1. NEUROLOGICAL
EXAMINATION
BY,
MR. RAMPRASAD.S M.SC NURSING
ASST.PROFESSOR
DEPT.MEDICAL SURGICAL
NEUROSCIENCES NURSING
GOPALA GOWDA SHANTHAVERI MEMORIAL COLLEGE OF
NURSING, MYSORE.

6. A MECHANIC DOES NOT NEED TO USE
EVERY TOOL ON EVERY PROJECT

7. REQUIRED TOOLS ARE

8. STEPS
1. A COMPREHENSIVE HISTORY
2. A NEUROLOGICAL PHYSICAL
EXAMINATION
3. GENERAL AND SPECIFIC
NEUROLOGICAL STUDIES

9. A PROPER NEUROLOGIC
EXAMINATION BEGINS WITH A
CAREFUL CLINICAL HISTORY

10. http://www.cbu.edu/~mcondren/IRM/Stop-Look-Listen-sign-IRM-7-7-07.jpg

11. A COMPREHENSIVE HISTORY
1. DEMOGRAPHICAL DATA
2. CURRENT HEALTH
1. Chief complaints
2. Symptom analysis
3. PAST HISTORY
1.Childhood infectious diseases,
immunization
2. Major illness
3. Growth and development

12. 4. FAMILY HEALTH HISTORY
5. PSYCHO SOCIAL HISTROY
6. REVIEW OF SYSTEMS

13. PHYSICAL EXAMINATION
1. VITAL SIGNS
2. MENTAL STATUS
3. HEAD, NECK, BACK
4. CRANIAL NERVES
5. MOTOR SYSTEMS
6. SENSORY FUNCTION
7. REFLEXES
8. ANS

14. MENTAL STATUS
1. LOC
2. ORIENTATION
3. MEMORY
4. MOOD AND AFFECT
5. INTELLECTURAL PERFORMANCE
6. JUDGEMENT AND INSIGHT

15. 1. LANGUAGE AND COMMUNICATION
2. INTEGRATED SENSORY FUNCTIONS

16. GLASGOW COMA SCALE

18. HEAD NECK AND BACK
1. INSPECTION
2. PALPATION
3. PERCUSSION
4. AUSCULTATION

19. CRANIAL NERVES FUNCTION TEST
1. OLFACTION
Test by asking if patients can
smell,coffee,vanilla, or cinnamon in
each nostril. Avoid noxious odors

21. 2. OPTIC
Visual Acuity (test with hand card)
Visual Fields (can be tested at the bedside by
counting fingers in each quadrant)

23. OCULOMOTOR NERVE
The size and shape of the pupil should be
recorded at rest. Under normal
conditions, the pupil constricts in
response to light. by having the patient
follow an object moved across their full
range of horizontal and vertical
eyemovements.

24. TRIGEMINAL NERVE
1. Cotton fore head,cheeks,jaw
Check for tactile sensation
2. Sharp and blunt edge of the tongue
blade check for pain sensations
3. Hot and cold water test tubes check
for temperature.
4. Eyes looks up cotton against
temporal surface of the cornea
blinking

25. FACIAL NERVE
Observe symmetry while patient performs
facial movements, smiles, elevates eye
brow.

26. ACOUSTIC NERVE

27. GLASSO PHARYNGEAL NERVE
Ability to swallow and discriminate
between sugar and salt on posterior
third of the tongue.

28. VAGUS NERVE
Depress the tongue blade n
posterior tongue and stimulate the
posterior pharynx to elicit gag reflex
see hoarseness of the voice.

29. SPINAL ACCESSORY NERVE
Ask the patient to shrug their
shoulders, turn their head in both
directions, and raise their head from
the bed, flexing forward against the
force of your hands.

30. HYPOGLOSSAL NERVE
Protrude the tongue note for any
deviation and tremors.

32. EXAMINING THE MOTOR SYSTEM
1. MUSCLE STRENGTH
2. BALANCE AND CO-ORDINATION
A. POINT TO POINT TEST
B. ROMBERG TEST
3. GAIT
4. ARM BOUNCE

34. Upper extremity
1. Pat the thigh with each hand separately
2. Alternatively pronate and supinate the
hand
3. Touch each fingers with the thumb in a
consecutive manner
4. Finger to nose {eye open and eye
closed }

35. Lower extremity
Run the patient heel down the anterior
surface of the tibia of the other leg.

36. COORDINATION TEST
1. Romberg test
Stand with feel together and arm at the
Side, both with eye closed and eye open
stand for 20-30 sec.

37. EXAMING THE REFLEXES
1. BICEPS REFLEX
2. TRICEPS REFLEX
3. BRACHIO RADIALIS REFLEX
4. PATELLAR REFLEX
5. ANKLE REFLEX
6. CLONOUS
7. SUPERFICIAL REFLEX

38. 1. Biceps reflex
Response is flexion at the elbow and
contraction of the biceps

39. 2. Triceps reflex
Response is extension of the elbow and
contraction of the triceps muscle

40. 3. Brachio radialis reflex
Response is flexion and supination of the
fore arm

41. 4. Patellar reflex
Response is contraction of the quadriceps
and knee extension are normal

42. 5. Ankle reflex
Response is plantar flexion

43. 6. Clonus reflex
Unsustained clonus is normal

44. 7. Corneal reflex
Blink and tearing are normal

45. 8. Gag reflex
Equal elevation of the uvula and gag
with stimulation

46. 9. Plantar reflex
Flexion of the toe is normal response

47. 10. Babinski reflex
Toes are contract and draw together
is normal

49. 1. Tactile sensation
2. Pain sensation
3. Proprioception