Lower Limb Neurological Examination | OSCE Guide | NEW | UKMLA | CPSA

Summary

In this instructional video, medical student David conducts a comprehensive neurological examination of the lower limbs on Yousef, a 30-year-old male. The examination includes assessing gait, muscle tone, strength, reflexes, sensation, and coordination. All findings are normal, indicating no neurological issues. The video concludes with a recommendation for further cranial nerve and upper limb assessments, and promotes a clinical examination guide for medical students.

Takeaways

• 🔄 David, a medical student, is performing a neurological examination on Yousef Smith, born January 1, 1993.
• 💵 The examination focuses on the lower limbs, assessing nerves, movement, and sensation in the legs.
• 💲 Yousef is asked to perform various walking tasks, including walking on tiptoes, heels, and in a tightrope manner.
• 💵 Yousef is tested for muscle tone by relaxing his legs and having his ankle moved by David.
• 💲 Strength in Yousef's legs is evaluated by resisting David's attempts to push his leg down and lifting his leg against resistance.
• 💵 Reflexes are tested at the knees and ankles, and Yousef is asked to relax his leg for accurate results.
• 💲 Sensation is assessed using a cotton wisp and a pin to differentiate between light touch and sharp sensations.
• 💵 Vibration sensation is tested with a tuning fork, and Yousef is asked to indicate when the vibration stops.
• 💲 Joint position sense is evaluated by moving Yousef's big toe up and down while he has his eyes closed.
• 💵 Coordination is tested by having Yousef perform a heel-to-shin slide on both legs.
• 💲 The examination concludes with normal findings, suggesting no neurological issues in Yousef's lower limbs.
• 💵 For a comprehensive assessment, David recommends examining cranial nerves and performing an upper limb neurological examination.
• 📝 The video promotes the 'geeky Medics clinical examination guide' as a resource for practical exam skills.

Q & A

What is the purpose of the lower limb neurological examination performed by David?

The purpose of the lower limb neurological examination is to test the nerves in the legs, including movement, sensation, tone, strength, reflexes, and coordination.

What is the patient's name and date of birth as mentioned in the script?

The patient's name is Yousef Smith and his date of birth is January 1st, 1993.

How does David instruct Yousef to walk during the examination?

David instructs Yousef to walk towards him, turn and walk back, walk on tiptoes, turn and walk back on tiptoes, walk on heels, and then walk with one foot in front of the other as if on a tightrope.

What does David do to test the tone in Yousef's legs?

David tests the tone in Yousef's legs by asking him to let his legs go loose and floppy and then pulling back on his ankle.

How does David test the strength in Yousef's legs?

David tests the strength by asking Yousef to lift his leg straight up off the bed and resist being pushed down, and then to push his leg down into the bed and resist being lifted.

What specific movements does David ask Yousef to perform to test coordination?

David asks Yousef to bend his knee and bring his ankle back towards him, kick out against resistance, bring his toes up towards him and keep them up, and turn his foot in and out.

How does David test the reflexes in Yousef's legs?

David tests the reflexes by tapping at Yousef's knees and ankles while instructing him to relax his leg as much as possible.

What tools does David use to test sensation in Yousef's legs?

David uses cotton wisp to test light touch sensation and a pin to test sharp sensation.

How does David test vibration sensation in Yousef's legs?

David tests vibration sensation using a tuning fork, asking Yousef to close his eyes and indicate when he feels the vibration and when it stops.

What joint position test does David perform?

David tests joint position by holding onto Yousef's big toe and asking him to close his eyes, then telling him if the toe is being moved up or down.

What does David conclude about Yousef's neurological examination?

David concludes that Yousef's neurological examination is normal, with no signs of neurological disease, and all findings are in keeping with a normal lower limb neurological examination.