Neurological examination

Equipment Needed

• Reflex Hammer
• 128 and 512 (or 1024) Hz Tuning Forks
• Wooden Handled Cotton Swabs
• Paper Clips

General Considerations

• Always consider left to right symmetry
• Consider central vs. peripheral deficits
• Organize your thinking into seven categories:

1. Mental Status
2. Cranial Nerves
3. Motor
4. Coordination and Gait
5. Reflexes
6. Sensory
7. Special Tests

Motor

Observation

• Involuntary Movements
• Muscle Symmetry
  • Left to Right
  • Proximal vs. Distal
• Atrophy
  • Pay particular attention to the hands, shoulders, and thighs.
• Gait

Muscle Tone

1. Ask the patient to relax.
2. Flex and extend the patient's fingers, wrist, and elbow.
3. Flex and extend patient's ankle and knee.
4. There is normally a small, continuous resistance to passive movement.
5. Observe for decreased (flaccid) or increased (rigid/spastic) tone.