex positive response
    2. Lower Motor Neuron Lesion (everything is DOWN - tone, reflexes, toes)
      1. Flaccid Paralysis
      2. Muscular atrophy
      3. Muscle fasciculations and fibrillations
      4. Hyporeflexia
      5. Absent Babinski reflex
  3. Exam: Muscle Strength Grading
    1. Grade 0: Total Paralysis
    2. Grade 1: Palpable or visible contraction
    3. Grade 2: Full range of motion with gravity eliminated
    4. Grade 3: Full range of motion against gravity
    5. Grade 4: Full range of motion with decreased strength
    6. Grade 5: Normal Strength
    7. NT: Not testable
  4. Exam: Rapid Extremity Motor Exam (Common Extremity Motor deficits)
    1. Upper extremity
      1. Radial Nerve (C5-C6, C7-C8): Wrist Drop
        1. Dorsiflexion wrist, fingers against resistance (extensor carpi radialis, extensor digitorum)
      2. Median Nerve (C7, C8, T1): Cannot make 'OK' Sign
        1. Opposition of thumb and index finger against resistance
      3. Ulnar Nerve (C8-T1): Claw Hand
        1. Finger abduction against resitance
    2. Lower extremity
      1. Femoral Nerve (L1-L4)
        1. Hip flexion against resistance (Iliopsoas muscle)
      2. Sciatic Nerve (L5-S2)
        1. Knee flexion against resistance (Hamstring muscles)
      3. Deep Peroneal Nerve (L4-L5): Foot drop
        1. Dorsiflexion against resistance (tibialis anterior muscle)
      4. Tibial Nerve (S1-S2)
        1. Plantar flexion against resistance (gastrocnemius muscle, soleus muscle)
  5. Exam: Upper Extremity Strength
    1. C2-C4: Spontaneous Breathing
    2. C3-4: Trapezius function
    3. C5: Shoulder External Rotation (Infraspinatus)
    4. C5: Deltoid and Supraspinatus abduction at Shoulder
    5. C6: Biceps Flexion at Forearm
    6. C6: Wrist Extension (extensor carpi radialis)
    7. C7: Wrist Flexion
    8. C7: Elbow Extension (Triceps)
    9. C7: Finger Extension
    10. C8: Thumb Extension and Adduction
    11. C8: Wrist Extension and incline ulnar aspect of hand (Extensor Carpi Ulnaris)
    12. C8: Fingers Flexion middle finger (flex dig profundus)
    13. T1: Small finger abductors (abductor digiti minimi)
    14. T1: Interossei - Spread Fingers
  6. Exam: Lower Extremity Strength
    1. L2-3: Hip flexors (Iliopsoas)
    2. L3-4: Knee Extension (Quadriceps)
    3. L4: Ankle dorsiflexion (tibialis anterior)
    4. L4: Anterior Tibial - Foot Inversion
    5. L5: Great toe extension (Extensor hallucis longus)
    6. L5: Foot dorsiflexion (Extensor digitorum longus)
    7. L5: Weak heel walking, foot drop
    8. S1: Ankle plantar flexors (Gastrocnemius, Soleus)
    9. S1: Toe walking
    10. S1: Foot Eversion

Structure of myotome (C0231043)

Concepts Embryonic Structure (T018)
SnomedCT 5898009
English myotome, myotomes, Myotome, Structure of myotome (body structure), Structure of myotome, Myotome, NOS
Spanish estructura del miótomo (estructura corporal), estructura del miótomo, miótomo
Derived from the NIH UMLS (Unified Medical Language System)

Motor testing (C0430740)

Concepts Diagnostic Procedure (T060)
SnomedCT 164837008, 141998009, 34118006
English Musculo-skeletal test NOS, motor test, motor tests, motor testing, Musculo-skeletal test NOS (procedure), Locomotor test, Motor testing (procedure), Motor testing, Motor testing, NOS
Spanish prueba para el sistema musculoesquelético, SAI, prueba para el sistema musculoesquelético, SAI (procedimiento), Musculo-skeletal test NOS, prueba musculoesquelética, SAI, examen motor (procedimiento), examen motor
Derived from the NIH UMLS (Unified Medical Language System)

Motor nerve (C0501384)

Definition (FMA) General anatomical term applied to nerves in which somatic efferent nerve fibers predominate.
Concepts Body Part, Organ, or Organ Component (T023)
English Motor nerve, Nervus motorius, motor nerves, motor nerve, nerve motor
Derived from the NIH UMLS (Unified Medical Language System)

Muscle Strength (C0517349)

Definition (MSHCZE) Síla vytvořená svalovou kontrakcí (SVALY – KONTRAKCE). Svalová síla může být změřena v průběhu izometrické, izotonické nebo izokinetické kontrakce svalu buď manuálně nebo zařízením na měření SVALOVÉ SÍLY – DYNAMOMETRem. R
Definition (CSP) force exerted by a muscle, as a response parameter (e.g. bioassay) or as an indicator of health, endurance, fitness, etc.
Definition (MSH) The amount of force generated by MUSCLE CONTRACTION. Muscle strength can be measured during isometric, isotonic, or isokinetic contraction, either manually or using a device such as a MUSCLE STRENGTH DYNAMOMETER.
Concepts Organ or Tissue Function (T042)
MSH D053580
English Muscle strength, Muscle Strength, Strength, Muscle, muscle strength, strength muscle
Portuguese Força Muscular
Spanish Fuerza Muscular
Italian Forza muscolare
German Muskelkraft
French Force musculaire, Force du muscle
Swedish Muskelstyrka
Finnish Lihasvoima
Czech svaly - síla, svalová síla
Polish Siła mięśni, Wytrzymałość mięśni
Croatian Mišićna snaga
Norwegian Muskelstyrke, Muskelkraft
Derived from the NIH UMLS (Unified Medical Language System)

Motor root (C2339332)

Concepts Classification (T185)
English Motor root
Derived from the NIH UMLS (Unified Medical Language System)

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