Motor Exam Overview
The motor exam focuses on body position, involuntary movements, muscle characteristics, and coordination.
Inspect muscles for accessory movements, tremor, fasciculations, etc.
Bulk
- compare size and contours of muscles, looking for atrophy
- pay particular to hands (thenar and hypothenar eminences, interosseus muscles), shoulders, and thighs
Tone
Muscle tone is the residual tension when a muscle is voluntarily relaxed. Testing tone is actually looking for a subtle reflex.
- marked floppiness suggests hypotonic/flaccid muscles
- spacticity is increased resistance that varies, being worse at the extremes
- rigidity is
Do a fairly large arc, going fast
Increase tone by encouraging movement on the opposite side
Strength
On a 0-5 scale (add pluses or minuses)
- 0 - no contraction detected
- 1 - barely detectable flicker or trace of contraction
- 2 - active movement without gravity
- 3 - movement against gravity
- 4 - movement against gravity and some resistance
- 5 - full strength