Neurological Case Study
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Copyright © 2015 by Mosby, an imprint of Elsevier Inc.
Copyright © 2015 by Mosby, an imprint of Elsevier Inc.
Ball: Seidel’s Guide to Physical Examination, 8th Edition
Chapter 22: Neurologic System
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I. Inspection, palpation, and neurologic tests
A. Test cranial nerves I through XII.
1. I (olfactory)
2. II (optic)
3. III (oculomotor)
4. IV (trochlear)
5. V (trigeminal)
6. VI (abducens)
7. VII (facial)
8. VIII (acoustic)
9. IX (glossopharyngeal)
10. X (vagus)
11. XI (spinal accessory)
12. XII (hypoglossal)
B. Cerebellar function and proprioception
1. Evaluate coordination and fine motor skills by rapid rhythmic alternating movements, accuracy of upper and lower extremity movements.
2. Evaluate balance using the Romberg test.
3. Observe the patient’s gait for posture and rhythm and sequence of stride and arm movements.
C. Sensory function
1. Test primary sensory responses to superficial touch and pain.
2. Test vibratory response to tuning fork over joints or bony prominences on upper and lower extremities.
3. Evaluate perception of position sense with movement of the great toes or a finger on each hand.
4. Assess ability to identify familiar object by touch and manipulation.
5. Assess two-point discrimination.
6. Assess ability to identify letter or number “drawn” on palm of hand.
7. Assess ability to identify body area when touched.
D. Superficial and deep tendon reflexes
1. Test abdominal reflexes.
2. Test the cremasteric reflex in male patients.
3. Test the plantar reflex.
4. Test the following deep tendon reflexes: biceps, brachioradialis, triceps, patellar, and Achilles.
5. Test for ankle clonus.
