Lower Limbs Exam

Question 1

Causes of a broad based ataxic gait

Answer 1

Midline cerebellar pathology: MS

Degeneration of cerebellar vermis: chronic alcohol

Question 2

Small, shuffling steps, reduced arm swing, stooped posture

Answer 2

PD

Question 3

High stepping gait

Answer 3

Foot drop
Common peroneal nerve (L4-S2)

Question 4

Tandem gait difficulty

Answer 4

Cerebellar vermis dysfunction (chronic alcohol)

Question 5

Waddling gait

Answer 5

Proximal myopathy

Question 6

Hemiparetic gait

Answer 6

One leg held stiffly + swings round in arc
Stroke

Question 7

Romberg’s test

Answer 7

Positive = falling without correction
Indicates sensory ataxia (proprioceptive/ vestibular dysfunction)

Question 8

3 causes of proprioceptive dysfunction

Answer 8

B12 deficiency
Parkinsons
Hyper-mobility e.g. EDS

Question 9

2 causes of vestibular dysfunction

Answer 9

Vestibular neuronitis
Menieres

Question 10

Spasticity

Answer 10

Velocity dependent (faster move = worse)
Pyramidal tract lesion e.g. stroke

Question 11

Rigidity

Answer 11

Velocity independent
Cogwheel (superimposed tremor): PD
Lead pipe: NMS
Extrapyramidal tract lesions

Question 12

UMN lesions weakness

Answer 12

Pyramidal
LL Flexors
UL Extensors

Question 13

Knee jerk reflex

Answer 13

L3
L4

Question 14

Ankle jerk reflex

Answer 14

S1

Question 15

Plantar reflex

Answer 15

L5
S1