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TAS Neurology > Lower Limb Examination > Flashcards

Lower Limb Examination Flashcards

1
Q

What are the steps in lower limb examination?

A
  1. General observation
  2. Assess gait
  3. Inspection
  4. Tone
  5. Power
  6. Reflexes
  7. Coordination
  8. Sensation
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2
Q

What should be looked for on general examination in lower limb examination?

A

Clues such as wheelchair, orthoses or splints, helmet, or dysmorphic features

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3
Q

What should you inspect in lower limb examination?

A

Legs and spine

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4
Q

In what position should you inspect a child in lower limb examination?

A

Child lying on the bed

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5
Q

What should you look for on inspection in lower limb examination?

A
  • Posture
  • Contractures
  • Muscle bulk, wasting, and (pseudo)hypertrophy
  • Involuntary muscles and fasciculations
  • Scars
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6
Q

How should you assess tone in lower limb examination?

A
  • Roll legs from side to side, taking note of movement of foot at the ankle
  • Place palmar surfaces of both your hands under the childs thighs and lift them slightly off the bed, then let them fall
  • Flex and extend at the hip, knee, and ankle joints
  • Asses for clonus
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7
Q

How should you assess for clonus?

A

Rapidly dorsiflexing the foot

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8
Q

What is considered abnormal regarding clonus?

A

More than 3 beats

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9
Q

What nerves provide hip flexion?

A

L1 and 2

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10
Q

What nerves provide hip extension?

A

L5 and S1

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11
Q

What nerves provide ankle dorsiflexion?

A

L4

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12
Q

What nerves provide ankle plantar flexion?

A

S1 and 2

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13
Q

What reflexes should be tested in lower limb examination?

A
  • Knee
  • Ankle
  • Plantar
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14
Q

What nerves are responsible for knee reflex?

A

L3 and 4

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15
Q

What nerves are responsible for ankle reflex?

A

S1 and 2

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16
Q

What is an abnormal plantar (Babinski) reflex?

A

The great toe going up and therefore the toes to be splayed

17
Q

How is the Babinski reflex elicited?

A

Stroking lateral aspect of the sole of the foot and medially across the ball of the foot

18
Q

When is a positive Babinski a normal finding?

A

In infants

19
Q

How should you test co-ordination in lower limb examination?

A

Heel-shin test (ask to run heel of one foot down the shin of the other)

20
Q

What modalities need to be tested when testing sensation?

A
  • Light touch
  • Vibration
  • Joint proprioception
21
Q

What dermatome does L1 supply?

A

Upper outer thigh

22
Q

What dermatome does L2 supply?

A

Middle anterior thigh

23
Q

What dermatome does L3 supply?

A

Anterior knee

24
Q

What dermatome does L4 supply?

A

Medial calf

25
Q

What dermatome does L5 supply?

A

Lateral calf

26
Q

What dermatome does S1 supply?

A

Sole of the foot

27
Q

What dermatome does S2 supply?

A

Strip up posterior calf and thigh

TAS Neurology (11 decks)

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