Lower Limb

Question 1

What are the UMN signs in a lower limbs exam?

Answer 1

Increased tone (potentially with ankle clonus)
Pyramidal pattern of weakness (extensors weakner than flexors in arms and vice versa in legs)
Exaggerated or brisk reflexes
Upgoing/extensor plantar reflexes (Babinski positive)

Question 2

What are LMN signs in a Lower Limb exam?

Answer 2

Wasting and fasciculation of muscles
Decreased (hypotonia) or normal 
Different patterns of weakness
Reduced or absent reflexes
Normal (downgoing/flexor) or mute plantar reflexes

Question 3

What is an ataxic gait?

Answer 3

Broad-based

Unsteady

Question 4

What is Parkinsonian gait?

Answer 4

Small shuffling steps
Stooped posture
reduced arm swing

Question 5

What is the High-stepping gait associated with?

Answer 5

Caused by foot drop (weakness of ankle dorsiflexion)
Patient won’t be able to walk on heels
Associated with peripheral neuropathy

Question 6

What is a waddling gait?

Answer 6

Shoulders sway from side to side

Legs lifted off ground with the aid of tilting the trunk

Question 7

What is a waddling gait caused by?

Answer 7

Proximal lower limb weakness (e.g. myopathy)

Question 8

What is a Hemiparetic gait?

Answer 8

One leg held stiffly and swings round in an arc with each stride

Question 9

What is a hemiparetic gait associated with?

Answer 9

Stroke

Question 10

What is spastic paraparesis?

Answer 10

Similar to hemipareitc gait but bilateral with both legs stiff and circumducting

Question 11

What is spastic paraparesis associated with?

Answer 11

Hereditary spastic paraplegia