EXAMINATION OF MOTOR SYSTEM

Observations: gait, symmetric body and the extremities, paralysis of the body Voluntary movement: cubiti artikulus flexion and extension, flexion and genu artikulus akstensi, plantar flexion and dorso flexion of the foot

Palpation of muscles: the muscles, tenderness, contractures, consistency

Percussion muscle: -Nomal: muscle contraction on percussion will be temporary and last only 1 or 2 seconds -Miodema: hoarding that has been in place for a moment percussion (usually in patients with malnutrition) -Miotonik: the percussion place becomes concave for a few seconds due to muscle contractions longer than usual

Muscle tone: ektrimitas relaxes patients ask we will be examining. -flaccid : there is no resistance at all (at UMN paralysis) -Hipotoni : prisoners reduced -Spastic : prisoners increased and are at the beginning of the movement (the paralysis UMN) -Rigid : Strong resistance continuously during movement, eg Parkinson

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

EXAMINATION OF SENSORY SYSTEM

Eksteroseptik sensibility or protopatik: Pain : the needle Temperature : with a warm water bottle (40-45 C and a bottle of cold water (10-15 C Touch : cotton Propioseptif: Kinesthesia Statesthesia Palesthesia Baresthesia discriminatory: Stereognosis Barognosis Topesthesia / topognosis Gramesthesia autotopognosis

EXAMINATION OF REFLEXES

Superficial reflexes: 1. Abdominal reflex: stimulus epigastric region of the abdominal , supraumbilical, infra umbilical from lateral to medial Response : contraction of the abdominal 2. Cremaster reflex : stimulus to the medial thigh skin from top to bottom Response : The elevation of the ipsilateral testis

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

Triceps reflex: knocking on the tendon triceps brachii muscles, arm flexion position at the elbow joint and a little pronation. Response: extension forearm at the elbow joint Afferent: n. radial Efferent: idem

Patellar reflex: tap on the patellar tendon. Response: extension of the lower limbs due to contraction. femoral quadriceps Efferent: n.femoralis Afferent: idem Achiles reflex: a knock on the tendon Achiles Response: plantar flexion of the foot due to contraction. gastrocnemius Efferent: n. tibialis Afferent: idem

THE DEGREE OF PHYSIOLOGICAL REFLEX RESPONSE

4 +: hyperactive and constantly klonus 3 +: hyperactivity 2 +: normal 1 +: hypoactive 0 +: no reflexes

pathological reflexes 1. Babinsky : etching foot lateral part of the posterior to the anterior Response : toe extension and development (fanning) toes 2. Chaddock : etching dorsum pedis around the lateral malleolus lateral from posterior to anterior Response : As babinsky 3. Oppenheim : sorting crista anterior tibiae from proximal to distal Response: As babinsky

4. Gordon: calf presses are hard Response: As babinsky 5. Schaffer: Achiles be hard pressed tendon Response: As babinsky 6.Gonda: bending (flexion plantar) toes up to four Response: As babinsky 7.Stransky: bending (lateral) fifth toes Response: As babinsky

8. Rossolimo: pengetukan on the soles Response: flexion of the toes on the joint interphalangealnya 9. Mendel-bechterew: pengetukan dorsum pedis in the area os cuboideum Response: As rossolimo 10. Hoffman: middle finger nail scratches on patient Response: thumb, index finger and the other fingers reflect 11. Trommer: poke the tip of the middle finger of patients Response: As Hoffman

LESIONS IN THE VERTEBRAL COLUMNA

CI-C4: diaphragm and respiratory muscles disturbed C5: motor and sensory gangngguan the deltoid

C6: interference with biceps

C7: Triceps disorders

C8-Th1: interosseous muscle disorders, Horner's syndrome

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