Lower limb motor

Question 1

Prepare the patient

Answer 1

a. Introduce yourself and the exam
b. Ask them to remove their pants (shorts are ok)
c. Check the patient is comfortable
d. Prepare bed (flat)

Question 2

Hand Hygiene

Answer 2

Normal

Question 3

Gait

Answer 3

a. Fluidity of movement
b. The way the foot strikes the floor
c. Asymmetry

Question 4

General Inspection

Answer 4

a. Scars or Deformities
b. Muscle Bulk
c. Fasciculations
d. Inspect lower back also

Question 5

Tone

Answer 5

a. Ask patient to allow you to take their weight/ make their legs go floppy
b. Knee and Ankle
c. Look for clonus

Question 6

Power

Answer 6

a. Hip flexion (L2,L3)
b. Hip extension (L4,L5,S1)
c. Hip abduction (L4,L5, S1)
d. Hip adduction (L2,L3,L4)
e. Knee flexion (L5, S1)
f. Knee extension (L2,L3,L4)
g. Ankle dorsiflexion (L4,L5)
h. Ankle plantarflexion (S1,S2)
i. Inversion of the foot (L4, L5)
j. Eversion of the foot (L5,S1)
k. Great toe extension (L4, L5, S1)

Question 7

Reflexes

Answer 7

a. Knee Jerk (L2,L3,L4)
b. Ankle Jerk (S1, S2)
c. Plantar reflex – look for Babinski sign (L5,S1,S2)

Question 8

Coordination

Answer 8

a. Heel-shin test