This document outlines the components and process of performing a motor examination. It describes examining muscle mass, tone, power, coordination, gait, and reflexes. Deep tendon reflexes are tested using a reflex hammer at sites including the biceps, triceps, patella, and Achilles tendons. Abnormal reflex responses include spasticity, rigidity, and hypotonia. Motor strength is graded on a scale from 0 to 5. The plantar reflex test assesses upper motor neuron function.

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3. * Components of motor examination :
1- State of muscle.
2- Tone of muscle.
3- Power of muscle.
4- Motor co-ordination.
5- Gait.
6- Reflexes.
7- Involuntary movement (if present).

4. * Can be done by :
1- Inspection :
- Inspect the muscle mass and note if there is wasting (atrophy) or hypertrophy of an individual muscle.
- Fasciculations (induced).
2- Palpation :
Palpate the muscle to assess the consistency, Bulk and contour.
3- Measurement :
Measure the mid-arm and mid-forearm circumferences in the upper limbs, and mid-thigh and mid-calf
circumferences in the lower limbs.

5. * Response :
- Normal Response:
Minimal resistance to passive movement is encountered.
- Abnormal Response:
1- Spasticity (clasp knife) : feature of an upper motor neuron lesion.
2- Rigidity : seen in extrapyramidal disorders.
3- Hypotonia (flaccidity) or decreased tone : seen with lower motor neuron or cerebellar lesions.

6. 1- Paresis (weakness) : Decreased strength of the muscle.
2- Paralysis (plegia) : Absence of contraction of the muscle.
Grading Motor Strength
Grade Description
0/5 No muscle movement (Complete paralysis)
1/5 Visible muscle contraction but no movement at the joint
2/5 Movement at the joint, but not against gravity
3/5 Movement against gravity, but not against added resistance
4/5 Movement against resistance, but less than normal
5/5 Normal strength
Grade strength using the medical research council (MRC) scale from 0 to 5.

7. * The are 2 type of reflexes :
1- Superficial reflexes.
2- Deep tendon reflexes.

8. * Instrument name :
Reflex Hammer.
* Uses :
Used to test deep tendon reflexes.

9. * Test name :
Plantar reflex.
* Center of reflex :
(S1 & S2).
* Method :
Rubbing The lateral side of the sole of the foot with a blunt instrument, the instrument is run from the heel along a curve to the toes.
* Response :
1- Flexor (Planter flexion & adduction) :
Seen in healthy adults.
2- Indifferent :
No response.
3- Extensor (Dorsi-flexion & abduction) :
This is known as Babinski response,
In Adults : Indicate upper motor neuron lesion.
In Infant : Normal, due to unmyelinated corticospinal pathways.

11. * Test name :
Biceps tendon reflex.
* Center of reflex :
(C5 & C6).
* Response :
Flexsion of the elbow due to contraction of the biceps brachii,
in response to tapping its tendon.

12. * Test name :
Triceps tendon reflex.
* Center of reflex :
(C6 & C7 & C8).
* Response :
Extension of the elbow due to contraction of the triceps brachii,
in response to tapping the triceps brachii tendon.

13. * Test name :
(Knee jerk) Patellar tendon reflex.
* Center of reflex :
(L2 & L3 & L4).
* Response :
Extension of the knee due to contraction of the
quadriceps femoris,
in response to tapping the patellar tendon.

14. * Test name :
(Ankle jerk) Achilles tendon reflex.
* Center of reflex :
(S1).
* Response :
Plantar flexion of ankle due to contraction of
gastrocnemius muscle.
in response to tapping the Achilles tendon.