Simplifying neurologic assessment

Assessing for pronator drift

“…If your patient' s motor pathway is intact, the arms should remain in this position equally. 2 Patients with a slight weakness in one arm won't be able to keep the affected arm raised, and ultimately the palm may begin to pronate, or turn downward. (See Picturing pronator drift.)…”

“…Pronator drift may occur in patients with cerebral injury such as stroke or cervical spine injury. 1,2 Other abnormal findings include an arm that moves up or laterally. This is a sign of loss of proprioception (position sense), which is mediated by the spinothalamic tract.…”

“…This is a sign of loss of proprioception (position sense), which is mediated by the spinothalamic tract. 1,2 Be sure the patient keeps his or her eyes closed during the exam, and don't ask the patient to raise the arms until after closing the eyes. If the patient can see the drift, the brain will use the sensory input to correct it.…”