Neurological Exam Flashcards
Technique
1) Check the Glasgow Coma Seale score 0-15
2) Explain the procedure to the patient and obtain permission
3) Observe the patient walking to the exam table
4) Perform a cranial nerve examination: smell (CN I), vision (CN II), touch on the face (CN V), smile (CN VII), rub fingers (CN VIII), gag reflex (CN IX and CN X), shrug the shoulders (CN XI), stick the tongue out (CN XII),
5) Remember SO4 LR6 / 3 for the eye movements: superior rectus ask the patient to look up (CN III), Inferior Rectus ask the patient to look down (CN III). Medial Rectus - ask the patient to look towards the nose (CN III), Lateral Rectus ask the patient to look towards the ear (CN VI), Superior Oblique ask the patient to look in and down (CN IV), Inferior Oblique ask the patient to look in and up (CN III)
6) Examine the pupil size and reaction to light and accommodation (CN II and III)
7) Perform a MRS screen (C5 deltoid muscle, biceps reflex, sensation over the outer arm / C6 biceps muscle, brachioradialis reflex and sensation over the lateral forearm / C7 triceps muscle and reflex and sensation in the middle finger / L4 tibias anterior muscle, patellar reflex and sensation over the medial aspect of the foot / L5 extensor helices longs muscle, medial hamstring reflex, sensation over the dorsum of the foot / S1 preens longs, ankle reflex and sensation over the lateral aspect of the foot
8) Test thumb movement (opposition = median nerve / adduction= ulnar nerve / extension = radial nerve)
9) Perform a Romberg test (dorsal columns integrity)
10) Perform cerebellar tests - nose to finger, rapid alternating movements, heel to shin
11) Record findings
12) Interpret findings in the light of the history
