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EXAMINATION OF MOTOR SYSTEM

Observations: gait, symmetric body and the

extremities, paralysis of the body

Voluntary movement: cubiti artikulus flexion andextension, flexion and genu artikulus akstensi,

plantar flexion and dorso flexion of the foot

Palpation of muscles: the muscles, tenderness,

contractures, consistency

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Percussion muscle:-Nomal: muscle contraction on percussion

will be temporary and last only1 or 2 seconds-Miodema: hoarding that has been in place

for a moment percussion (usually inpatients with malnutrition)

-Miotonik: the percussion place becomesconcave for a few seconds due

to muscle contractions longerthan usual

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Muscle tone: ektrimitas relaxes patients ask wewill be examining.

-flaccid : there is no resistance at all (atUMN paralysis)

-Hipotoni : prisoners reduced-Spastic : prisoners increased and are at

the beginning of the movement(the paralysis UMN)

-Rigid : Strong resistancecontinuously duringmovement, eg Parkinson

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Muscle strength:With a 0-5 scale-0: Total paralysis, no slightest contraction-1: No contraction, but no joint movement

muscle-2: No muscle movement, but was unableto resist gravity

-3: Can resist gravity-4: Can cope with a bit of prisoners given-5: Normal (no paralysis)

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EXAMINATION OF SENSORY SYSTEM

Eksteroseptik sensibility or protopatik:Pain : the needleTemperature : with a warm water bottle (40-45 C and a bottle

of cold water (10-15 CTouch : cotton

Propioseptif:KinesthesiaStatesthesiaPalesthesiaBaresthesia

discriminatory:

StereognosisBarognosisTopesthesia / topognosisGramesthesiaautotopognosis

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EXAMINATION OF REFLEXES

Superficial reflexes:1. Abdominal reflex: stimulus epigastric region

of the abdominal ,supraumbilical, infra

umbilical from lateral tomedial

Response : contraction of theabdominal

2. Cremaster reflex : stimulus to the medialthigh skin from top to bottomResponse : The elevation of the

ipsilateral testis

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Physiological reflexes:

Biceps reflex; knocking on the finger probe

is placed on the tendon m. Bracii biceps,arm position half bend on the elbow joint.

Response: flexion of the arm at the

elbow joint

Afferent: n. Muskulocutaneus

Efferent: idem

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Triceps reflex: knocking on the tendon tricepsbrachii muscles, arm flexion position at the

elbow joint and a little pronation.

Response: extension forearm at theelbow joint

Afferent: n. radial

Efferent: idem

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Patellar reflex: tap on the patellar tendon.Response: extension of the lower limbs dueto contraction. femoral quadriceps

Efferent: n.femoralisAfferent: idem

Achiles reflex: a knock on the tendon AchilesResponse: plantar flexion of the foot due to

contraction. gastrocnemiusEfferent: n. tibialisAfferent: idem

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THE DEGREE OF PHYSIOLOGICAL REFLEX

RESPONSE

4 +: hyperactive and constantly klonus

3 +: hyperactivity

2 +: normal

1 +: hypoactive

0 +: no reflexes

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pathological reflexes1. Babinsky : etching foot lateral part of the

posterior to the anteriorResponse : toe extension and development

(fanning) toes2. Chaddock : etching dorsum pedis around the

lateral malleolus lateral fromposterior to anterior

Response : As babinsky3. Oppenheim : sorting crista anterior tibiaefrom proximal to distal

Response: As babinsky

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4. Gordon: calf presses are hardResponse: As babinsky

5. Schaffer: Achiles be hard pressedtendon

Response: As babinsky6. Gonda: bending (flexion plantar) toes

up to fourResponse: As babinsky

7. Stransky: bending (lateral) fifth toesResponse: As babinsky

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8. Rossolimo: pengetukan on the solesResponse: flexion of the toes on the jointinterphalangealnya

9. Mendel-bechterew: pengetukan dorsum pedis in

the area os cuboideumResponse: As rossolimo10. Hoffman: middle finger nail scratches on

patientResponse: thumb, index finger and the other

fingers reflect11. Trommer: poke the tip of the middle fingerof patients

Response: As Hoffman

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LESIONS IN THE VERTEBRAL COLUMNA

CI-C4: diaphragm and respiratory musclesdisturbed

C5: motor and sensory gangngguan the deltoid

C6: interference with biceps

C7: Triceps disorders

C8-Th1: interosseous muscle disorders, Horner'ssyndrome

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Th4: highest sensory mammary papilla

Th7: sensory-high arch of the aorta

Th10: highest sensory level of the umbilicus

Th12-L1: high sensibility disorder groin

L3: patellar tendon reflex negative

L5-S1: impaired dorsiflexion of the foot

Konus-epikonus: perianal anesthesia, bladder disorders arts,impotence, motor not so tertanggu