Lower Limb PNS

Question 1

what do you inspect

Answer 1

1. (SWIFT).
   - scars
   - wasting - lower motor neurone
   - involuntary movement
   - fasciculations - Lower motor neurone
   - tremors

• then ask if they are in any pain

Question 2

what reflex is the patella reflex

Answer 2

L3 L4

Question 3

what additional examinations would you do

Answer 3

babinski reflex 
- CNS exam 
- sensory
tests such as two-point discrimination,
-  vibration sense, 
- proprioception,

Question 4

what tests for ankle clonus

Answer 4

6. Assesses ankle clonus – holds the foot and lower leg, then rotates the foot at the ankle joint before briskly dorsiflexing the foot, sustaining the pressure.

Question 5

what types of gait are you looking for

Answer 5

o Antalgic
o Foot-drop
o Scissor walking
o Shuffling

Question 6

what is hypertonicity a sign of

Answer 6

 Hypertonicity (spastic and rigid) = UMN lesion

Question 7

what is hypotonicity a sing of

Answer 7

Hypotonicity (floppy and wasted) = LMN lesion

Question 8

what are the power grades

Answer 8

5 – Full power
4 – Movement against weak resistance
3 – Movement without any resistance
2 – Movement without gravity
1 – Muscle contraction without joint movement 0 – Complete paralysis

• these can be a sing of uMN or LMN

Question 9

hyperreflexia is a ..

Answer 9

UMN

Question 10

hyporefleixa is a

Answer 10

LMN

Question 11

what are you looking for if you roll the leg from side to side

Answer 11

o Spasticity in the ankle=UMN lesion

o Completely floppy ankle=LMN lesion

Question 12

what are you looking for when you briskly pick up each leg underneath the knee

Answer 12

o Kicking out of the ankle = UMN lesion

Question 13

what are you looking for when you gently roll each ankle then briskly dorsiflex the foot

Answer 13

Beats of clonus (repetitive muscle contractions) = UMN lesion

Question 14

name the spinal roots for

• hip flexion
• hip extension
• knee flexion
• knee extension
• ankle dorsiflexion
• angle plantarflexion
• big to exnteion

Answer 14

o HipFlexion(L2/3)
o HipExtension(L4/5)
o KneeFlexion(L5/S1)
o KneeExtension(L3/4)
o AnkleDorsiflexion(L4/5)
o AnklePlantarflexion(S1/2) o Bigtoeextension(L5only)

Question 15

what spinal tract do motor fibres run in

Answer 15

they run in the corticospinal tract of the spinal cord