GAIT AND ROMBERG'S TEST ALONG WITH: 1. mental and emotional status 2. cranial nerves 3. motor system 4. reflexes 5. coordination

1. DEMONSTRATION ON
NEUROLOGICAL
EXAMINATION
PRESENTED BY-
PALAK GIRI
AIN/2020/598
2ND YEAR BSC NURSING

2. CONTENT
• Definition
• Purpose
• Indication
• Contraindication
• Scientific principles
• Article preparation
• Preparation of unit and patient
• Procedure
• After care of patient and articles
• Documentation

3. DEFINITION
• A neurological examination is an essential component of a comprehensive
physical examination. It is a systematic examination that surveys the
functioning of nerves delivering sensory information to the brain and
carrying motor commands and impulse back to the brain for processing and
coordinating.

4. PURPOSE
• To determine if there is a neurological deficit:
1. Sensory
2. Motor
3. Behavioural
4. Coordinative
• To localize the site of problem.
• To determine the etiology of the problem.

5. INDICATION
• To identify the presence of any neurological dysfunction.
• As a part of routine physical examination.
• Patients suffering under such as:
1. Meningitis
2. Head injury
3. Brain tumour
4. Unconscious patient
5. Tetanus

6. CONTRAINDICATION
• Injury or congenital anomalies to spinal cord or joints
• Malignancy of nervous system.

7. SCIENTIFIC PRINCIPLES
• People have diversity of habits and mode of behaviour.
• Patient and family will understand the patient’s behaviour and
mental changes to physical changes.

8. PREPARATION OF UNIT
• Quiet.
• Adequate lighting.
• Unnecessary odour should be avoided.

9. ASSESSMENT OF PATIENT
• Should do not consume alcohol before the procedure.
• The patient should be awaken and alert, sitting on the chair facing the
examiner.
• Assess the exercise tolerance level of client.

10. ARTICLES
Opthalmoscope Sneller’s chart Torch

11. Reflexes Hammer Tunning fork Tongue depressor
Essence vial
Q tips cotton

12. CONTENT OF PROCEDURE
• Mental and emotional status
• Cranial status
• Motor system
• Reflexes
• Coordination

14. Gait assessment

15. Romberg’s Test

16. 1.Mental and emotional status
• Level of consciousness- ask questions
• Attentiveness- spell words
• Orientation- name place person
• Language- aphasia
• Memory

17. 2. Cranial nerve

18. 3. Motor system
• Visual inspection: Musculature
Muscle Wasting
Involuntary Movements
Tremors
• Tone: flexion and Extension
• Strength and endurance: Shoulder
Hands
Legs

19. 4. Reflexes

20. Babinski reflex

21. 5. Coordination
• Finger nose test – dysdiadochokinesia

22. AFTER CARE OF ARTICLES
• Articles that cannot be used again should be discarded in their respective
bins like cotton balls.
• Articles like tongue depressor should be send for sterilization to Central
sterile processing department(CSSD)
• Reflexes hammer, tunning fork cotton swab with isopropyl alcohol solution
or alcohol swabs.

23. DOCUMENTATION
• Before coming to conclusion :Review
Integrate