Neurological

Question 1

General inspection

Answer 1

Any abnormalities

• speech
• facial
• eyelids
• pupils
• limbs

Question 2

Olfactory (I)

Answer 2

Sensory
Can you smell things? Any change to the smell recently
Test each nostril separately.

(Infections, head injury, neurodegenerative diseases)

Question 3

Optic (II)

Answer 3

Sensory
Assess pupil size 
Assess pupil shape 
Assess pupil symmetry 
Snellen chart- distance and acuity 
Can you see each side - focus on middle and wave fingers each side ask if they can see

Question 4

Occulomotor (III)

Trochlear (IV)

Answer 4

Motor

H tests- head still and follow the pen/finger.

Question 5

Abducens (VI)

Answer 5

Motor
H test.

Assess for good movement of the eyes.
Changes may be due to raised ICP, tumours, lesions

Question 6

Trigeminal (V)

Answer 6

Both

Open and closing the jaw. Assess all 3 branches
Ophthalmic, maxillary, mandibular
Assess sensation.

Question 7

Facial (VII)

Answer 7

Both.
Facial movement and expressions
Closing eyes and mouth against resistance.

Also sensory, ensure taste is the same and has not changed

Question 8

Vestibulocochlear (VIII)

Answer 8

Sensory
Ensure that hearing is the same and hasn’t changed
Whisper test

Question 9

Glossopharangeal (IX)

Answer 9

Both
Listen to voice
Observe swallowing
Say ahhhh and observe alignment of uvula

Question 10

Vagus (X)

Answer 10

Both

Motor- check gag reflex tickle throat in both sides
Sensory- Blood pressure (hypotension and bradycardia)

Question 11

Accessory (spinal) (XI)

Answer 11

Motor
Shoulder shrug against resistance
Turn head against resistance

Question 12

Hypoglossall (XII)

Answer 12

Stick tongue out (wastage, tremors, central)

Press tongue against cheeks internal and palpate externally for strength

Question 13

Nystagmus

Answer 13

Rapid involuntary movement of eyes

Aquired/ acute - stroke/ MS/trauma

Question 14

Red reflexes

Answer 14

Missing red reflex when shining light can indicate eye CA

Question 15

Rinne test

Answer 15

Strike fork on hand
Place on mastoid process, figure out when they can’t hear it anymore.
Hold next to ear and ask when no longer any sound

Question 16

Weber test

Answer 16

Start tuning fork,

Place in forehead evaluate hearing in both sides

Question 17

Oh 
Oh 
Oh 
To 
Touch 
And 
Feel 
Virgin 
Girls 
Vagina 
Ah 
Heaven

Answer 17

Olfactory 
Optic
Oculomotor 
Trochlear 
Trigeminal 
Abducens 
Facial
Vestibulocochlear 
Glossopharynx 
Vagus 
Accessory 
Hypoglossal

Question 18

Wrist and Arms (peripheral nerve assessment)

Answer 18

C5-T1
Wrist extension 
Grip 
Finger abduction 
Elbow extension and flex ion

Question 19

Lower limbs peripheral nerve assessment

Answer 19

L2-S1
Hip flexion and extension 
Abduction and addiction
Knee extension and flexion 
Ankle flexion

Question 20

DANISH (cerebellum)

Answer 20

Dysdiadochokinesia 
Ataxia 
Nystagmus 
Intention tremor 
Slurred staccato speech 
Hypertonia

Question 21

Romberg test (cerebellum)

Answer 21

Feet together and close eyes

Assess for poor balance

Question 22

Probated drift (corticospinal)

Answer 22

Both arms out flat and eyes closes. Press downwards and assess for return to normal position

Finger to nose
finger to finger