Motor System Assessment
Sheeba Jacob BSN ,RN
Victorian Kim BSN ,RN
Motor System
What Is Motor System Assessment
• Motor System Assessment
• Assessment of the motor system include
evaluation of bilateral muscle strength and
coordination and balance tests. Be sure to
assess bilaterally and compare findings.
Motor system
• Inspection
• Start by looking at the patient. Do muscles
look wasted? Is there asymmetry?
• If the nurse strike the affected muscle with
a jerk hammer, it may induce fasciculation.
Motor System Assessment
findings on YouTube
• http://www.youtube.com/watch?v=z62JMY2dKjU
&feature=related
• http://www.youtube.com/watch?v=Ul6sAiJY9cA
&feature=related
• http://www.youtube.com/watch?v=UgycfWSn_0
w&feature=related
You Tube on Motor System
Assessment
• http://www.youtube.com/watch?v=UgycfWSn_0w&featur
e=related
• http://www.youtube.com/watch?v=hvkT08HYEbM&featur
e=related
• http://www.youtube.com/watch?v=15oh7rs1jE&feature=related
• http://www.youtube.com/watch?v=Ul6sAiJY9cA&feature
=related
• http://www.youtube.com/watch?v=PcZuTEwHSrw&featur
e=related
How To Examine Muscle Strength
• Examine arm and leg muscles looking for
atrophy and abnormal movements such as
tremors. For a quick check of muscle tone,
perform passive range of motion exercises
and note any resistance.
• Assess upper leg muscle strength of a bed
patient by having him flex his hip and knee
so that the knee is about 8 inches off the
bed.
Coordination and Balance Tests
• Coordination can be checked by having
the patient close the eyes and touch the
finger to the nose. Coordination can also
be assessed by having the patient perform
rapid alternating movements (RAMs).
• These tests will help you evaluate
coordination and detect intentional
tremors.
You Tube
• http://www.youtube.com/watch?v=Ul6sAiJ
Y9cA
• http://www.youtube.com/watch?v=6XAPsA
KLJN4
• http://www.youtube.com/watch?v=oYeqav
QiZdg
Rapid alternating movements test
• Seat the patient. Instruct him to pat his
knees with his hands, palms down then
palms up. Have him alternate palms
down and palms up rapidly.
• Watch the patient to notice if his
movements are stiff, slow, nonrhythmic,
or jerky.
• The movements should be smooth and
rhythmic as he does the task faster.
Rapid alternating movements test
• Ask the patient to walk back and forth
across the room .
• Observe for equality of arm swing ,
balance and rapidity and ease of
turning .
• Next, ask the patient to walk on his
tiptoes ,then on heels .
• Ask the patient to tandem walk .
Rom berg test
• Instruct the patient to stand with his feet
together and his arms at his side.
• Have the patient do this with his eyes
open and then with his eyes closed.
(Stand close to the patient to keep him
upright if he starts to sway.)
• Expect the patient to sway slightly but not
fall. This is a test of balance
A reflex
• A reflex is defined as an immediate and involuntary
response to a stimulus.( Details were covered in the
DTR PPT)
• Superficial reflexes.
• Stroke the skin with a hard object such as an applicator
stick. What is felt is a superficial reflex
• •5 Ps
• –Pain
• –Pallor
• –Pulses
• –Paresthesia
• –Paralysis
Tests used clinically to
assess motor system function.
Motor system
• Tone: Flex and extend limbs. Rapidly
pronate and supinate forearms. Look
for spasticity ('clasp-knife'), rigidity
• ('lead-pipe'), and clonus.
Tests used clinically to
assess motor system function.
• Power:
• oppose active flexion and extension at
each major joint: biceps (C5,6); triceps
(C6-8); grip (C8); psoas
• (L2,3); quadriceps (L2-4); glutei (L5;S1);
hamstrings (L5;S1); tibialis anterior (L4);
extensor hallucis longus (L5).
Tests used clinically to
assess motor system function.
• Reflexes:
• biceps (C5,6); patellar (L3,4); wooden
spatula along outer sole, note first
movement of big toe. Flexor
• (downgoing) is normal. Extensor response
indicates upper motor neurone lesion.
• Stance and gait:
• observe and record.
DVD’s Available
• PHYSICAL EXAMINATION AND HEALTH ASSESSMENT DVD
SERIES: DVD 1: NEUROLOGIC: MOTOR SYSTEM AND
REFLEXES, VERSION 2
•
• To order this title, and for more information, click here
By
Carolyn Jarvis, PhD, APN, CNP, Family Nurse Practitioner,
Chestnut Health Systems, Bloomington; Adjunct Assistant Professor
of Nursing, School of Nursing, Illinois Wesleyan University,
Bloomington, IL
•
http://www.elsevier.com/wps/find/bookdescription.cws_home/71316
9/description#description
Post-Test
• 1. Assessment of the motor system
include:
A. Bilateral muscle strength
B. Bilateral muscle coordination
C. Balance test
D. All of the above
Correct Answer
• D. All of the above. The test includes
strength, coordination, and balance
Post-Test
• True or False
It is not necessary to test extremities
bilaterally and compare findings.
Correct Answer
• False
It is necessary to compare extremities to
determine if there is a weakness in one
and perhaps the degree of weakness
Post-Test
• Which of the following is an example of how to
test coordination
A. Have the patient push up both of their hands
as you push down with your hands to create
resistance
B. Have a patient touch the nose with the tip of
their index finger, alternating fingers from both
hands
C. Have a patient in a sitting position push both
feet up against your hands
Correct Answer
• B. Having the patient place their finger to
nose will show how well the patient is
coordinating movements. A and C will
help you to test muscle strength.
References
• http://nursinglink.monster.com/training/arti
cles/240-physical-assessment---chapter-8neurological-system
• http://www.google.com/search?hl=en&q=
motor+system++assessment&start=20&sa
=N