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ramalakshumma[1].pptx adgtufh bdhGUDJK Djgh

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RAKESH KUMAR

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Name- S . Ramalakshmamma Age- 55/F Mrd no-1381595 Diagnosis – L4-L5 grade 2 listhesis (osteopenia) Comorbidities – nil
• c/o low back pain – radiating to right LL , posterior aspect till tips of toes for 2 yrs , aggrevated in last 6 months • Paresthesias in right lower limb present • Neurogenic claudication for 500 mts • No h/o slippage of chappals • No bowel and bladder complaints • h/o fall of bricks over lower back 4 years ago
O/E: Patient conscious and coherent Vitals stable -CNS examination Higher mental function-normal
CRANIAL NERVE EXAMINATION • CN 1: B/L sense of smell normal • CN2: VA right –6/6 and left – 6/6 CN 3,4,6- • EOM full range • No nystagmus • No ptosis • Pupils- B/L 3mm equal and reactive.
CN 5- Normal CN 7- Intact CN 8 • B/L AC>BC , Weber's not lateralised • CN 9, 10 • Uvula midline • Palatal movements normal ,no asymmetry
CN 11 • Shoulder shrugging – Normal on both sides CN 12 • No fasciculations of tongue • no Tongue deviation
MOTOR SYSTEM: Tone • Normal in both upper and lower limbs Bulk • Normal in both upper and lower limbs
Power - right left Upper limb Shoulder- 5/5 5/5 Elbow- 5/5 5/5 Wrist- 5/5 5/5 HG- 100% 100% Lower limb Hip- 5/5 5/5 Knee- 5/5 5/5 Ankle- DF 5/5 5/5 PF 4+/5 5/5 EHL- 4+/5 5/5 • Reflexes – • Superficial reflexes-present • DTR: BJ TJ S KJ AJ Right - 2+ 2+ 2+ 2+ 1+ Left - 2+ 2+ 2+ 2+ 2+ Plantars- both flexors
Sensory examination: decreased pinprick along right L5 dermatome Romberg's sign: Negative Tandem gait: Normal Cerebellar examination: Normal Involuntary movements: No Meningeal signs: No
ramalakshumma[1].pptx adgtufh bdhGUDJK Djgh
ramalakshumma[1].pptx adgtufh bdhGUDJK Djgh
ramalakshumma[1].pptx adgtufh bdhGUDJK Djgh
ramalakshumma[1].pptx adgtufh bdhGUDJK Djgh
ramalakshumma[1].pptx adgtufh bdhGUDJK Djgh
ramalakshumma[1].pptx adgtufh bdhGUDJK Djgh
ramalakshumma[1].pptx adgtufh bdhGUDJK Djgh
ramalakshumma[1].pptx adgtufh bdhGUDJK Djgh
ramalakshumma[1].pptx adgtufh bdhGUDJK Djgh
ramalakshumma[1].pptx adgtufh bdhGUDJK Djgh

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ramalakshumma[1].pptx adgtufh bdhGUDJK Djgh

  • 1. Name- S . Ramalakshmamma Age- 55/F Mrd no-1381595 Diagnosis – L4-L5 grade 2 listhesis (osteopenia) Comorbidities – nil
  • 2. • c/o low back pain – radiating to right LL , posterior aspect till tips of toes for 2 yrs , aggrevated in last 6 months • Paresthesias in right lower limb present • Neurogenic claudication for 500 mts • No h/o slippage of chappals • No bowel and bladder complaints • h/o fall of bricks over lower back 4 years ago
  • 3. O/E: Patient conscious and coherent Vitals stable -CNS examination Higher mental function-normal
  • 4. CRANIAL NERVE EXAMINATION • CN 1: B/L sense of smell normal • CN2: VA right –6/6 and left – 6/6 CN 3,4,6- • EOM full range • No nystagmus • No ptosis • Pupils- B/L 3mm equal and reactive.
  • 5. CN 5- Normal CN 7- Intact CN 8 • B/L AC>BC , Weber's not lateralised • CN 9, 10 • Uvula midline • Palatal movements normal ,no asymmetry
  • 6. CN 11 • Shoulder shrugging – Normal on both sides CN 12 • No fasciculations of tongue • no Tongue deviation
  • 7. MOTOR SYSTEM: Tone • Normal in both upper and lower limbs Bulk • Normal in both upper and lower limbs
  • 8. Power - right left Upper limb Shoulder- 5/5 5/5 Elbow- 5/5 5/5 Wrist- 5/5 5/5 HG- 100% 100% Lower limb Hip- 5/5 5/5 Knee- 5/5 5/5 Ankle- DF 5/5 5/5 PF 4+/5 5/5 EHL- 4+/5 5/5 • Reflexes – • Superficial reflexes-present • DTR: BJ TJ S KJ AJ Right - 2+ 2+ 2+ 2+ 1+ Left - 2+ 2+ 2+ 2+ 2+ Plantars- both flexors
  • 9. Sensory examination: decreased pinprick along right L5 dermatome Romberg's sign: Negative Tandem gait: Normal Cerebellar examination: Normal Involuntary movements: No Meningeal signs: No