Lower Limb

Wash Hands Introduce Patients Name Explain Procedure Consent Expose Legs to underwear Position Upright

Close
3han% Patient Co7er Patient Wash Hands

Overall
U ( " M

Inspect
Patient General Appearance Muscle Wasting asciculation As!mmetr! "cars Gait #e$ormities

Tone
"ha%e leg at %nee Clonus

Power
Li$t leg to touch hand &esist pushing down Lower leg &esist pushing up lex 'nee Pull Heel to (ottom 'ic% Awa! Coc% )ac% $oot Plantar$lex Coc% oot #own #orsi$lex

Reflexes
'nee *L+, Heel *"- "., Plantar *L/0".,

Sensation
Cotton wool on arm "ide to side1 each dermatome "uper$icial2deep pain 3emperature 4i)ration -.5 H6 * ig -, 3wo point discrimination
Using a compass or similar 3ouch one $oot or )oth $eet with patients e!es closed and as% pt which was touched Hold )ig toe at sides and mo7e up and down

Figure 1

"ensor! Inattention

What would indicate an upper motor neuron pro)lem8 H!perre$lexia Upgoing plantar Increased 3one Clonus General Muscle Wea%ness What would indicate a lower motor neuron pro)lem8 H!pore$lexia "peci$ic muscle group wea%ness H!potonia

Proprioception

Coordination
Heel to shin

Michael "mith .9-9

Lower Limb asciculations What would rigidit! classicall! indicated8 Par%insonism :Led Pipe; What is the medical research council classi$ication $or power8 9 < No contraction - 0 lic%er . < Mo7ement with gra7it! eliminated = < Mo7es against gra7it! )ut not resistance + < Wea%er than normal / 0 Normal

Michael "mith .9-9