Neurologic Exam

Aka: Neurologic Exam

1. Exam: Highest yield tests
   1. Cranial Nerve tests
      1. Visual field testing with double stimulation upper fields and lower fields
      2. Extraocular Movements
   2. Motor strength
      1. Upper extremity
         1. Grip strength
         2. Proximal strength
      2. Lower extremity
         1. Heel and toe walking
         2. Stand from chair without pushing off
   3. Balance and coordination
      1. Rhomberg
      2. Tandem walking
2. Exam: General
   1. Appearance: Well groomed or unkempt
   2. Eye contact: Good, fleeting, sporadic or avoidant
   3. Behavior: Cooperative, candid, withdrawn, guarded, hostile or irritable
3. Exam: Eye
   1. See Eye Neurologic Exam
4. Exam: Face
   1. See Cranial Nerve Exam
   2. Palpebral fissures equal
   3. Facial symmetry
   4. Tongue midline with no fasciculations
   5. Jaw symmetric
5. Exam: Oropharanx
   1. Gag Reflex
   2. Swallow reflex
   3. Regurgitation (nasal or liquid)
6. Exam: Larynx and Language
   1. Voice quality
   2. Speech Exam
   3. Dysarthria (explosive or nasal)
   4. Aphasia (writing)
7. Exam: Sensory
   1. Two Point Discrimination
   2. Sharp and dull discrimination
   3. Proprioception (finger up or down?)
   4. Stereography
8. Exam: Motor Exam
   1. Motor Strength
   2. Tone (flaccid, rigid, or cogwheel)
   3. Atrophy
   4. Fasciculations
   5. Muscle tenderness
   6. Tremor
9. Exam: Reflexes
   1. Deep Tendon Reflexes
   2. Primitive Reflexes
      1. Babinski Reflex
      2. Grasp Reflex
      3. Suck Reflex
      4. Glabellar Reflex
      5. Hoffman Reflex
10. Exam: Cerebellar
    1. Finger-Nose-Finger
       1. Dysmetria
       2. Overshooting target
       3. Intention Tremor
    2. Alternating hand movements
    3. Heel-knee-shin
    4. Romberg Test
    5. Gait
       1. Walking on base of foot
       2. Tandem walking
       3. Overall coordination
    6. Vestibular Exam