Lower limb neuro

Inspection

Lower limbs and lumbar spine

·           Wasting

·           Scars

·           Deformity

·           Gait

Tone

·           Hip

·           Knee

·           Ankle

Power

·           Hip flexion: L1-2

·           Hip extension: L5-S1

·           Hip abduction: L2-3

·           Hip adduction: L5-S1

·           Knee extension: L3-4

·           Knee flexion: L5-S1

·           Ankle dorsiflexion: L4-5

·           Ankle plantarflexion: S1-2

·           Ankle inversion: L4-5

·           Ankle eversion: L5-S1

(Nothing 0, flicker 1, no gravity 2, gravity 3, reduced 4, normal 5)

Reflexes

·           Knee jerk: L3-4

·           Ankle jerk: S1-2

·           Plantar reflex: UMN sign

(Low 1+, normal 2+, high 3+)

Co-ordination

·           Run heel along shin

Sensation

·           DCML: light touch, vibration, proprioception

·           ALS: pain, temperature

·           L1: upper anterior thigh

·           L2: mid anterior thigh

·           L3: knee

·           L4: medial leg

·           L5: lateral leg

·           S1: sole of foot

·           S2: posterior leg

 

 

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