Lower limb short cases
1.
2.
3.
4.
5.

Severity: functional capacity- walk with support,
muscle power

Structural/ functio...
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Short cases in Lower limbs: in paediatrics-final MBBS

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This is not a complete note or a guide. This was prepared by me based on the teachings of Dr.R.M.Mudiyanse just to aid the short cases.

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Short cases in Lower limbs: in paediatrics-final MBBS

  1. 1. Lower limb short cases 1. 2. 3. 4. 5. Severity: functional capacity- walk with support, muscle power Structural/ functional Anatomy Severity Etiology Complications Etiology Quadriplegia Dysmorphism CP- OFC, ↓glucose Monoplegia Hemiplegia: vascular Diplegia: ICH-int capsule- usually in premature Cerebellum: chickenpox, malaria, agenesis, ArnoldChiari malformation, Ataxia telengiectasia (→nystagmus→ bulbar telengiectasia) Basal ganglia: ↑ bilirubin Possible exam cases Structural Bone: rickets, CTEV Muscle: congenital myopathy, DMD Skin/vascular: Klippel-Trenaunay Sy Functional UMN: CP, ataxia LMN: GBS Complications Contractures: adductor/ Achilles’ tendon Anatomy UMN 1. ↑ Tone 2. ↑ Reflex 3. Upgoing plantar 4. Clonus 5. +/- global dvt delay 6. Microcephaly Could this be cortical lesion? 1. UMN features with higher functionscommunication/ speech 2. Cortical type motor (fine motor loss)/ sensory (graphesthesia, steriognosis) loss 3. Microcephaly: seizures Differentiate GBS-diplegia-paraplegia GBS: LMN lesion Diplegia: paralysis involving both sides of the body & affecting legs > arms Cerebral diplegia→ UMN Paraplegia: paralysis of both legs, usually due to dx or injury of the SC. So sensory loss+ disturbed bladder function Comprehensive diagnosis This child probably having target joint on L/S may have presented with haemophilia & wasting of quadriceps on L/S with contractures. Mid-brain 1. Eye muscle 2. Dense hemiplegia Pons 1. 2. Facial muscle Mastication muscles Medulla 1. Swallowing/ palatal palsy Spinal cord 1. Motor & sensory level 2. Bladder bowel involvement Mixed 1. Hereditary: inverted Shampane bottle Cerebellum 1. Ataxia 2. Nystagmus Basal ganglia 1. Dyskinesia LMN 1. 2. 3. 4. ↓ Tone ↓ Reflex Fasciculation Generally sparing higher functions Yapa Wijeratne

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