NEUROLOGICAL EXAMINATIONS

PREPARED BY: MUHAMMAD ARIFF B. MAHDZUB

BACHELOR MEDICINE AND SURGERY (MBBS)
UNIVERSITY COLLEGE SHAHPUTRA, KUANTAN

1. 1 NEUROLOGICAL EXAMINATIONS PROBLEM BASED LEARNING (PBL) PREPARED BY: MUHAMMAD ARIFF B. MAHDZUB BACHELOR MEDICINE AND SURGERY (MBBS) UNIVERSITY COLLEGE SHAHPUTRA, KUANTAN

2. WHAT IS NEUROLOGICAL EXAMINATIONS?

3. COMPONENTS

4. A) Appearance

5. B) Attitude and behaviour

6. c) Speech

7. d) Perception

8. TEST EXAMPLE :GCS

9. TEST EXAMPLE : AMTS

10. TEST EXAMPLE : MMSE

11. 2) Reflex examination

12. A)Tendon reflex

13. B)Superficial reflex

14. C)Pathological reflex

15. 3) Sensory examination graphesthesia

16. Cranial nerve mnemonics (function) Olfactory Oh Some Optic Oh Say Oculomotor Oh Marry Trochlear To Money Trigeminal Take But Abducent A My Facial Family Brother Vestibulocochlear Vacation! Says Glossopharyngeal Go Big Vagus Vegas Brain Accessory And Matter Hypoglossal Hawaii Most

17. XI Spinal Accessory Nerve The spinal accessory supplies the trapezius and sternocleidomastoid muscles. observe for atrophy or asymmetry of the muscles. quickness of shoulder shrug XII Hypoglossal Nerve The hypoglossal nerve is motor to the tongue. Normal Response: the tongue should be able to protrude relatively straight. Minimal degrees of deviation (i.e. only millimeters ) affecting only the tip are insignificant. Abnormal Response: with tongue weakness, the tongue deviates towards the weak side.

18. Motor Examination

19. MRC Scale Grade Description no contraction 1 flicker or trace of contraction 2 active movement with gravity eliminated 3 active movement against gravity 4* active movement against gravity and resistance 5 normal power

20. Coordination & Gait

21. Coordination To perform tasks of co-ordination one requires normal motor, sensory, and cerebellar systems. Lesions affecting any of these areas could give rise to abnormal tests of co-ordination. Examine Upper extremities Lower extremities Gait observe the patient walk. if there is a subtle abnormality this may be made more obvious by asking the patient to run. ask the patient to perform tandem gait by walking heel to toe (eyes open).