Common Sense Aspects of the Neurological Exam

1,018 views

Published on

The nature and technique of the neurological examination

Published in: Health & Medicine
0 Comments
2 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
1,018
On SlideShare
0
From Embeds
0
Number of Embeds
3
Actions
Shares
0
Downloads
9
Comments
0
Likes
2
Embeds 0
No embeds

No notes for slide

Common Sense Aspects of the Neurological Exam

  1. 1. Common Sense Aspects of the Neurological Exam Or Why Can’t Neurologists KISS? (Keep It Simple Stupid)?
  2. 2. 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.
  3. 3. Pupillary Reflexes Afferent Pupillary Defect (Marcus Gunn Pupil)
  4. 4. What Six Little Eye Muscles Can Do Eye Simulator.html.lnk
  5. 5. CN VI (ABDUCENS) AND III(OCULOMOTOR) PALSIES
  6. 6. Directions in Nystagmus Horizontal Upbeating vertical Downbeating vertical
  7. 7. Direction in Nystagmus Unidirectional Bidirectional
  8. 8. Horizontal Nystagmus First Degree Second Degree Third Degree
  9. 9. Horizontal Third Degree Nystagmus
  10. 10. Bidirectional Nystagmus in a Patient
  11. 11. Eye Movement Problems With Brain Injury
  12. 12. Doll’s Eye Reflex
  13. 13. CN VII (Facial)Peripheral v Central
  14. 14. Do-It-Yourself Cranial Nerve Exam
  15. 15. 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
  16. 16. CN IX and X Palsy • Absent gag on stimulated side • Weakness of levator of palate • Dysphonia secondary to vocal cord paralysis
  17. 17. 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
  18. 18. 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
  19. 19. Thinking About Biceps Jerk
  20. 20. Thinking About The Triceps Jerk
  21. 21. Thinking About the Brachioradialis Jerk
  22. 22. Thinking About the Knee Jerk
  23. 23. …Remember evenPresidentsdon’t knoweverything

×