Prompts Flashcards
Assess freestyle gait for rhythm, symmetry of movement in legs and arms.
Assessed spring of the gait and swing of the arms- start in exam room and if abnormal, took patient out to
common area to provide a longer distance for walking.
Assess toe walking
Had patient walk away from examiner on toes while observing elevation of heels
Assess heel walking
Had patient walk toward examiner on heels while observing elevation of toes
Assess tandem gait
Explained test to the patient (example: walk heel-to-toe). Stood close to patient to provide support if needed
Perform Romberg test
Asked patient to stand with feet together and arms at sides.
Asked patient to close eyes to assess balance.
Stood close to patient to prevent a fal
Assess upper extremity drift
Observed outstretched upper extremities for drift. Test is performed by extending arms with palms facing up and
eyes closed.
CN I
Tested sense of smell by identifying mild fragrance in each nostril (may use any item with recognizable odor)
CN II - visual acuity
Tested visual acuity in each eye using pocket vision card (test is performed by holding card 14 inches from
patient and asking patient to read the smallest line and moving up or down the lines until patient can read a full
line in the smallest possible print. Each eye should be tested independently by closing the other eye)
CN II - visual field
Screened visual fields (test is performed with the examiner standing or sitting about 3 feet from patient, with
examiner and patient eyes at same level. One eye is examined at a time by covering the other eye, by presenting
a varied number of fingers (0, 1, or 2) to the patient in each of the four quadrants and asking the patient to
count (add) the fingers).
CN II - pupillary reaction
Tested direct and consensual pupillary reaction to light (room lights should be dimmed, may cup the eye with
hand to prevent light from going into the other eye)
CN II - movement
Performed the swinging light test (room lights should be dimmed). May cup the eye with hand to prevent light
from going into the other eye.
CN III, IV, VI
Observed all extraocular movements (examiner moves finger or light into the 6 cardinal positions and asks the
patient to follow the movement with the eyes. The 6 cardinal positions are: up and right, straight right, down
and right, up and left, straight left, and down and left). Observed eyelids.
CN V - pain sensation
Tested the three divisions for pain sensation - using a sharp object, with patient’s eyes open or closed:
- Tested sensation on forehead, cheek, and chin on both sides
- Asked if patient feels the object on each side
- Asked patient to compare the sensation between the 2 sides
CN V - light sensation
Tested the three divisions for light touch - using a tissue or a cotton tip, with patient’s eyes closed.
- Tested sensation on forehead, cheek, and chin on both sides
- Asked if patient feels the object on each side
CN V - motor
Tested contraction of masseter
- Asked patient to clench teeth or bite
- Asked patient to move jaw side to side
CN VII
Observed motor function and tone in musculature of face.
Had patient raise eyebrows. Had patient squeeze eyes shut.
Had patient grimace to show teeth.
Had patient puff out cheeks and pushed on each cheek with 1 finger to deflate it.
CN VIII - finger friction or whisper
Screened hearing using finger friction or whisper on both sides (hand should be behind the field of vision).
CN VIII - Rhinne test
Performed the Rinne test on both sides (examiner taps the tines of the tuning fork, places the base of the fork on the
mastoid bone and asks the patient to report when he/she stops hearing the vibration (bone conduction). Then
examiner places the still vibrating fork 1-2 cm from the ear and asks the patient to report when he/she stops hearing
the vibrations (air conduction). Duration of air conduction should be longer than that of bone conduction
CN VIII - Weber test
Performed the Weber test (examiner taps the tines of the tuning fork, places the base of the fork on the midline of the
patient’s head and asks the patient to report if he/she hears the vibrating sound equally in both ears or if it is better in
one ear. The bones of the skull will transmit the sound which then should be heard equally in both ears.
CN IX and X
Observed elevation of palate by asking patient to say “Ahh.”
Performed gag reflex on both sides using a cotton swab to touch back of palate on each side (may use a tongue
depressor to move tongue out of the way if needed).
. CN XI
Tested rotation of patient’s head against resistance. Tested shoulder shrug against resistance.
CN XII
Observed tongue for atrophy and fasciculations (twitching) while at rest inside the mouth. Observed midline
protrusion of tongue. Tested tongue strength by asking patient to push tongue against the inside of cheek while
applying resistance on the outside of the cheek - both sides should be tested.
