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Foot-and-Mouth Disease:
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Motor Exam II

JoVE 10095

Source:Tracey A. Milligan, MD; Tamara B. Kaplan, MD; Neurology, Brigham and Women's/Massachusetts General Hospital, Boston, Massachusetts, USA

There are two main types of reflexes that are tested on a neurological examination: stretch (or deep tendon reflexes) and superficial reflexes. A deep tendon reflex (DTR) results from the stimulation of a stretch-sensitive afferent from a neuromuscular spindle, which, via a single synapse, stimulates a motor nerve leading to a muscle contraction. DTRs are increased in chronic upper motor neuron lesions (lesions of the pyramidal tract) and decreased in lower motor neuron lesions and nerve and muscle disorders. There is a wide variation of responses and reflexes graded from 0 to 4+ (Table 1). DTRs are commonly tested to help localize neurologic disorders. A common method of recording findings during the DTR examination is using a stick figure diagram. The DTR test can help distinguish upper and lower motor neuron problems, and can assist in localizing nerve root compression as well. Although the DTR of nearly any skeletal muscle could be tested, the reflexes that are routinely tested are: brachioradialis, biceps, triceps, patellar, and Achilles (Table 2). Superficial reflexes are segmental ref


 Essentials of Physical Examinations III

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Adapting Human Videofluoroscopic Swallow Study Methods to Detect and Characterize Dysphagia in Murine Disease Models

1Department of Otolaryngology - Head and Neck Surgery, University of Missouri, 2Department of Communication Science and Disorders, University of Missouri, 3Department of Medicine, University of Missouri

JoVE 52319


 Medicine

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Motor Maps

JoVE 10175

Source: Laboratories of Jonas T. Kaplan and Sarah I. Gimbel—University of Southern California

One principle of brain organization is the topographic mapping of information. Especially in sensory and motor cortices, adjacent regions of the brain tend to represent information from adjacent parts of the body, resulting in maps of the body expressed on the surface of the brain. The primary sensory and motor maps in the brain surround a prominent sulcus known as the central sulcus. The cortex anterior to the central sulcus is known as the precentral gyrus and contains the primary motor cortex, while the cortex posterior to the central sulcus is known as the postcentral gyrus and contains the primary sensory cortex (Figure 1). Figure 1: Sensory and motor maps around the central sulcus. The primary motor cortex, which contains a motor map of the body's effectors, is anterior to the central sulcus, in the precentral gyrus of the frontal lobe. The primary somesthetic (sensory) cortex, which receives touch, pain, and temperature information from the external parts of the body, is located posterior to the central sulcus, in the postcentral gyrus of the parietal lobe.

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Computerized Dynamic Posturography for Postural Control Assessment in Patients with Intermittent Claudication

1Discipline of Exercise and Sport Science, Faculty of Health Sciences, University of Sydney, 2Department of Sport, Health and Exercise Science, University of Hull, 3Academic Vascular Department, Hull Royal Infirmary, Hull and East Yorkshire Hospitals, 4Department of Vascular Surgery, Addenbrookes Hospital

JoVE 51077


 Medicine

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Using Gold-standard Gait Analysis Methods to Assess Experience Effects on Lower-limb Mechanics During Moderate High-heeled Jogging and Running

1Faculty of Sports Science, Ningbo University, 2Research Academy of Grand Health Interdisciplinary, Ningbo University, 3Department of Automation, Biomechanics and Mechatronics, The Lodz University of Technology, 4Savaria Institute of Technology, Eötvös Loránd University

Video Coming Soon

JoVE 55714


 JoVE In-Press

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Adapted Resistance Training Improves Strength in Eight Weeks in Individuals with Multiple Sclerosis

1Motion Analysis Laboratory, Kennedy Krieger Institute, 2Physical Medicine & Rehabilitation, Johns Hopkins University School of Medicine, 3Johns Hopkins University School of Medicine, 4Department of Neurology, Johns Hopkins University School of Medicine

JoVE 53449


 Medicine

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Foot Exam

JoVE 10192

Source: Robert E. Sallis, MD. Kaiser Permanente, Fontana, California, USA

The foot is a complex structure composed of numerous bones and articulations. It provides flexibility, is the essential contact point needed for ambulation, and is uniquely suited to absorb shock. Because the foot must support the weight of the entire body, it is prone to injury and pain. When examining the foot, it is important to remove shoes and socks on both sides, so that the entire foot can be inspected and compared. It is important to closely compare the injured or painful foot to the uninvolved side. The essential parts of the evaluation of the foot include inspection, palpation (which should include vascular assessment), testing of the range of motion (ROM) and strength, and the neurological evaluation.


