Documente Academic
Documente Profesional
Documente Cultură
Done by
Dr/ Abdullah Mohd. Jan
MBBS,Intern
Aspects of Examination
1. General Ex
2. The Cranial nerves
3. The upper limbs
( Motor + Sensory + coordenation )
4. The lower limbs
( Motor + Sensory + coordenation)
5. The skull and spine for local disease
6. The carotid arteries for bruits
General Examination
• Assessment of the higher centers
• Speech
• Neck stiffness
• Abnormal movements
General Examination
1. Assessment of the higher centers
o Consciousness
o Orientation ( Person , Place , Time ).
o Memory
o Handedness
2. Speech
o Flow of speech
o Comprehension
o Repetition
3. Neck stiffness
looking for meningism ( meningitis ,SAH)
Cranial Nerves Examination
• Inspection of pupil
• Light reflex
• Eye Movement & nystagmus
• Convergence & accomodation
• Look at pupils: shape, relative size,
• Ptosis.
• Shine light in from the side to look for
pupil's light reaction.
• Assess both direct and consensual
responses.
• Assess afferent pupillary defect by
moving light in arc from pupil to pupil.
The pupils
CN V :Trigeminal
• Motor
• Sensory
• Reflex
• Motor :pt opens mouth, clenches teeth
)pterygoids).
• Palpate temporal, masseter muscles as
they clench .
• Jaw jerk :
– Dr's finger on tip of jaw .
– Grip patellar hammer halfway up shaft and
tap Dr's finger lightly.
• Sensory
Facial sensation by cotton on forehead,
cheek & jaw.
• Corneal reflex :patient looks up and away.
• Touch cotton wool to other side.
• Look for blink in both eyes, ask if can
sense it.
• Repeat other side [ tests V sensory, VII
motor].
CN VII :Facial
• Motor
• Taste sensation
CN VII :Facial
• Inspect for facial droop or asymmetry .
• Drift test
• Feel the muscle bulk ( proximally &
Distally ) – muscle tenderness.
• Power ( 0 – 5 )
by active movement at the hip , knee ,
ankle , and tarsal joints
• Reflexes ( 0 - ++++ )
Knee jerk ( L3,L4 ) – Ankle jerk (S1,S2 ) –
Plantar reflex ( L5, S1 , S2 )
• Coordination
Heal to shin test
Toe finger test Foot
Tapping test
Sensory system
• Spinothalamic pathway
Pain and Temperature ( usually temperature is
not tested )