lower motor examination with its important steps . fasciculation , bulk , tone , reflexes , power , ankle clonus , heel shin test and gait

1. LOWER MOTOR
NEURON
examination
Muhammad shahzeb
Medical student

2. Timeline
consent
Greeting
Introduction
Explaining the findings
Examinaion Explaining findings
First appearene then positive findings
And obvious finding and then negative
findings
bingo
Exposure, fasciculation
Bulk,Tone,
Reflexes,power,clonus,heel shin ,
gait

3. Moto examination lower limb
◦ Initiate the conversation by making gook rappot
◦ Like .hello what is your name what is your age how are you
hope you are doing well , my name is ……….. I m here to
examine your lower limb so kindely expose your self upto
thighs .

4. Lower limb examination
◦Expose the lower limb upto mid thigh and make sure to
preserve the patient privacy
◦Make patient to lie comfortably on bed

5. Lower limb examination
◦Start by checking muscle fasiculation by tping gently with
finger or by reflex hammer

6. Lower limb examination
◦Examine the bulk by compairaing bulk on both legs and
thighs

7. Lower limb examination
◦Now check bulk by more qualitative method from medial
condyle of knee to medial malleolus of ankle

8. Lower motor examination
◦now take mid line of inch tape and measure bulk of
both legs

9. Lower motor examination
◦Check tone by manulally moving all the joints of
lower limb
◦Cesk for spasticity and righidity on both lower limbs

10. Lower motor examination
◦Do reflexes on achilles tendon by supporting leg on
other lower limb

11. Lower motor examination
◦Check for knee reflex by supporting the lower limb
from poplitaial surfase on your own upper limb

12. Lower motor examination
◦Do the planter reflex and see barbinski sign from heel
to fore foot

13. Lower motor examination

14. Lower motor examination
◦Check for power of lower limb muscles by asking
patient to actively push against resistance you applied
by your hand

15. Lower motor examination

16. Lower motor examination
◦Leg extensors( quadreceps)
thigh extensor gluteus and
plus hamstring muscles

17. Lower motor examination
◦Abductor adductors

18. Lower motor examination
◦Check for ankle clonus by hyperextending ankle joint

19. Lower motor examination
◦Do the heel shin test in 3 steps 3 command method.
Ask to place ankle on upper leg then slide to lower
leg and then neutral position

20. Lower motor examination
◦Ask patient to walk by opening his eyes and to stand still
by closing eye and also do march without moving.
◦.
◦.
THANKYOU

21. Lower motor examination
◦Explain the examination by saying
◦My patient name ……. His age is ……… he has ……..
Built …….. Norish …….
Is well oriented and lying comfortably on bed .
Now explain the whole examination in sequence but
start with positive and obvious findings

22. Lower motor examination
◦THANK
YOU