Plantar Response

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Plantar Response

INTRODUCTION
Introduction to the Neurological Exam
MENTAL STATUS
Mental Status Introduction
Level of Alertness, Attention, and Cooperation
Orientation: A Caveat to Those Who Write "A&O×3"
Memory
Language
Calculations, Right–Left Confusion, Finger Agnosia, Agraphia
Apraxia
Neglect and Constructions
Sequencing Tasks and Frontal Release Signs
Logic and Abstraction
Delusions and Hallucinations
Mood
CRANIAL NERVES
Cranial Nerves Introduction
Olfaction (CN I)
Opthalmoscopic Exam (CN II)
Vision (CN II)
Pupillary Responses (CN II, III)
Extraocular Movements (CN III, IV, VI)
Facial Sensation and Muscles of Mastication (CN V)
Muscles of Facial Expression and Taste (CN VII)
Hearing and Vestibular Sense (CN VIII)
Palate Elevation and Gag Reflex (CN IX, X)
Muscles of Articulation (CN V, VII, IX, X, XII)
Sternocleidomastoid and Trapezius Muscles (CN XI)
Tongue Muscles (CN XII)
MOTOR EXAM
Motor Exam Introduction
Observation
Inspection
Palpation
Muscle Tone Testing
Functional Testing
Strength of Individual Muscle Groups
REFLEXES
Reflexes Introduction
Deep Tendon Reflexes
Plantar Response
Finger Flexors
Reflexes Tested in Special Situations
COORDINATION AND GAIT
Coordination and Gait Introduction
Appendicular Coordination
Romberg Test
Gait
SENSORY EXAM
Sensory Exam Introduction
Primary Sensation, Asymmetry, Sensory Level
Cortical Sensation, Including Extinction

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Test the plantar response by scraping an object across the sole of the foot beginning from the heel, moving forward toward the small toe, and then arcing medially toward the big toe (see Figure 3.2 in Neuroanatomy through Clinical Cases 3e). The normal response is downward contraction of the toes. The abnormal response, called Babinski's sign, is characterized by an upgoing big toe and fanning outward of the other toes. In some patients the toes are "silent," moving neither up nor down. If the toes are downgoing on one side and silent on the other, the silent side is considered abnormal. The presence of Babinski's sign is always abnormal, but is often present in infants, up to the age of about 1 year.

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