Neurological examination
神经系统检查
自贡市第一人民医院神经内科 崔萍
说教材
• 《神经病学》第七版 全国高等学校教材 人民卫生出版社 ﹙贾建平主编﹚
教材紧扣执业医师考试 大纲，又突出了专业 能力的培养
神经病学
说教材—课程分析
• 第四章神经系统疾病的病史采集和体格检 查 • 第二节体格检查
• 神经系统
一、一般检查 二、意识障碍检查
三、精神状态和高级皮质功能
四、脑神经检查 五、运动系统检查 六、感觉系统检查 七、反射检查 八、脑膜刺激征检查
九、自主神经检查
掌握 运动功能检查方法及临床意义。
掌握 浅反射、深反射、病理反射、脑膜刺激征、
Lasegue Sign的检查法及临床意义
掌握 神经系统常见疾病的体征
嗜睡 昏睡 浅昏迷 中度昏迷 深昏迷
嗜睡
意识障碍早期表现，患者精神萎靡， 动作减少，持续地处于睡眠状态，能 被唤醒，正确回答问题及配合全身检 查，但停止刺激后以进入睡眠。
昏睡
• 意识清醒水平较前下降，高声叫喊或 较强疼痛刺激方能唤醒，醒后表情茫 然，能简单回答问话，不能配合检查， 刺激停止后立即进入熟睡。
特殊意识障碍
谵妄状态：觉醒水平、注意力、定向力、 智能、情感发生极大紊乱，多伴有激惹、 焦虑视幻觉等；见于急性弥漫性脑损害 或中毒性脑病。 模糊状态：起病较缓，定向力障碍多不 严重，时间定向相对明显，表现淡膜、 嗜睡、注意力缺陷；见于代谢性脑病等。
√闭锁综合征：患者无意识障碍，对语言的理 解无障碍，但不能讲话，可眼球上下运动 示意与周围环境建立联系，四肢全瘫。见 于脑桥基底部病变。
神经系统检查工具
叩诊锤 小电筒 眼底镜 感觉检查仪 音叉
医学常用辅助检查中英文名称翻译
医学常用辅助检查中英文名称翻译在医学领域中，常常使用辅助检查来帮助医生进行疾病的诊断和治疗。
这些辅助检查的名称常常存在中英文之间的翻译差异，因此在国际交流中，对于这些名称的准确翻译非常重要。
本文将介绍一些医学常用辅助检查的中英文名称翻译，以促进医学领域的跨国交流。
1. 血液检查 (Blood Test)- 血常规检查 (Complete Blood Count)- 血型检查 (Blood Typing)- 血糖检查 (Blood Glucose Test)- 血脂检查 (Lipid Profile Test)- 血液生化检查 (Blood Biochemical Test)- 血凝检查 (Coagulation Test)2. 尿液检查 (Urinalysis)- 尿常规检查 (Routine Urinalysis)- 尿液培养 (Urine Culture)- 尿蛋白检查 (Urine Protein Test)- 尿糖检查 (Urine Glucose Test)- 尿酮体检查 (Urine Ketone Test)3. 影像学检查 (Imaging Test)- X射线检查 (X-ray Examination)- CT扫描 (Computed Tomography Scan)- MRI检查 (Magnetic Resonance Imaging)- 超声波检查 (Ultrasound Examination)- PET扫描 (Positron Emission Tomography Scan)- 核磁共振检查 (Nuclear Magnetic Resonance Imaging) 4. 心电图检查 (Electrocardiogram)- 静息心电图 (Resting Electrocardiogram)- 动态心电图 (Holter Monitoring)- 应激心电图 (Stress Electrocardiogram)- 24小时心电图 (24-hour Electrocardiogram)- 心脏负荷试验 (Cardiac Stress Test)5. 生物医学检查 (Biopsy)- 细胞活检 (Fine Needle Aspiration Biopsy)- 组织活检 (Tissue Biopsy)- 腹腔镜检查 (Laparoscopy)- 内镜检查 (Endoscopy)- 骨髓穿刺 (Bone Marrow Aspiration)6. 病理学检查 (Histopathology)- 标本制备 (Specimen Preparation)- 切片染色 (Histological Staining)- 免疫组化检查 (Immunohistochemistry)- 液基薄层细胞学检查 (Liquid-based Cytology)- 细胞遗传学检查 (Cytogenetics)7. 神经系统检查 (Neurological Examination)- 神经电生理检查 (Electrophysiological Examination) - 脑电图检查 (Electroencephalography)- 眼底检查 (Fundoscopy)- 神经影像学检查 (Neuroimaging)- 脑脊液检查 (Cerebrospinal Fluid Examination)8. 免疫学检查 (Immunological Test)- 血清学检查 (Serological Test)- 免疫组化检查 (Immunohistochemistry)- 免疫荧光检查 (Immunofluorescence Test)- 免疫酶标法检查 (Enzyme-linked Immunosorbent Assay)- 免疫电泳检查 (Immunoelectrophoresis)以上是一些医学常用辅助检查的中英文名称翻译，对于不同的检查，可能存在不同的翻译方式，因此在实际应用中，还需要结合具体的文献和规范进行准确选择和使用。
Neurological Examination(神经系统检查)
Fundus ( Ophthalmoscopic ) Examination
CRANIAL NERVES -Pupillary Reflexes (II, III)
A normal pupil will constrict (1) in response to direct light, (2) as a consensual response to light in the opposite eye, and (3) to accommodation ( convergence to focus on a close object)
Nylen-Barany( Dix-Hallpike) maneuver test for
Mental State & Cognitive Function
-Level of consciousness( Mental State) NORMAL:
