← Full lesson and references Paired practice cardsSt Emlyn’s · MLA

One learner performs. One learner checks the key steps and gives feedback. Then swap roles. This is a practice aid, not an official mark scheme.

Candidate

Lower limb neurology

MLA · Paired examination practice

Your task

You are a medical student. Examine the lower limbs neurologically. Present your findings and discuss appropriate next steps with the responsible clinician.

Starting information

Practise with a consenting partner, using the equipment and scope agreed before starting.

Suggested practice time: 8–10 minutes for a focused run, followed by feedback. Allow longer to practise the full sequence. This is not an official examination timing.

St Emlyn’s · MLA · Practice aid, not an official mark schemeCandidate card

Show examiner checklist

Examiner / observer

Lower limb neurology

Tick the actions you observe. Discuss any step that was not needed for this examination; unchecked boxes are not a score.

Examiner / observer · 1 of 3

Lower limb neurology

Preparation · History and inspection

Agree supervision and any communication or chaperone support before starting. Provide a couch, usual walking aid if used, reflex hammer, cotton wool, 128 Hz fork and suitable sensory equipment. Ensure walking can be supported. Use a model or description for uncomfortable tests unless a suitable supervised setup is agreed.

St Emlyn’s · MLA · Practice aid, not an official mark schemeObserver 1 of 3

Examiner / observer · 2 of 3

Lower limb neurology

Tone and power · Sensation

St Emlyn’s · MLA · Practice aid, not an official mark schemeObserver 2 of 3

Examiner / observer · 3 of 3

Lower limb neurology

Reflexes and coordination · Close

Reflexes and coordination

Compares knee and ankle reflexes, with reinforcement if needed.

Uses a blunt plantar stimulus from lateral heel towards forefoot, then medially.

Records flexor, extensor or absent plantar responses and distinguishes withdrawal.

Tests heel–shin with eyes open on both sides; adds eyes-closed testing only if useful.

Close

Restores comfort and privacy, offers help with dressing and thanks the patient.

Ask the candidate

How would you present your findings and their significance? Present symmetry, proximal/distal distribution, tone, power, reflexes, plantar responses and mapped sensation. Relate findings to function and consider relevant spinal, hip or vascular assessment. Acute weakness, a sensory level or bladder, bowel or saddle symptoms need prompt assessment; a routine limb examination cannot exclude a spinal emergency.

What would you do next, and why? Explain the important uncertainty, a relevant next assessment and when help is needed. State what you could not assess.

Feedback

What went well:

One thing to improve:

Try again focusing on:

St Emlyn’s · MLA · Practice aid, not an official mark schemeObserver 3 of 3

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