coordination of movement

Practical medical physiology coordination of movement
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-10- Co-ordination of movement
Introduction
Coordination of movement is principally the function of cerebellum.
Cerebellum is located in the postero-inferior part of brain, it s
composed of cerebellar cortex & medulla containing deep cerebellar
nuclei (dentate, fastigial & interposed). It also cconsist of two
hemispheres with a central vermis, each hemisphere controls
ipsilateral coordination (figure 10-1).
Basically, the cerebellum plays major roles in the 1- timing, speed
and direction of motor activities and in 2- rapid, smooth progression
from one muscle movement to the next. It also helps to 3- control
intensity of muscle contraction when the muscle load changes, 4-
equilibrium, as well as 5- controlling necessary instantaneous
interplay between agonist and antagonist muscle groups.
Objective:
To test cerebellar function.
Materials and instruments:
No instruments or materials are required.
Procedure:
1-Finger-to-nose test
* Ask the patient to touch his nose with the tip of his index finger
and then touch your finger tip. Hold your finger just within the
patient’s arm’s reach.
* Ask the patient to repeat the movement between nose and target
finger as quickly as possible.
* Make the test more sensitive by changing the position of your
target finger figure 10-2.
Inability to perform test called dysmetria or past pointingPractical medical physiology coordination of movement
50
2- Heel-to-shin test
* With the patient lying supine, ask him to place his heel on his
opposite knee, and then slide his heel up and down the shin between
knee and ankle figure 10-3.
3- Rapid alternating movements
* Demonstrate repeatedly patting the palm of your hand with the
palm and back of your opposite hand as quickly and regularly as
possible.
Inability to perform the test correctly called dysdiadochokinesia
4- Testing patient’s speech by listening to patient’s speech while
taking his history.
Unintelligible, slurred (drunken) speech called dysarthria
5- Examination of stance and gait
* Romberg s sign:- by asking the patient to stand with his foot close
together and then close his eyes.
* ask the patient to walk a short distance (10 meters) and then turn
180? and return.
Unsteady (drunken) gait which is can t be performed on straight line
is called ataxic gait.Practical medical physiology coordination of movement
51
figure 10-1 anatomy of cerebellum
figure 10-2 finger nose test figure 10-3 heel to shin
test