CLINICAL EXAMINATION OF THE NERVOUS SYSTEM

1. CLINICAL EXAMINATION OF THE
NERVOUS SYSTEM
QURATULAIN MUGHAL
BATCH IV
ISRA UNIVERSITY
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2. OBSERVATION
• General appearance
• Mood (e.g. anxious, depressed)
• Facial expression (or lack thereof)
• Handedness(the tendency to use either the
right or the left hand more naturally than the
other).
• Nutritional status
• Blood pressure
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3. STANCE AND GAIT
• Posture
• Romberg’s test
• Arm swing
• Pattern of gait
• Tandem (heel-toe) gait
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4. BACK
• Scoliosis
• Operative scars
• Evidence of spina bifida occulta
• Winging of scapula
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5. NECK AND SKULL
• Skull size and shape
• Neck stiffness
• Kernig’s test
• Carotid bruit(A carotid bruit is a systolic sound
heard over the carotid artery area
during auscultation).
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6. CRANIAL NERVES
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7. OPTIC FUNDI
• Papilloedema
• Optic atrophy
• Cupping of disc (glaucoma)
• Hypertensive changes
• Signs of diabetes
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8. MOTOR
• Wasting, fasciculation
• Abnormal posture
• Abnormal movements
• Tone (including clonus)
• Strength
• Coordination
• Tendon reflexes
• Abdominal reflexes
• Plantar reflexes
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9. SENSORY
• Pin-prick
• Temperature
• Joint position
• Vibration
• Two-point discrimination
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10. HIGHER CEREBRAL FUNCTION
• Orientation
• Memory
• Speech and language
• Localised cortical functions
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11. REFERENCES
• Davidsons Principles & Practice of Medicine
22nd Edition.
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