🧠 Chapter 714 · Neurologic Evaluation in Orthopedics

Nelson Textbook of Pediatrics 22nd Edition | Focus on motor strength (MRC scale), muscle tone (Ashworth), deep tendon reflexes, developmental milestones, gait disturbances, and upper motor neuron signs in the pediatric orthopedic exam.

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📋 30 Clinical Scenarios — Neurologic Evaluation (Orthopedic Context)

📇 High‑Yield Review Cards: Neurologic Exam

🩺 Clinical Presentations: Neurologic Deficits in Orthopedic Practice

Select a neurologic presentation to review localization, exam findings, and next steps per Nelson Ch 714.

📋 Stepwise Approach: Neurologic Evaluation in the Child with Orthopedic Complaint

🔑 Key Principles — Neurologic Assessment (Nelson Ch 714)
• MRC Scale (0-5): Grade 5 normal, grade 4 against resistance, grade 3 against gravity, grade 2 with gravity eliminated, grade 1 visible contraction, grade 0 none.
• Ashworth Scale (0-4): 0 no tone, 1 slight catch, 2 moderate tone throughout, 3 considerable increase, 4 rigid.
• Motor Control Grades: 1 hypotonic no motion, 6 volitional control of specific joints.
• Deep Tendon Reflexes: Biceps, triceps, patellar, Achilles. Hyperreflexia = UMN lesion.
• Upper Motor Neuron Signs: Clonus (>3 beats), Babinski, Hoffman, spasticity.
• Developmental Milestones: Head control 3-6mo, sitting 6-9mo, crawling 8mo, ambulation 12-18mo.

    ⚡ Reflex Prompts — Neurologic Decision Making

    📖 Summary: Neurologic Evaluation in Orthopedic Practice (Nelson 714)