Lower Limb Neurological Examination (OLD) - Power, Reflexes, Sensation, and Coordination - Dr Gill

hello my name's dr gil i've been asked to do an examination of your lower limbs today specifically the neurological aspect that's going to look at how your nerves control your legs and your muscles is that okay yeah so to start off could i please confirm your name and date of birth yeah it's the 7th of december 1996. super so before we start um in terms of doing this exam it's going to involve you standing up and walking i'm going to get you to do certain uh tests when we get you to walk and we're going to get you to lie back onto the bed when we're there we're going to get you to do some movements with your legs i'm also going to check your powers to see how strong you are as well as checking sensations and reflexes is that okay super so to start off if we can just get you to put your hands over your chest and please stand up excellent please walk that way and turn and come back and turn and if you could walk back on your tiptoes please thank you and if you could walk back once more but this time on your heels thank you and if you could walk back finally doing heel toes so walking with your heels to touch your toe and heels to touch your toe going forward thank you and if you just stand to face the wall please and i'm just going to have a look from behind at your ankles everything looks good there if you can turn back to face me i'm just going to have a quick look at your shoes now we've got a reasonable wear pattern on those shoes although you've got slightly more wear so we want to see how good your balance is now so what i'm going to do and put my arms either side so you're not going to fall over don't worry we're going to get you to close your eyes and put your feet together okay so if you put your feet together and close your eyes okay that's fine you can open your eyes please so if you'd be kind enough to sit back on the bed and swing your legs up please so we're just having a look at your legs i can't see any obvious scars and everything seems to be nice and symmetrical so what i'd like to do is like to have a look at your tone so do you mind if i put my hands on your legs thank you before i start do you have any pain in your legs no okay let's roll okay everything seems to be good there and now i'm going to pick up your leg and just drop it ever so slightly that's fine and same again excellent so i'm just going to rotate your leg out slightly okay and i'm going to pull on your foot and see what happens if anything to your calf that's fine i would please relax what are the same again on this side that's fine please relax for me so we're going to check your powers now so if you could raise this leg up as high as you can that's brilliant back down and similarly with this leg up as high as you can and down so i'm just going to put my hand on your leg and if you could push up against me and relax and we'll do the same again on the opposite side push up and relax put my hand underneath now if i might and push down at the bed and again push down as the bed please excellent so if you could bring your heel halfway up please okay and relax that so don't let me straighten the leg now you push me away excellent and relax down i'll do the same again here just bring her ankle up and push me away and don't let me straighten excellent relax please so if you could push your legs into my hands please okay and then if you push again into my hands superb okay just looking at your ankles so i'm just going to hold your ankle okay and if you just push your ankle out and then push your ankle in please i'm going to same again over here push your ankle out and then in oh it's excellent okay push your feet up for me and then push me away excellent we're going to do the same with your toes now so don't let me push you down and then you push me down excellent thank you okay so we didn't find any problems with your powers there so we're just going to see how good your sensation is so i've got a neurotip here so i'm going to touch this on your chest so you can see what it feels like can you feel that yeah okay so in a moment close your eyes please and i'm going to touch your legs in the same way so please say yes if we touch you yeah yep yep yep yep yep yep yep yep yep yep super thank you now we're going to do the same thing again but this time just a soft touch so i'm going to touch your chest feel that super we'll do the same again so if you close your eyes please yes yes yes yes yes yes yes yes yes yes yes yes yep yep super thank you okay now we're going to check vibration sense so you can feel that on your chest yes turn when the sensation goes yeah okay we're going to do the same thing now with your legs so please close your eyes and tell me what you can feel uh vibration on my right okay turn when the vibration stops no okay excellent we'll do the same again can you feel there um vibration on my left toe and tell when it stops now perfect now i need to check your reflexes if we could so if you just swing your legs around please okay and i'm going to take the two tenon hammer i'm going to tap over your legs so just close your eyes please okay excellent so we've got brilliant reflexes there on your knees if you swing your legs back up please i'm just going to so i'm just going to move your leg out for me and just go loose loose and floppy loose and floppy excellent excellent and relax down for me we'll do the same again on this side all the way out staying loose and floppy loose and floppy just relax relax nice loose and floppy brilliant okay i'm just going to run the base of this just around your foot excellent and same again over here perfect final thing that we need to do we're going to check your coordination so if you please take this heel and take it up to your knee then bring it down to your foot and then back up in a d shape excellent i'm going to stop and swap legs so if we take this ankle up to your knee and then back down and return in a d shape please superb okay so finally if you could just tap your feet against me together both together excellent okay so what we're going to do now we're going to see if you can sense your joint position in space so i'm going to hold your toe and that will be up and that will be down okay so if you close your eyes for me and tell me where your toe is up down super we're going to do the same on the opposite side up down excellent that completes her examination we haven't found any abnormalities do you have any questions to myself today no super thank you very much you