GALS examination Flashcards
In the GALS examination, what do we GENERALLY INSPECT for?
Surrounding area:
Walking aids
Specialist shoes
Patient:
Signs of pain
Well or unwell
Body habitus
Patient standing in neutral position:
Overall alignment and willingness to weight bear (equally on both legs)
Bulk and symmetry of shoulder, gluteal, quadriceps, and calf muscles (looking for muscle wasting)
Limb alignment
Alignment of the spine
Equal level of iliac crests
Ability to fully extend the elbows and knees
Popliteal swelling?
Abnormalities in feet - high arch? (pes cavus) or flat feet? (pes planus)
In the GALS examination, what do we look for in GAIT?
Symmetry
Smoothness
Ability to turn quickly
In the GALS examination, what do we assess in the SPINE?
Inspection:
Normal lordosis and kyphosis of the spine? or is there abnormalities?
Scoliosis?
Cervical spine:
Lateral flexion - ear to shoulder
Lumbar spine:
Flexion - place 2 fingers vertically along lumbar spine and get patient to bend forward. As patient flexes, fingers should move apart
In the GALS examination, what do we assess in the ARMS?
Shoulders & elbows:
Shoulder abduction and external rotation
Elbow flexion
“Hands behind head and pull elbows back”
Hands:
Inspect for swelling, deformity and loss of muscle bulk
Check finger extension and abduction
Check grip strength - squeeze my fingers
Thumb to tips of all fingers
Check function - ask to pick up something small or do a button
Gentle squeeze of MCP joints - ask about pain
In the GALS examination, what do we assess in the LEGS?
Knees:
Patella tap test - for effusion
Flex and extend fully
Hips:
Flex knee and passively internally rotate hip
Foot:
Inspect for swelling and deformity
Gentle squeeze of MTP joint
What are the 6 stages of the gait cycle?
Heel strike Foot flat (loading phase) Mid-stance Heel-off Toe-off Swing - foot swings back forward for heel strike (and gait cycle repeats)
What is a Trendelenburg’s gait?
An abnormal gait caused by unilateral weakness of the hip abductor muscles, secondary to a superior gluteal nerve lesion or L5 radiculopathy
What is Waddling gait caused by?
Bilateral weakness of the hip abductor muscles, usually associated with myopathies
What is valgus joint deformity?
Tibia is turned outward in relation to femur, resulting in knees “knocking” together
What is varus joint deformity?
Tibia is turned inwards in relation to femur, resulting in bowlegged appearance
Why do we squeeze MCP/MTP joint?
To check for tenderness that may be suggestive of active inflammatory arthropathy
What can cause joint effusion?
Ligament rupture e.g. ACL
Septic arthritis
Inflammatory arthritis
Osteoarthritis
