the arm may be held in a flexed posture.
Parkinsonian gait classically has a stooped forward posture with small
shuffling steps and a tendency to fall over backward ( retropulsion) . Tu rns a re
not made with a smooth rotation , but usually consist of a series of small steps
(en-bloc turning). Parkinsonian patients may have difficulty getting started walking,
but once started may actually walk faster and faster and be unable to stop
(festi nation ) .
Steppage gait is associated with a foot drop, and this involves simply stepping
h igher with the affected leg so that the foot, which is hanging down, can
clear the ground. These patients often give a history of stumbling/tripping over
their toes on the weak side.
Scissor gait is seen in patients with a spastic paraparesis (spinal cord injury,
cerebral palsy) and shows increased tone in the thigh adductors, such that whenever
a step forward is attempted, the legs actually cross (hence the name scissor) .
S e nsory Exa m i nation
It is not necessary to memorize every possible combination of peripheral
nerve or dermatomal sensory loss; however, some general guidelines are helpful
. A pin (or a toothpick) is more accurate than a finger at mapping out areas of
sensory loss.
Root
C6
C 7
C8
T4
T 1 0
L5