Assess upper extremity functional muscle groups for bulk, atrophy and fasciculations
Observed and compared deltoids on both sides.
Observed and compared biceps on both sides.
Observed and compared pectoralis on both sides.
Assess lower extremity functional muscle groups for bulk, atrophy and fasciculations
Observed and compared calves on both sides.
Observed and compared quadriceps on both sides.
Assess muscle tone.
Asked patient to relax completely.
Passively moved the arms to check for spasticity or rigidity (both sides).
Passively moved the legs to check for spasticity or rigidity (both sides).
Grade muscle strength in the hands, both sides.
Asked patient to squeeze 2 fingers with each hand and pulled fingers out (distal muscles).
Asked patient to spread fingers and tried to push them together (distal)
Grade muscle strength in the arms, both sides.
Asked patient to extend arms to the sides with elbows bent, pushed down on the elbows and asked patient to
resist (proximal).
Asked patient to flex elbow against resistance (proximal).
Asked patient to extend elbow against resistance (proximal)
Grade muscle strength in the feet, both sides.
Asked patient to dorsiflex (move foot up) ankle against resistance (distal).
Asked patient to plantar flex (point toes) ankle against resistance (distal).
Grade muscle strength in the legs, both sides.
Asked patient to lift knee up while sitting against resistance (proximal).
Asked patient to extend bent knee against resistance (proximal).
Assess pain sensation on lower extremities - both sides
Using a sharp object, agreed with patient on how sharp should feel by touching skin with object.
Touched top of foot on each side and asked patient to compare the 2 sides.
Touched shin on each side and asked patient to compare the 2 sides.
On each side separately: touched foot then shin moving distal to proximal and asked patient for any changes in
sensation as object moved up
Assess pain sensation on upper extremities - both sides
Using a sharp object, touched dorsum of hand on each side and asked patient to compare the 2 sides.
Touched forearm on each side and asked patient to compare the 2 sides.
On each side separately: touched hand then forearm moving distal to proximal and asked patient for any
changes in sensation as object moved up
Assess light touch on lower extremities - both sides
Using a cotton tip or tissue, agreed with patient on how light touch should feel by touching skin with object.
Asked patient to close eyes. Touched top of foot on each side and asked patient if he/she can feel it.
Touched shin on each side and asked patient if he/she can feel it. On each side separately: touched foot then
shin moving distal to proximal and asked patient for any changes in sensation as object moved up
. Assess light touch on upper extremities - both sides (patient’s eyes closed).
Touched dorsum of hand on each side using a cotton tip or tissue and asked patient if he/she can feel it.
Touched forearm on each side and asked patient if he/she can feel it.
On each side separately: touched hand then forearm moving distal to proximal and asked patient for any
changes in sensation as object moved up
Assess position sense in both feet
Asked patient to close eyes.
Separated big toe from other toes and grasped it on the sides.
Moved the toe up and down several times in a random fashion while asking the patient to describe the direction
of movement
Assess position sense in both hands
Asked patient to close eyes.
Separated index finger and grasped it on the sides.
Moved finger up and down several times in a random fashion while asking patient to describe the direction of
movement
Assess vibration sense in toes - both sides
In big toe:
Tapped the tines of tuning fork and placed it on the joint below the nail, while examiner’s finger is on the other
side of the toe.
Tested duration of time patient felt the vibration and compared it to examiner’s sensation in the finger that is on
the toe
Assess vibration sense in fingers - both sides
In index finger:
Tapped the tines of tuning fork and placed it on the joint below the nail, while examiner’s finger is on the other
side of the finger.
Tested duration of time patient felt the vibration and compared it to examiner’s sensation
Brachioradialis deep tendon reflex - both sides
n/a
Biceps deep tendon reflex - both sides
n/a
Triceps deep tendon reflex - both sides
patient’s hands on hips
Patellar deep tendon reflex - both sides
n/a
Achilles deep tendon reflex - both sides
gently dorsiflex the foot
Babinski reflex - both sides
Rubbed bottom of foot, back to front, lateral to slightly medial
Test rapid alternating movements in upper extremities - both sides (one side at a time)
Asked patient to extend arm and fully turn hand up and down fast
Test rapid alternating movements in lower extremities - both sides (one side at a time)
Can be done by asking patient to rapidly tap his/her toes on the floor.
Test fine finger movements - both sides
Asked patient to touch each finger against thumb.