Neurological examination of the lower limb Flashcards
What is the order of examination for lower limb?
- inspection
- motor system assessment
- sensory system assessment
- co-ordination and rapid alternating movements
- reflexes
What do you need to comment on during inspection of LL?
- size of the limbs
- symmetry
- involuntary movements
- atrophy/hypertrophy
What do you need to assess during motor system assessment?
- palpates bilaterally for size and tone of muscles
- passively moves the limb through: flexion extension, abduction, adduction, to check for muscle tone
- muscle strength tested by applying full resistance mid-action
- describes: size of the muscles, muscle tone, muscle strength, pain or tenderness
Which dermatomes do you assess during sensory system assessment?
L2-S2
what is another name for the sensory system assessment?
sharp/dull test
what do you need to comment on during sensory system assessment?
- intactness of anterolateral spinothalamic tracts
- intactness of posterior column tracts for proprioception
what 2 tests do you do for co-ordination and rapid alternating movements?
- heel on opposite and run it down the shin from the knee to ankle
- tapping the examiner’s hands or the ground with both feet, alternatingly
Which reflexes do you need to check?
- Patellar reflex
- achilles reflex
- plantar reflex
which spinal segments coordinate with patellar reflex?
L2-L4
what is the normal reflex for patellar reflex?
extension of the lower leg
what are the spinal segments associated with achilles reflex and the normal reflex?
- L5-S2
- plantar flexion of the foot
What are the spinal segments associated with plantar reflex and the normal reflex?
- L4-S2
- withdrawing of the foot and plantar flexion of toes
- explains the babinski sign
