Major Weakness Of Muscle Testing
1. A 13-year-old male presents with a two-year history of progressive weaknesses in both upper and lower extremities. He finds it difficult to lift heavy objects off a shelf. When sitting on the floor he has to hold onto objects such as a chair to pull himself up. On examination, there is significant wasting of muscles in the shoulders, upper arms, and hips. There is significant weakness on muscle testing (i.e., the patient is unable to exert a normal force with muscle contraction). On tapping the knee tendon there is a contraction of the quadriceps muscle in the leg, and on tapping the biceps tendon there is a contraction of the biceps muscle in the arm. No fasciculations are noted. There is normal muscle tone detected by passive movement through the joints.
• Atrophy is caused by a lesion in the lower motor neurons, that and weakness are the only two signs that this patient exhibits. This could be caused by progressive muscular atrophy, which is lower motor neuron disease characterized by atrophy and muscle weakness, it is also characterized by fasciculations, however this patient did not exhibit that (Wikipedia, 2015).
2. A 67-year-old female presents with complaints of clumsiness in her arms. She notices this when she attempts to bring a cup of water to her lips. As she does so, she develops shaking and spills the contents. Also, she notices some incoordination in her walking. Her speech has become somewhat slurred. On examination, there is normal strength in