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Sensitivity is the ability of a machine to see in dim light or to detect weak impulses at invisible wavelengths In some environments, high sensitivity is necessary In others, it is not needed and might not be wanted A robot that works in bright sunlight doesn t need to be able to see well in a dark cave A robot designed for working in mines, pipes, or caverns must be able to see in dim light, using a system that might be blinded by ordinary daylight Resolution is the extent to which a machine can differentiate between objects The better the resolution, the keener the vision Human eyes have excellent resolution, but machines can be designed with greater resolution In general, the better the resolution, the more confined the field of vision must be To understand why this is true, think of a telescope The higher the magnification, the better the resolution (up to a certain maximum useful magnification) Increasing the magnification reduces the angle, or field, of vision Zeroing in on one object or zone is done at the expense of other objects or zones Sensitivity and resolution are interdependent If all other factors remain constant, improved sensitivity causes a sacrifice in resolution Also, the better the resolution, the less well the vision system will function in dim light

All normal muscles display a slight resistance to stretch even when fully relaxed When stretched to their limit and released, they recoil, mainly because of the elasticity of the bers and their connective tissue sheaths In addition, the trunk and proximal limb musculature is intermittently or constantly activated in the maintenance of attitudes and postures To relax ie, to completely disengage a muscle from all its natural activities requires practice and seems increasingly dif cult in the elderly, in whom it merges with oppositional, or paratonic, rigidity ( gegenhalten, page 63) A reduced innervation of muscle, atrophy, or loss of contracting bers are causes of hypotonia In infants this state has come to be accepted as a mark of neuromuscular disease; the infant is said to be oppy For this reason, the assessment of muscle tone is of special importance in infants (the oppy baby), but the testing of strength at this age is dif cult Tone can be assessed by lifting the infant in a prone position; if the child is hypotonic, the head and legs cannot be supported against gravity and, therefore, dangle Or, when held under the arms, the hypotonic infant slips through the examiner s hands Andre-Thomas and colleagues introduced the terms passivite, to refer to the amplitude of the apping move ment of the hand or foot when the limb is shaken, and extensibilite, to denote the reduced resistance of a relaxed muscle to slow passive stretch In our opinion, these are but different ways of testing muscle tone Diminution in tone is observed in infants suffering from Werdnig-Hoffman disease or the congenital myopathies as well as in those with a benign type of hypotonia; diminished tone may also be seen in sickly infants with a variety of systemic diseases In

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atrophy; these are polymyositis, myasthenia gravis, periodic paralyses, steroid myopathy, hypothyroidism, and Addison disease

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Fascicular twitches of muscle at rest (fasciculations), if pronounced and combined with muscular weakness and atrophy, usually signify motor neuron disease (amyotrophic lateral sclerosis, progressive muscular atrophy, or progressive bulbar palsy); but they may be seen in other diseases that involve the gray matter of the spinal cord (eg, syringomyelia or tumor) as well as in lesions of the anterior roots (eg, protruded intervertebral disc) and in certain peripheral neuropathies Widespread fasciculations may occur acutely with severe dehydration and electrolyte imbalance after an overdose of neostigmine or with organophosphate poisoning Slow and persistent fasciculations, spreading in a wave-like pattern along the entire length of a muscle and associated with slight reduction in the speed of contraction and relaxation, are part of the syndrome of continuous muscular activity (page 1278) Fasciculations that occur with muscular contraction, in contrast to those at rest, indicate a state of heightened irritability of muscle; this may occur for no discernible reason or as a sequela of denervation that leaves muscle with some paralyzed motor units, so that during contraction small and increasingly larger units are not enlisted smoothly Fasciculations of the facial muscles are typical of the Kennedy type of bulbospinal atrophy Benign fasciculations, a common nding in otherwise normal individuals, can be identi ed by the lack of muscular weakness and atrophy and by the smallness of the muscle fascicle involved and repetitive appearance in only one or two regions The recurrent twitches of the eyelid or muscles of the thumb experienced by most normal persons are often referred to as live esh or myokymia but are benign fasciculations of this type Individuals with truly benign fasciculations have normal EMGs (ie, they have no brillations) as demonstrated in a large series of such patients studied and followed for many years by Blexrud and colleagues Myokymia is a less common condition, alluded to earlier, in which repeated twitchings impart a rippling appearance to the muscle Another form of rippling is familial and associated with an unspeci ed type of myopathy (Chap 55) Muscle cramps, despite their common occurrence, are a poorly understood phenomenon They occur at rest or with movement (action cramps) and are frequently reported in motor system disease, tetany, dehydration after excessive sweating and salt loss, metabolic disorders (uremia and hemodialysis, hypocalcemia, hypothyroidism, and hypomagnesemia), and certain muscle diseases (eg, rare cases of Becker muscular dystrophy and congenital myopathies) Gospe and colleagues have reported a familial (X-linked recessive) type of myalgia and cramps associated with a deletion of the rst third of the dystrophin gene, which is implicated in Duchenne dystrophy; strangely, there was no weakness or evidence of dystrophy Lifelong, severe cramping of undetermined type has also been seen in a few families The dramatic Satoyoshi syndrome is characterized by continuous painful leg cramps and alopecia universalis Far more frequent than all these types of cramping, and experienced at one time or another by most normal persons, is the benign form (idiopathic cramp syndrome) in which no other neuromuscular disturbance can be found Most often benign cramps occur at night and affect the muscles of the calf and foot, but they may occur at any time and involve any muscle group Some pa-.

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