Examination of the lower limbs

Question 1

Observation:

Answer 1

Look for:

• Scars
• Skeletal deformity
• Wasting of the muscles (i.e atrophy)
• Involuntary movements (ballismus, chorea+athetosis, dystonia, ticks)
• Fasciculation
• Tremor (physiological, parkinsonian)

Question 2

Muscle tone:

Answer 2

• Ask about pain
• Tell the patient to relax

Test tone by performing passive movement of:

• Hip rotation
• Hip and knee flexion

(Access both sides, the tone may be NORMAL, increased or decreased)

Question 3

Power:

Answer 3

To test power:

• Hip flexion and extension
• Knee flexion and extension
• Ankle dorsiflexion and plantar flexion
• Big toe extension

Question 4

Co-ordination:

Answer 4

• Heel-shin test

Question 5

Reflexes:

Answer 5

• Knee reflex

- Ankle reflex