Lower limb PNS

Question 1

Increased tone = ?

Answer 1

Spasticity (clasp knife)= UMN lesion

‘Lead pipe’ rigidity= disorder of basal ganglia

Question 2

What is the cog wheel rigidity in Parkinsons?

Answer 2

Tremor on top of lead pipe rigidity

Question 3

Decreased tone =?

Answer 3

LMN or cerebellar lesion

Question 4

Myotome of patellar reflex?

Answer 4

L3/4

Question 5

Myotome of ankle reflex?

Answer 5

S1/2

Question 6

Anormal babinski reflex indicates? And what does it look like?

Answer 6

UMN lesion

Extension of big toe

Question 7

Ankle clonus indicates?

Answer 7

UMN lesion

Question 8

What does a positive Rhomberg’s test indicate?

Answer 8

If they are unsteady with their eyes open this suggests a cerebellar lesion
If they become unsteady only when closing the eyes this suggests a sensory ataxia.

Question 9

Broad based ataxic gait suggests

Answer 9

cerebellar lesion

Question 10

Spastic gait suggests

Answer 10

Hemiplegia

Question 11

Shuffling gait suggests

Answer 11

Parkinsonism

Question 12

high stepping gait suggests

Answer 12

Foot drop

Question 13

What other things can affect gait?

Answer 13

Pain and muscle wasting

Question 14

End pieces

Answer 14

Rhomberg’s test and gait

Question 15

What are the things you check in this examination?

Answer 15

Tone
Power
Reflexes
Sensation (including vibration sense)
Proprioception
Co-ordination