How to examine the nerves of the leg
Other platforms explain it with text and video. In Making Synapses you practice it on the patient.
Lower limb neuro exam follows the same order as the arm.
Step by step
Look
Wasting, twitching, deformity. [1]
Tone
Roll the leg, lift the knee quickly; check for clonus at the ankle. [1]
Power
Hip flexion (L2), knee extension (L3), ankle dorsiflexion (L4), big toe extension (L5), plantarflexion (S1). [1]
Reflexes
Knee, ankle, plantar response. [1]
Sensation
Light touch and pinprick by dermatome; vibration and position at the big toe. [1]
Coordination and gait
Heel to shin, then walking. [1]
Common errors
- Missing clonus.
- Not testing the big toe.
- Skipping gait.
Practice it in Making Synapses
In Making Synapses you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.
Making Synapses cases that train this skill
- Polio
- Herniated disk
- Cauda equina syndrome
- Common peroneal nerve palsy
- Preeclampsia with magnesium toxicity
- Pressure injury in a wheelchair user
36 Making Synapses cases train this skill: open the case library
Sources
- Open RN, Nursing Skills 2e (Chippewa Valley Technical College) (CC BY 4.0)
- NCCPA PANCE Content Blueprint
- Stanford Medicine 25 (bedside exam)
Steps adapted from Open RN, Nursing Skills 2e (Chippewa Valley Technical College), licensed under CC BY 4.0. Facts and steps also follow NCCPA PANCE Content Blueprint; Stanford Medicine 25 (bedside exam). Making Synapses is not affiliated with these organizations. Updated: 2026-10-11.