Tonicity and Muscle

Power Examination
Aims

 To examine motoric neuron

 Compare muscle mass contour
Muscle Power

 Examine muscle power, asks patient to active move

against your resistance.
 Compare with other side
 Grade 0 No movement.
 Grade 1 Only a flicker of movement.
 Grade 2 Movement with gravity eliminated.
 Grade 3 Movement against gravity.
 Grade 4 Movement against resistance.
 Grade 5 Normal power.
 If you find weakness compare proximal and distal.
Proximal = muscle disorder, distal = neurogical disorder
Tonicity

 A state of continuous activity or tension beyond that

related to physical properties.
 Passive movement resistance
 Asks patient to relax. Do passive movement and
examiner compare with other side
Upper Extremity

 Flexion and Ekstension

Ask patient to pull and push you resistance
“push my resistance down”
“push my resistance up”
“push my resistance behind”
“push my resistance in front of”
Abduction

 To see nervus aksilaris and radiks C5-C6

 Ask patient to extension both of hands in prone
position. Then, asks patient to abduction againts a
resistance
Flexion

 Asks patient to fist hand and flexion the elbow. The

examiner hold wrist or fist the hand of patient. Ask
patient to pull the hand to patient direction and
against examiner resistance. To check
musculocutaneus nerve from radiks C5-C6
Ekstention

 Asks patient to abduction the hand in the middle

between flexion and extension. The examiner hold
wrist. Ask patient to push the hand to patient direction
and against examiner resistance. To checks radialis
nerve from radiks C6-C8
Wrist Extension

 Asks patient to fist hand and extension the wrist.

Examiner push the wrist up. To check nervus radialis
from C6-C8
Wrist Flexion

 Asks patient to fist hand and extension the wrist.

Examiner push the wrist down. To check nervus
medianus from radiks C6-C7
Fingers Adduction

 Ask patient to hold examiner’s point and middle

fingers. Ask patient press it
Fingers Abduction

 Ask patient to abduction her/his fingers in prone

potition. Ask patient to against the examine power to
united patient fingers. To check nervus ulnaris C8-T1
Thumb Adduction

 Ask patient to the distal of the thumb touch distal of

small finger and ask patient to against resistance. To
check nervus medianus from radiks C8-T1
Upper Extremity Tonicity

 Asks patient do flexion and extension. Examiner hold it

with no resistance
 Increase resistance example rigidities/spacid =
increase tonicity
 Decrease resistance example flaccid tonicity =
decreace tonicity
 Normal tonicity have soft sensation
 Extrapyramidal sensation cogwheeling
Hip Adduction

 Ask patient to spread the leg and hand examiner in

medial of knee patient. Ask patient to close the leg
and against Examine resistance. To check nervus
obturator from radiks L2-L4.
Hip Abduction

 Examine put the hand in lateral knee patient. Ask

patient to spread the legs.. To check nervus gluteus
superior from L4-S1
Knee Flexion

 To check nervus ischiadicus from radiks L4-S1

Knee Extention

 Check nervus Femoralis from radiks L2-L4

Ankle dorsifleksi

 Examiner’s hand in dorsum pedis. Ask patient to dorso

flexion the ankle against Examiner’s resitance. To
check nervus peroneus profundus radiks L4-L5
Wrist Plantar Flexion

 To check nervus tibialis from L5-S2

Big Toe Dorsifleksi

 To check nervus peroneus profundus from radiks L4-S1

Big Toe Plantar Flexion

 To check nervus tibialis posterior from radiks L5-S2

Lower Extremity Tonicity

 Asks patient do dorsoflexion and flexion plantar.

Examiner hold it with no resistance.
 Asks patient to do it repeatedly.
 If suddenly patient dorsoflexion and flexion plantar
involuntered. This condition is clonus ankle = Increase
tonicity