GALS exam (gait arms legs spine)

Question 1

What are the 3 screening questions to ask at the beginning?

Answer 1

1. do you have any pain or stiffness in your muscles, joints or back?
2. do you have any difficulty getting yourself dressed without any help?
3. do you have any problem going up and down the stairs?

Question 2

What causes Trendelenburg’s gait?

Answer 2

unilateral weakness of hip abductor muscles (superior gluteal nerve lesion)

Question 3

What causes waddling gait?

Answer 3

bilateral weakness of hip abductor muscles (due to myopathies e.g. muscular dystrophy)

Question 4

What are the 6 phases of gait cycle?

Answer 4

1. heel strike
2. foot flat
3. mid stance
4. heel off
5. toe off
6. swing

Question 5

What is an increased carrying angle called?

Answer 5

cubitus valgus
(linked to previous elbow trauma or congenital deformity e.g. Turner's syndrome)

Question 6

Valgus vs varus?

Answer 6

valgus= bone distal to joint angled laterally
(e.g. knocked knees)

varus= bone distal to joint angled medially
(e.g. bowlegged)

Question 7

What is cervical lordosis linked to?

Answer 7

chronic degenerative joint disease (e.g. osteoarthritis)

Question 8

What is associated with thoracic kyphosis?

Answer 8

hyperkyphosis linked to Scheuermann’s disease (wedging of vertebrae- congenital)

Question 9

What causes popliteal swellings?

Answer 9

Baker’s cyst
or
popliteal aneurysm (usually pulsatile)

Question 10

How are arms examined?

Answer 10

1. hands behind head
2. hands held out in front with palms facing down (nails for psoriasis and any deformities)
3. hands held out in front with palms facing up (inspect eminences for muscle wasting)
4. make a fist
5. grip strength (squeeze fingers)
6. precision grip

Question 11

How are legs examined?

Answer 11

1. passive knee flexion
2. passive knee extension
3. passive internal rotation of hip
4. metatarsophalangeal joint squeeze (tenderness= active inflammatory arthropathy)
5. patellar tap

Question 12

What is the final part of the assessment?

Answer 12

temporomandibular joint
(open mouth place 3 fingers in mouth)

tests for range of movement and screens for deviation of jaw movement