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Common Sense Aspects of the Neurological Exam
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Common Sense Aspects of the Neurological Exam

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The nature and technique of the neurological examination

The nature and technique of the neurological examination

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    Common Sense Aspects of the Neurological Exam Common Sense Aspects of the Neurological Exam Presentation Transcript

    • Common Sense Aspects of the Neurological Exam Or Why Can’t Neurologists KISS? (Keep It Simple Stupid)?
    • Visual Loss From Brain Injury • Patients may see movement even if they can count static fingers • Don’t forget that you can get field cuts with disease of the optic chiasm or optic tract (especially in MS) • Superior cuts suggest involvement of the contralateral temporal occipital region • Inferior cuts suggest involvement of the contralateral parietal occipital region.
    • Pupillary Reflexes Afferent Pupillary Defect (Marcus Gunn Pupil)
    • What Six Little Eye Muscles Can Do Eye Simulator.html.lnk
    • CN VI (ABDUCENS) AND III(OCULOMOTOR) PALSIES
    • Directions in Nystagmus Horizontal Upbeating vertical Downbeating vertical
    • Direction in Nystagmus Unidirectional Bidirectional
    • Horizontal Nystagmus First Degree Second Degree Third Degree
    • Horizontal Third Degree Nystagmus
    • Bidirectional Nystagmus in a Patient
    • Eye Movement Problems With Brain Injury
    • Doll’s Eye Reflex
    • CN VII (Facial)Peripheral v Central
    • Do-It-Yourself Cranial Nerve Exam
    • CN VIII (Auditory) Weber and Rinne Tests• Weber test = Tuning fork over middle of head to lateralize hearing loss• Rinne=bone conduction v air conduction
    • CN IX and X Palsy • Absent gag on stimulated side • Weakness of levator of palate • Dysphonia secondary to vocal cord paralysis
    • CN XI (Spinal Accessory Nerve) Palsy • Affects SCM and trapezius • Shoulder shrugging tests trapezius • Forward flexion of the next tests both SCM • Most often injured with pathology of the anterior cervical triangle
    • CN XII (Hypoglassal) Palsy • Atrophy and often fasculations on the side of the palsy • Tongue deviates towards the side of the lesion • Beware bilateral tongue atrophy and fasciculationsALS
    • Thinking About Biceps Jerk
    • Thinking About The Triceps Jerk
    • Thinking About the Brachioradialis Jerk
    • Thinking About the Knee Jerk
    • …Remember evenPresidentsdon’t knoweverything