Upper vs. lower motor neuron lesions
Inspection
Muscle Bulk
- loss of muscle bulk in LMN and late in UMN
- symmetry
Fasciculations
- present in LMN, none in UMN
Muscle Tone
- flexion/extension, pronation/supination of joint through its ROM
Hypotonia
- flaccidity
- LMN lesions, spinal shock, cerebellar lesions
Hypertonia
- Spasticity - UMN lesion
- limb moves, then catches, and then goes past catch (clasp-knife)
- test by rapidly supinating forearm
- Rigitity
- LMN lesions, extrapyrimidal tract lesion
- increased tone throughout ROM (cog-wheeling, lead-pipe)
- circumducting the wrist
Other OSCE Modules
Acute Confusion - Acute Coronary Syndrome Orders - Anemia - Arterial Blood Gasses - Asthma - Blood Pressure - Chest pain - Chest XRay - CHF - Coma - COPD - Cranial Nerves - Diabetic History - Diabetic Foot - Dysphagia - EKGs - Gallbladder and Liver - Liver Disease - Gait and Balance - Headache - Hematemesis - Hypertension - Jugular Venous Pulses - Knee Exam - Lymph Nodes - Community Acquired Pneumonia - Parkinson Disease - Peripheral Arterial Insufficiency - Pneumonia Examination - Precordial Exam - STD's - Spleen - Swollen Leg Exam - Thyroid Exam - Upper vs Lower Motor Neuron Lesions - Urinary Incontinence