MCML Assessment and Treatment of Abnormal Muscle Tone Practice Test 2026 – Comprehensive All-in-One Guide to Exam Success!

Flexor posturing (decorticate rigidity) happens when the pathways from the cerebral hemispheres to the brainstem are disrupted. When the cortex and its connections are damaged, the corticospinal input to the brainstem is diminished, allowing the midbrain and rubrospinal systems to drive flexion of the arms while the legs may extend. This pattern indicates injury above the red nucleus, involving the cerebral hemispheres and midbrain nerve pathways. If the injury were lower in the brainstem (below the midbrain), you’d see an extensor, decerebrate posture rather than flexion. Cerebellar damage doesn’t typically produce this decorticate posture, since it mainly affects coordination rather than the specific hierarchies governing this flexor pattern.