To investigate movement co-ordination

Romberg’s pose - the investigated person is proposed to move his feet together, to rise his head, to put his hands alongside his trunk. To determine whether his pose is stable. Complicated Romberg’s pose: the doctor proposes to the investigated person to stretch his hands forward horizontally. Initially his eyes must be opened, than closed. Cerebellum functions disorders are accompanied by unstable pose (falling forward is observed at vermis anterior parts injuries; ahead - at vermis caudal parts disorders).

Walking - the investigated person must go on right line with his opened eyes, then with closed ones. At good performing these tests the investigated person is proposed to go on right line such that sock of one foot was touched to the heel of the other one.

Phalanx walking - step movements towards; the investigator put his attention to the step clearance and to the possibility of fast stoppage at sudden order (at injury one can see ataxic walking: legs are significantly extensed and putted forward).

 

Asynergy investigation

Babynsky probe - the investigated person lies on solid bed, he is asked to cross his hands on his thorax and to stand up (legs are rised without legs in people with cerebellum injury).

Ozhehovsky probe - the investigated person while his standing is strongly leant on doctor’s palm. At sudden taking doctor’s hands away the investigated person must be on his place, must be unmoved or turned ahead (in sick person this probe leads to the turning his trunk forward).

Stuart-Holms’s probe - upper extremities proximal parts asynergy is checking. The hand putted till horizontal state investigated person must strongly bend in crural joint (antebrachium and hand in pronation state, hand is in fist). Doctor tries to straighten the investigated person antebrachium out and at sudden resistance stoppage the investigated person hand mustn’t beat himself in his thorax. For the control the investigator’s second hand must be putted to the place of allowed beat. In a healthy person muscles-antagonists are involved quickly and the beat is prevented.

 

Dynamic ataxy investigation

Finger-nose probe- investigated person while his standing with closed eyes must touch nose ending by his index finger. To pay the attention to finger movement trajectory (locomotory ataxy existance) and putting to mentioned place (dysmetry existance), finger’s tremor.

Heel-knee probe- the investigated person while sitting at the chair must touch by heel of one foot the knee of another one and to draw by it through tibia down. To mention locomotor ataxy absence or presence and dysmetry from lower extremities.

Probe to adiadochokinesis- investigated person while his sitting must at the same time (simultaneously) by two hands stretched forward to perform pronation and supination. At disturbance of movement sinchronism and equality one can determine adiadochokinesis on the side where the extremity is retarded.

Probe to the movement proportionality - the investigated person must stretch his hands forward by his palms up, the fingers are diverged. At order to turn hands by their palms down. At cerebellum injury side one can determine excessive rotation - dysmetry.

 

To put the attention to:

a) At cerebellum injury speech is slowed, speech fluency, explosed, scanding- accents are not on necessary syllable.

b) The writing in sick people is large, uneven, the person hasn’t draw the circle.

c) There is rhythmic eyeballs fluctuation at sight towards and up - nistagm.

 

15.Autonomic nervous system reflexes (pupils size changes at direct light and in the darkness, reflex to eyes convergence, skin vasomotor functions, red and white dermographism, Erben’s and Abrams’ reflexes).