Post on 03-Apr-2018
7/28/2019 Tugas Dr Jeffrey 1
1/15
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
7/28/2019 Tugas Dr Jeffrey 1
2/15
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
7/28/2019 Tugas Dr Jeffrey 1
3/15
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
7/28/2019 Tugas Dr Jeffrey 1
4/15
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)
7/28/2019 Tugas Dr Jeffrey 1
5/15
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
7/28/2019 Tugas Dr Jeffrey 1
6/15
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
7/28/2019 Tugas Dr Jeffrey 1
7/15
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
7/28/2019 Tugas Dr Jeffrey 1
8/15
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
7/28/2019 Tugas Dr Jeffrey 1
9/15
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
7/28/2019 Tugas Dr Jeffrey 1
10/15
THE DEGREE OF PHYSIOLOGICAL REFLEX
RESPONSE
4 +: hyperactive and constantly klonus
3 +: hyperactivity
2 +: normal
1 +: hypoactive
0 +: no reflexes
7/28/2019 Tugas Dr Jeffrey 1
11/15
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
7/28/2019 Tugas Dr Jeffrey 1
12/15
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
7/28/2019 Tugas Dr Jeffrey 1
13/15
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
7/28/2019 Tugas Dr Jeffrey 1
14/15
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
7/28/2019 Tugas Dr Jeffrey 1
15/15
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