Babinski reflex - correct answer - apply stimulus to lateral aspect of foot and across
metatarsal heads
- normally, response is absent, great toe and small toes flex
- positive Babinski response - great toe will extend and small toes will fan out
- positive Babinski is seen in young kids, but goes away later
Hoffman reflex - correct answer - flicking of terminal joint of middle finger
- postive Hoffman - flexion and adduction of the thumb, other fingers may also flex
- normally, should see no change in the fingers or thumb
- essentially, the Babinski for the upper extremity
spasticity - correct answer • A motor disorder characterized by a velocity
dependent increase in resistance to muscle stretch (hypertonia) and an increase in tendon reflexes
(hyperreflexia)
• both hypertonia and hyperreflexia must be present for classic definition of spasticity
• there are times when you may see just hyperreflexia and not hypertonia
, • spasticity can be a problem, interfere with voluntary movement (if they have it)
• SCI = no voluntary movement in LE, use extensor spasms/spasticity to transfer
hypotonia - correct answer • flaccidity
• muscle tone is assessed by resistance to stretch, but this is difficult when assessing hypotonia
• in a normal person, no resistance to PROM, so how can we determine hypotonia?
• often seen with kids
- floppy baby, not enough muscle tone for baby to pick up its head
- facial expression, jaw is dropped, muscles look like they are not functioning properly
- shoulder and scapula: winging of scapula, slouched over
hypertonia - correct answer - spasticity
- rigidity
- easily assessed by resistance to stretch
muscle spindle - correct answer • all normal muscles have muscle spindles, some
have more than others
• muscle spindles are sensory organs that can tell how stretched the muscle is and how quickly its being
stretched; because of the way they sit in the muscle, they are also stretched with muscle
• muscle spindles are part of proprioception
• within muscle spindle, there are bag fibers and chain fibers
- bag fibers have dilated center portion; largely responsible for the ability to pick up the velocity/rate of
stretch
- chain fibers are straight; used to determine how far muscle is stretched, muscle length
sensory and motor neurons and muscle spindles - correct answer • two sensory
fibers that come off
- Ia fiber is large diameter fiber that enters dorsal area of spinal cord and picks up rate of stretch
- II fibers are smaller diameter and enter the same way and pick up how far muscle is stretched
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