Examination of the Lower Limb

(1)

Department of Neurosurgery, University of Wisconsin, Madison, WI, USA

Electronic supplementary material

The online version of this chapter (doi:10.1007/978-3-319-39694-1_24) contains supplementary material, which is available to authorized users.

24.1 Motor Examination

Muscles are tested and graded using the MRC system: 0: no function, 1: flicker, 2: movement with gravity eliminated, 3: movement against gravity, 4: movement against some resistance, 5: normal.

Fig. 24.1

Ilio-psoas (femoral n and lumbar plexus directly): hip flexion

Fig. 24.2

Quadriceps (femoral n): knee extension

Fig. 24.3

Hip adductors (obturator n)

Fig. 24.4

Hip abductors (superior gluteal n)

Fig. 24.5

Gluteus maximus (inferior gluteal n): hip extension

Fig. 24.6

Hamstrings (arrows) (sciatic n): knee flexion

Fig. 24.7

Plantar flexion: gastrocnemius (tibial n)

Fig. 24.8

Plantar flexion: soleus (tibial n)

Fig. 24.9

Toe flexion: flexor digitorum, flexor hallucis longus (tibial n)

Fig. 24.10

Tibialis posterior (tibial n): foot inversion in plantar flexion; the patient is asked to push the foot down and in against resistance. In the setting of a foot drop if this movement is lost, it suggests an L5 radiculopathy or a high sciatic nerve injury. This movement should be preserved in the setting of an isolated peroneal neuropathy

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