Phys · general-medicine

Neurological Examination of the Lower Limbs — The DCE Short-Case Routine

Also known as lower limb neurological examination · lower limb neurological exam · neurological examination lower limbs · examine this patient lower limbs neurologically · DCE short case lower limb neurology · PACES neurological station lower limb · motor examination lower limb · heel-shin test · Romberg test · Babinski sign · plantar response · ankle clonus · MRC power grading · myotome examination lower limb · dermatome examination lower limb · tone power reflexes coordination sensory gait · UMN versus LMN · pes cavus · high-stepping gait · foot drop

Consultant-physician-depth guide to the systematic neurological examination of the lower limbs for the FRACP DCE short case and the MRCP PACES neurological station. Covers the eight-step routine — inspection including gait and stance, tone with ankle clonus, power by myotome, reflexes by root level, the plantar response, coordination with the heel-shin test, the spinothalamic and dorsal column sensory pathways, and the gait assessment — the interpretation of each sign, the UMN versus LMN framework, the presentation template the candidate delivers aloud, and the examiner discussion questions by finding. Addresses gait patterns (hemiplegic, parkinsonian, ataxic, high-stepping, waddling), the Romberg test, muscle wasting patterns, foot deformity (pes cavus in Friedreich ataxia and Charcot-Marie-Tooth), tone abnormalities (spasticity with clonus, lead-pipe rigidity), the MRC power grading with myotomes from L2 to S2, reflex levels (knee jerk L3/4, ankle jerk S1/2), the absent ankle jerk with preserved knee jerk of diabetic neuropathy and the delayed relaxation of hypothyroidism, the Babinski sign, the heel-shin test for cerebellar function, stocking-distribution sensory loss, and the common examination traps. Structured for FRACP DCE and MRCP PACES preparation.