Flashcards in Lower Limb Examination Deck (27)
What are the steps in lower limb examination?
1. General observation
2. Assess gait
What should be looked for on general examination in lower limb examination?
Clues such as wheelchair, orthoses or splints, helmet, or dysmorphic features
What should you inspect in lower limb examination?
Legs and spine
In what position should you inspect a child in lower limb examination?
Child lying on the bed
What should you look for on inspection in lower limb examination?
- Muscle bulk, wasting, and (pseudo)hypertrophy
- Involuntary muscles and fasciculations
How should you assess tone in lower limb examination?
- 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
How should you assess for clonus?
Rapidly dorsiflexing the foot
What is considered abnormal regarding clonus?
More than 3 beats
What nerves provide hip flexion?
L1 and 2
What nerves provide hip extension?
L5 and S1
What nerves provide ankle dorsiflexion?
What nerves provide ankle plantar flexion?
S1 and 2
What reflexes should be tested in lower limb examination?
What nerves are responsible for knee reflex?
L3 and 4
What nerves are responsible for ankle reflex?
S1 and 2
What is an abnormal plantar (Babinski) reflex?
The great toe going up and therefore the toes to be splayed
How is the Babinski reflex elicited?
Stroking lateral aspect of the sole of the foot and medially across the ball of the foot
When is a positive Babinski a normal finding?
How should you test co-ordination in lower limb examination?
Heel-shin test (ask to run heel of one foot down the shin of the other)
What modalities need to be tested when testing sensation?
- Light touch
- Joint proprioception
What dermatome does L1 supply?
Upper outer thigh
What dermatome does L2 supply?
Middle anterior thigh
What dermatome does L3 supply?
What dermatome does L4 supply?
What dermatome does L5 supply?
What dermatome does S1 supply?
Sole of the foot