Neuro OSCE Flashcards
How do you test CN I clinically?
Odor test
How do you test CN II clinically?
Visual acuity with the Snellen eye chart
Test the visual fields by spreading your arms out to the patients peripheral vision and wiggle fingers
Light reaction- shining the light into the eyes to test for constriction
Describe how you would test CN III, IV, and VI clinically
Near reaction: patient shifts gaze from near to far
Check eyelids for ptosis
Cardinal signs of gaze: H test
check for nystagmus
Describe how you would test CN V clinically
- motor
- sensory
- corneal reflex
- Palpate the masseter muscles and ask to clench their cheeks; ask them to move their jaw from side to side to test the lateral pterygoids
- Test the forehead, jaw, and cheeks for sensation with the patients eyes CLOSED
If abnormality is found, test for temperature sensations
- corneal reflex: clean cotton swab to cornea lateral to the iris
How do you test CN VII clinically?
Have the patient use their muscles of facial expression; frown, smile, etc
How do you test CN VIII clinically?
Whisper test; stand behind the patient and whisper to see if they can hear you
How do you test cranial nerves IX and X clinically?
Talking, swallowing, soft palate elevation with the work “ah”
How do you test CN XI clinically?
Shrugging shoulders against resistance
Looking the head to the side against resistance
How do you test CN XII clinically?
Tongue movement and speech articulation
How do you test cerebellar coordination clinically?
Rapid alternating movements
Finger to nose
Heel to shin
What are ways in which you can test the patients gait?
Casual gait: have them walk around the room and observe
Tandem gait: walk in a straight line
Heel to shin
Hop in place on one leg
Shallow knee bend on each leg
How would you evaluate stance clinically?
Romberg test: have them stand with their legs together and close their eyes; if they wobble, its positive
Test for pronator drift: eyes closed for 10-20 seconds and hands in the air palms up
