MOTOR EXAMINATION OF THE LOWER LIMB
• Inspection - Ask the child to lie down on the bed and expose to the underpants with the legs and thighs entirely exposed. Place a towel over the groin and inspect the lower limb.
o Posture – Note the resting posture. Look for abnormal flexion or extension, unusual rotation, clawing of the foot or limb shortening. Always compare with the other side for symmetry.
o Muscle Bulk - Look for muscle wasting of the quadriceps and anterior tibials and hypertrophy of the calf muscles. Compare one side with the other and proximal with distal (asymmetry).
o Involuntary Movements - Inspect for abnormal involuntary motor activity like fasciculations, tremor, etc.
o Paucity of voluntary movements
o Contractures
o Scars particularly on the posterior aspect of the lower limb
o Equipment - Urinary catheter
• Gait Examination
Function assessment of the lower limbs is a very important part of the neurological examination. In some instances, this area alone is given as an individual case in the exam. It is important to remember that normal stance and gait depends on intact visual, proprioceptive, corticospinal, extrapyramidal, cerebellar pathways and motor systems. There are two phases to the normal walking cycle: stance phase, when the foot is on the ground; and swing phase, when it is moving forward. While assessing gait, one should evaluate both the stance and walking (with various manoeuvres). Prior to the assessment, ask the child to remove the socks and shoes and examine the shoe.
o Stance: Make sure the legs and the thighs are clearly visible.
Look for limb shortening
Foot and knee position – valgus/ varus
Width of stance
Romberg sign (refer cerebellar examination)
o Walking: ...
... middle of paper ...
...the sole from the heel upwards and curve inwards across the ball of the foot medially before it reaches the toes. In children older than one year, flexion of the big toe at the metatarsophalangeal joint is the normal response. The abnormal response, also called as positive Babinski's sign, is characterised by extension of the big toe and fanning of the other toes and is seen in upper motor neuron lesion.
Cremasteric reflex (L1-2): This reflex is NEVER elicited in the exam and is mentioned here only for the sake of completion. Ask the child to lie down on the back, abduct and externally rotate the thigh. With a blunt object, stroke the superior and medial aspect of the thigh in a downward direction. The normal response is the contraction of the cremaster muscle that pulls up the testicle on the side stimulated briskly.
• Function
o Gait assessment – refer above
The secondary survey consists of a systematic top-to-toe examination to look for other injuries that may not be immediately
For the lab test part, in this case we can do a muscle biopsy on him. A muscle biopsy is a procedure that removes a small sample of tissue for testing in a laboratory. The test can identify the disease is caused by nerve or by the muscle atrophy.
Kinesiology can be defined as the study of mechanics of body movements, so I think that is very important to know the meaning of movement when studying kinesiology. Everything in kinesiology has to do with the movement. Every action the body takes is a movement which is what kinesiology is. You cannot be successful in the field of kinesiology no matter what you are doing if you do not understand what movement is. It is the study of human movement, performance, and function by applying the sciences of biomechanics, anatomy, physiology, and neuroscience. It looks at movement and which muscles are involved to create movement relating to strength exercising and sports technique. Movement is an act of changing physical location or position or of
During a physical examination, a specialist may hear a heart murmur which will prompt a referral to a pediatric cardiologist for an analysis. Diagnostic testing will vary by the child’s age, clinical condition, and institutional preferences. Such test may incorporate a chest X-ray, electrocardiogram, echocardiography and cardiac catheterization. A chest X-ray uses unseen X-ray beams to cr...
A head to toe assessment consists of a general safety survey, vital signs, mental status, psychosocial, head, eyes, ears, nose, throat, neck, chest, abdomen, upper and lower extremities, activity, therapeutic devices (Haugh, 2015). The next step is for the nurse is to detail the assessment that she / he will undertake on the
After the injury has occurred, the injured should see the family doctor or possibly a specialist to see if something is torn. The doctor will do some range of motion testing. Theses test are the Lachman, Dynamic extension and the pivot jerk.
Attempt to run, or runs with stiff posture, you may notice little to no bending at the knees while the child runs, this is normal
Clubfoot is defined as a congenital foot deformity characterized by a kidney shaped foot that turns inward and points down. The forefoot is curved inward, the heel is bent inward, and the ankle is fixed in planter flexion with the toes pointing down. Shortened tendons on the inside of the lower leg, together with abnormally shaped bones that restrict movement outwards cause the foot to turn inwards. A tightened achilles tendon causes the foot to point downwards. The medical term for clubfoot is talipes equinovarus . It is the most common congenital disorder of the lower extremity. There are several variations, but talipes equinovarus being the most common. Clubfeet occurs in approximately 1 in every 800-1000 babies, being twice as common in boys than girls. One or both feet may be affected.
Diagnostic testing done/ continued testing/procedures (following your interview, place an * by those your child
Vasconcelos, O., Rodrigues, P., Barreiros, J. & Jacobsohn, L. (2009). Laterality, developmental coordination disorders and posture. In L. P. Rodrigues, L. Saraiva, J. Barreiros & O. Vasconcelos (Eds.) Estudos em desenvolvimento motor da criança II (pp.19-26). Escola Superior de Educação, Instituto Politécnico de Viana do Castelo.
A. Walks on toes, can look very odd when moving in general and appears rigid or droopy in posture.
Musculoskeletal system: He doesn’t have any stiffness and swelling at any joints. He can walk normally and never had history of falls.
There are different ways to determine your body composition and the risks that they involve. In this lab, body measurements are taken to find the body percent fat, waist-to-hip ratio, body mass index (BMI), and basal metabolic rate (BMR). Skin folds for the chest, abdomen, and thigh were taken for males, and triceps, iliac crest, and thigh for females. Age, height, and weight for each person were recorded as well as the waist and hip circumference.
"What Tests Might Be Ordered ." Penn Orthopaedics . N.p., n.d. Web. 26 Mar. 2014. .