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Neuro PE Cheat Sheet

This document summarizes the cranial nerves and a neurological exam. It describes testing of each of the 12 cranial nerves, including sensory and motor function. It also describes a full neurological exam assessing higher cortical function, motor and sensory function, reflexes, cerebellar testing, and special tests. The exam found no abnormalities and the patient had intact function of all cranial nerves and a normal neurological exam.

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Jill Sanchez-Sadia
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2K views

Neuro PE Cheat Sheet

This document summarizes the cranial nerves and a neurological exam. It describes testing of each of the 12 cranial nerves, including sensory and motor function. It also describes a full neurological exam assessing higher cortical function, motor and sensory function, reflexes, cerebellar testing, and special tests. The exam found no abnormalities and the patient had intact function of all cranial nerves and a normal neurological exam.

Uploaded by

Jill Sanchez-Sadia
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Neuro 251 3.

Cranial Nerves
[Complete Neuro PE] I Olfactory Midline septum, (-)
obstruction/lesions, sense of smell,
1. Sensorium intact on both L & R nostrils
- Awake, Alert, conversant, coherent II Optic a. VA
- Drowsy, arouses to name calling but does not b. VF
sustain c. Ophthalmoscopy: intact ROR,
2. MMSE/Higher Corticals AVR 2:3 CDR 0.3-0.4, DDB, (-)
a. Clean and appropriately dressed exudates/hem
b. Oriented to time, place, and person III, Oculomo Pupils 3/3 mm BRTL, (+) intact direct
c. Appropriate affect, euthymic mood IV tor & consensual pupillary light reflex, (+)
d. Intact thought process, good judgement, , accommodation, (-) ptosis
good insight VI Trochlear Full EOM
e. Clear, coherent speech Abducen
s
30-pt Cortical Functioning Test V (S) Facial Sensation:
a. Orientation (10pts) V1 – forehead (ophthalmic) *C2 –
a. Date: month/day/year, day of the week, cape and hood; C3 – angle of jaw
season V2 – cheeks (maxillary)
b. Place: room, building, floor, city, country Trigemin V3 – above mandible (mandibular)
b. Registration (3pts) al
a. Immediate recall “pera, mangga, bola” Corneal reflex: brisk/sluggish
c. Counting (5pts) (M) Temporalis, Masseter – atrophy,
a. Serial 7s or serial 3s asymm/deviation on opening,
b. MUNDO/ODNUM forcefully open/move with resistance
d. Recall (3pts) VI Facial (S) Taste – ant 2/3 of tongue
a. Pera, mangga, bola I
e. Language (4pts) (M) Frontalis, Orbicularis oculi,
a. Naming  point at watch, ballpen (2pts) Zygomatic, Buccinator, Platysma
b. Writing  any sentence (1pt) – agraphia VI Vestibulo Intact, gross hearing, (-) tinnitus,
c. Reading  perform written command (1pt) II chochlea Weber  lateralization, Rinne  AC
(“ipikit ang iyong mata”) r > BC
f. Constructional Apraxia (1pt)  R parietal
IX Glossoph (+) gag, taste pos 1/3
aryngeal
X Vagus Gutterals/good phonation, uvula
g. 3-step command (3pts)
midline, symmetrical palatal
a. “Kunin mo and papel, itiklop mo sa gitna,
elevation
at ibalik mo sa akin”
XI Accessor SCM  (-) wasting, shrug, head
h. Repetition (1pt)
y turning/forward and back
a. “Wala nang papero-pero pa”
XII Hypoglos Tongue midline, (-) atrophy,
sal fasciculations at rest
Special Tests
a. R-L confusion
4. Motor and Sensory
b. Finger agnosia
a. Atrophy
c. Agraphestesia: write number on hand
b. Tone, spasticity  WOF: hypertonic (if with
d. Astereognosia: hold object and name
prev stroke)
e. Hemisensory Neglect: R, L then B
c. Strength
5/5 5/5
*Gerstmann Syndrome (L parietal): R-L confusion,
agraphia, a/dyscalculia, finger agnosia 5/5 5/5
d. Sensation: pain, light touch,
proprioception, vibration
(4th digit (at least 5 correct answers))
100% 100%
100% 100%
 If spine injury, indicate last normal level

5. Reflexes and Cerebellars

If (+) Babinski
If (+) Clonus, +++

Gait: good posture, stance and normal gait demonstrating


normal balance and coordination; able to execute tandem
walking

Supple neck
(-) Kernig’s – flex knee than nape pain
(-) Brudzinski – flex nape then pain
(-) Chaddock – toe extension, rest flexion
(-) Oppenheim – shin  toe E, rest F
(-) Schaeffer - squeeze Achilles tendon  extensor
plantar reflex
(-) Gordon – calf  toe E, rest F

(-) pronator drift – close eyes


(-) Hoffman – 3rd finger DIP down  pincer
(-) Tromners – 3rd finger DIP up  pincer
(-) Nystagmus (CEREBELLAR)
(-) Finger to nose, dysmetria/terminal tremors
(-) Dysdiadochokinesia
(-) Heel to shin dysmetria/dystaxia
(-) Beevors (T10 below)
(-) Palmomental reflex 
frontal mass/vascular dementia

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