Clinical Skills: Neurological Examination

1 Lecture Notes Clinical Skills: Neurological Examination Objectives: 1. Demonstrate assessment of cranial nerves I - XII. 2. Demonstrate technique for assessing the motor system, including tone, muscle bulk, and strength (deltoid, biceps, triceps, finger abduction, hip flexion/extension/abduction, knee extension/flexion, ankle dorsiflexion/plantar flexion, toe dorsiflexion). 3. Demonstrate testing of muscle stretch reflexes (biceps, triceps, knee, ankle) and plantar reflex. 4. Demonstrate assessment of sensory system for light touch, pain, vibration, and position sense (including Romberg testing). 5. Demonstrate techniques for testing coordination (fine finger movements, rapid alternating movements, finger-nose-finger, heel-knee-shin). 6. Demonstrate techniques for testing gait and stance.2 Equipment needed: Reflex hammer (preferably Troemner or heavy round head, not the tomahawk style). 128-Hz tuning fork. Ophthalmoscope. Pocket eye chart (for near vision testing) (Cotton swabs, tongue blades, and safety pins will be provided for you). General Considerations The neurological exam should be incorporated into the rest of your physical exam. Although it can be intimidating to those just learning it and although it will inevitably take you a long time to do at first, practice will certainly allow you to become proficient. Your job at this stage is to work on accuracy and thoroughness, not speed. In practice, the neurological