Nervous system OSCE

Question 1

General Inspection

Answer 1

Postural abnormalities and deformities

Muscle wasting

Fasiculation

Abnormal movements

Question 2

Tone

Answer 2

Pain

Flex and extend hand at wrist (passive)

Flex and extend hand at elbow

Rotate arm at shoulder

(all passive)

Question 3

Power

Answer 3

Pronator Drift

(active and with resistance)
Shoulders - Abduct and adduct
elbows - flex and extend
wrist - flex and extend
fingers - flex and extend
fingers - abduct and adduct

Question 4

Co-ordination

Answer 4

Finger to nose test

rapid alternating wrist movements

Question 5

Tendon reflexes

Answer 5

Biceps (c5,c6)
Triceps (C7)
Brachioradialis (C5, C6)

Question 6

Sensation

Answer 6

Light touch and pain: (consider hot and cold)

Posterior aspect of shoulders (C4)
lateral aspect of upper arms (C5)
Tip of thumb C6
Tip middle finger C8
Medial lower arms T1
Medial upper arms t2

Joint position sense
Vibration (128Hz)