 Essentials of Physical Examinations III

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Motor Exam I

JoVE 10052

Source:Tracey A. Milligan, MD; Tamara B. Kaplan, MD; Neurology, Brigham and Women's/Massachusetts General Hospital, Boston, Massachusetts, USA

Abnormalities in the motor function are associated with a wide range of diseases, from movement disorders and myopathies to strokes. The motor assessment starts with observation of the patient. When the patient enters the examination area, the clinician observes the patient's ability to walk unassisted and the speed and coordination while moving. Taking the patient's history provides an additional opportunity to observe for evidence of tremors or other abnormal movements, such as chorea or tardive dyskinesia. Such simple but important observations can yield valuable clues to the diagnosis and help to focus the rest of the examination. The motor assessment continues in a systematic fashion, including inspection for muscle atrophy and abnormal movements, assessment of muscle tone, muscle strength testing, and finally the examination of the muscle reflexes and coordination. The careful systematic testing of the motor system and the integration of all the findings provide insight to the level at which the motor pathway is affected, and also help the clinician to formulate the differential diagnosis and determine the course of the subsequent evaluation and treatment.


 Essentials of Physical Examinations III

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Scaled Anatomical Model Creation of Biomedical Tomographic Imaging Data and Associated Labels for Subsequent Sub-surface Laser Engraving (SSLE) of Glass Crystals

1Department of Biological Sciences, University of Notre Dame, 2Models Plus Incorporated, 3Saint Joseph Regional Medical Center, 4Harper Cancer Research Institute, University of Notre Dame, 5Notre Dame Integrated Imaging Facility, University of Notre Dame

JoVE 55340


 Bioengineering

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Rodent Identification II

JoVE 10182

Source: Kay Stewart, RVT, RLATG, CMAR; Valerie A. Schroeder, RVT, RLATG. University of Notre Dame, IN

Animal records must be accurately maintained to ensure that data collection is correct. Records range from maintaining information on cage cards to having a detailed database with all of the relevant information on each animal. The primary component of recordkeeping is the individual identification of research animals. There are a variety of methods suitable for identifying mice and rats. This video describes the procedural techniques for tattooing, microchip placement, and temporary identification methods, and also explores the benefits of each.


 Essentials of Lab Animal Research

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Detection of Copy Number Alterations Using Single Cell Sequencing

1Koch Institute for Integrative Cancer Research, Department of Biology, Massachusetts Institute of Technology, 2Howard Hughes Medical Institute, 3Division of Health Sciences and Technology, Harvard Medical School, 4The Barbara K. Ostrom (1978) Bioinformatics and Computing Facility in the Swanson Biotechnology Center, Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, 5BioMicro Center, Department of Biology, Massachusetts Institute of Technology

JoVE 55143


 Genetics

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Structure-function Studies in Mouse Embryonic Stem Cells Using Recombinase-mediated Cassette Exchange

1Department of Biomedical Molecular Biology, Ghent University, 2Inflammation Research Center, VIB, 3Center for Medical Genetics, Ghent University Hospital, 4Cancer Research Institute Ghent (CRIG), 5Department of Basic Medical Sciences, Faculty of Medicine and Health Sciences, Ghent University, 6Helmholtz Center for Infection Research, 7Mammalian Functional Genetics Laboratory, Division of Blood Cancers, Australian Centre for Blood Diseases, Department of Clinical Haematology, Monash University and Alfred Health Alfred Centre

JoVE 55575


 Developmental Biology

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Visualization Method for Proprioceptive Drift on a 2D Plane Using Support Vector Machine

1Applied Brain Science Laboratory, Department of Mechanical Sciences and Engineering, Tokyo Institute of Technology, 2Department of Informatics, Graduate School of Informatics and Engineering, The University of Electro-Communications, 3Department of Media and Image Technology, Faculty of Engineering, Tokyo Polytechnic University

JoVE 53970


 Behavior

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Knee Exam

JoVE 10203

Source: Robert E. Sallis, MD. Kaiser Permanente, Fontana, California, USA

The knee is a hinged joint that connects the femur with the tibia. It is the largest joint in the body, and due to its location in the middle of the lower leg, it is subjected to a variety of traumatic and degenerative forces. Examination of the knee can be quite complex, owing to the fact it is an inherently unstable joint held together by various ligaments and supported by menisci, which act as shock absorbers and increase the contact area of the joint. In addition, the patella lies in front of the knee, acting as a fulcrum to allow the forceful extension of the knee needed for running and kicking. As the largest sesamoid bone in the body, the knee is a common source of pain related to trauma or overuse. When examining the knee, it is important to remove enough clothing so that the entire thigh, knee, and lower leg are exposed. The exam begins with inspection and palpation of key anatomic landmarks, followed by an assessment of the patient's range of motion (ROM). The knee exam continues with tests for ligament or meniscus injury and special testing for patellofemoral dysfunction and dislocation of the patella. The opposite knee should be used as the standard to evaluate the injured knee, provided it has not been previousl


 Essentials of Physical Examinations III

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