Loose papaers - Physical neurological examination

Question 1

Mental state:

Answer 1

• level of consciousness (glasgow coma scale)

- speech, comprehension, orientation

Question 2

Head and neck:

Answer 2

• appearance (symmetry, skull defects, scars etc)
• head palpitation and percussion
• neck mobility + sings of meningeal irritation
• palpitation and auscultation of the carotid and temporal arteries.

Question 3

Olfactory:

Answer 3

• I

- identification of odor on both sides

Question 4

Optic:
Trochlear:
Oculomotor:

Answer 4

• II
• visual acuity
• visual field
• pupils: shape and size; reaction to light (direct and consentual), accomodation and converge
• optic fundus

Question 5

Oculomotor:
Trochlear:
Abducent:

Answer 5

• III
• coordination and range of the external ocular movements
• strabismus, nystagmus, double vision

Question 6

Trochlear:
Abducent:
Oculomotor:

Answer 6

• IV
• coordination and range of the external ocular movements
• strabismus, nystagmus, double vision

Question 7

Abducent:
Trochlear:
Oculomotor:

Answer 7

• VI
• coordination and range of the external ocular movements
• strabismus, nystagmus, double vision

Question 8

Trigeminal:

Answer 8

• sensation on the face
• strength of masseters muscle
• corneal (blink) reflex
• mandibular nerve (jaw reflex)

Question 9

Facial:

Answer 9

• VII

- face expression and voluntary movements

Question 10

Auditory part of the vestibulo-cochlear

Answer 10

• VIII
• hearing
• Weber’s test
• Rinne’s test

Question 11

Glossopharyngeal and Vagus:

Answer 11

• IX, X
• symmetry of the soft palate
• position of the uvula
• gag and palatal reflexes

Question 12

Accessory:

Answer 12

• XI

- strength of the sternocleidomastoid muscles

Question 13

Hypoglossal:

Answer 13

• XII

- appearance and movements of tongue

Question 14

Upper extremities:

only important stuff

Answer 14

• involuntary movements (tremor, chorea, tics etc)
• pronator drift test; strength in different groups of muscles
• reflexes: triceps, biceps, radial
• cerebellar test; finger-to-nose test, alternating movements
• deep sensation: finger position (proprioseption) and vibration senses on both sides

Question 15

Trunk:

Answer 15

• abdominal reflexes: superficial (skin) - upper, middle and lower deep (muscular)

Question 16

Lower extremities:

only important stuff

Answer 16

• involuntary movements
• Muscle strength: Barre test, strength in different muscle groups)
• Reflexes: knee and ankle jerks, plantar response (normal plantar reflexes or Babinski sign)
• Cerebellar test: knee-to-heel test, alternating movements
• Deep sensation: toe position and vibration on both sides

Question 17

Balance and gait:

Answer 17

• Romberg’s test with open and closed eyes
• gait assessment
• walking on heels and toes