Review of Neurological Exam
Six categories:
- Mental status & speech
- Cranial nerves
- Motor function
- Sensory function
- Reflexes
- Cerebellar function
Carefully evaluate the hx of the CC CN assessment is essential!
CNS Terminologies
Mental Status
CNS Equipments needed
Cranial Nerve Examination
Motor-Sensory-Reflex Examination
Cerebellar Examination
Purpose of the Neurological Exam
- Determine if there is a neurological deficit
- Behavioral-Higher function
- sensory
- motor
- Coordination
- Localize the site of the problem
- Determine the etiology of the problem
- Orientation/short/long term memory
- Speech assessment /
- Neurological exam
- (ask patient to smell, close eyes, move their tongue etc.)
Focuses
- Mental status
- Cranial nerves
- Motor function
- Reflexes
- Sensory status
- Coordination and balance
Steps in the neurologic examination
In examining a patient, abnormalities of function lead to localization and, eventually, to the pathophysiology.
These steps include the following:
- General Appearance, including posture, motor activity, vital signs and perhaps meningeal signs if indicated.
- Mini Mental Status Exam, including speech observation.
- Cranial Nerves, I through XII.
- Motor System, including muscle atrophy, tone and power.
- Sensory System, including vibration, position, pin prick, temperature, light touch and higher sensory functions.
- Reflexes, including deep tendon reflexes, clonus, Hoffman’s response and plantar reflex.
- Coordination, gait and Romberg’s Test - Examining the comatose patient
Wash your hands, introduce yourself to the patient and clarify their identity. Explain the procedure and obtain consent.
Other Signs
Other CNS examination & manifestations
Lower limbs As with all examinations, the best method is your own – one with which you are comfortable and familiar. The one explained here takes the following format: