Dear All

Thank you for participating in the session today.

In RRR we discussed:

• Upper / Lower Motor Neurone Lesion
• Spasticity
• Constipation – visible healing anal fissure

The clinical station showed a 9 year old with evidence of left Hemiplegia. Dr R took the hotseat. Dr J, Dr J and DR P had the examiner hat. Verbalizing the exam is quite a challenge and in my opinion more difficult than having a child in front of you. It is very easy to overrun and not complete the exam in 6 minutes.

The Learning points are:

• Remember it is a Focused examination
• Systematic
• You will not be able to cover ‘ALL you wish’.
• Genral physical and looking around room – 1 min max.
• Comment on any ‘abnormal’ finding – cue
• Splints / aids / medications
• General health – mention
• Examine without ‘splint’ if shown wearing
• GAIT – start when child standing
• Follow by Sitting on floor and getting up
• Conclude with your impression: UML lesion / LMN lesion

Please visit www.mrcpshonline.org to add your comments or points I may have missed.

Anil Garg