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