neuro exam

Question 1

cranial nerve 1

Answer 1

change in smell

Question 2

cranial nerve 2,3,4,6

Answer 2

• visual acuity - shellen chart, each eye in turn
• poor vision - count fingers/ wave hand
• inattention - look at nose move index to temporal. check recognition
• visual field - eye move from peripheral to centre
• eye movement - H test convergence
• pupils - equal and reactive

Question 3

Cranial nerve 5

Answer 3

• motor - mouth open and close against resistance
• v1,2,3 light touch
• reflex - jaw jerk
• corneal reflex - afferent

Question 4

cranial nerve 7

Answer 4

• blinking symmetry
• wrinkling forehead
• raise eyebrows
• srew up eyes
• blow out cheeks
• smile

Question 5

cranial nerve 8

Answer 5

tuning fork in each ear

Question 6

cranial nerve 9, 10

Answer 6

• ahhh - uvular and palate symptry
• power and volume of speech
• ask to cough
• ask to swallow

Question 7

cranial nerve 11

Answer 7

• sternomastoid and trap muscles
• shrug shoulder and do it against resistance
• turn head against resistance

Question 8

cranial nerve 12

Answer 8

• tongue innervation
• stick tongue out and move side to side
• push tongue against side of cheek

Question 9

SWIFT

Answer 9

symmetry/ scars
weakness/ wasting
involuntary movements
fasciculations (small local involuntary muscle contractions
tremors

Question 10

lower limb

Answer 10

• gait - walk a few step
• ask to stand with eyes closed and see if they fall
• assess tone of muscles
• raise leg and knee against upward and downward resistance

Question 11

upper limb

Answer 11

• pronator drift
• asses tone
• assess power
• shoulder, elbow, wrist, finger, thumb - abduction, adduction, flexion and extension