patient awake and alert, attentive to surrounding and to
the examiner
Conductive loss
Sensorineural loss
Vestibular Function- need to be tested only if there are complaints dizziness or vertigo or evidence of nystagmus
CRANIAL NERVES
-Trigeminal Nerve (V) Facial Sensation Corneal Reflex-Sweep a wisp of cotton lightly across the lateral surface of the eye ( out of the direct visual field) from sclera to cornea- V, VII Motor V Testing- Observe the symmetry of opening and closing of the mouth. Ask the patient to clench the teeth and then attempt to force jaw opening Jaw jerk-brisk indicates UNL
坐骨神经痛病历范文
坐骨神经痛病历范文英文回答：Patient Name: [Patient's Name]Date of Birth: [Patient's Date of Birth]Gender: [Patient's Gender]Date of Visit: [Date of Visit]Chief Complaint:The patient presents with complaints of severe pain radiating from the lower back down to the legs,specifically along the path of the sciatic nerve. The pain is described as sharp, shooting, and sometimes accompanied by numbness or tingling sensations. The symptoms have been present for [duration].History of Present Illness:The patient reports that the pain started [duration] ago after lifting a heavy object. The pain initially started in the lower back and gradually radiated down to the legs. The patient has tried over-the-counter pain medications and hot/cold packs for relief, but the symptoms have persisted.Past Medical History:The patient has a history of [medical conditions], including [specific conditions]. There is no history of previous episodes of sciatica or similar symptoms.Physical Examination:Upon examination, the patient exhibits tenderness and muscle spasm in the lower back region. Straight leg raise test is positive, indicating sciatic nerve involvement. Neurological examination reveals decreased sensation and reflexes in the affected leg.Diagnostic Tests:To confirm the diagnosis of sciatica, the followingtests were performed:1. X-ray of the lumbar spine: to rule out anystructural abnormalities or degenerative changes.2. Magnetic Resonance Imaging (MRI) of the lumbar spine: to visualize the spinal discs, nerves, and surrounding structures for any signs of compression or herniation.Diagnosis:Based on the patient's clinical presentation, physical examination findings, and the results of diagnostic tests, the diagnosis of sciatica is established. Sciatica refersto the inflammation or compression of the sciatic nerve, resulting in radiating pain, numbness, and tingling sensations along the nerve pathway.Treatment:The patient was prescribed a combination of non-steroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants to alleviate pain and reduce inflammation. Physical therapy sessions were recommended to improve flexibility, strengthen the core muscles, and relieve pressure on the sciatic nerve. Additionally, the patient was advised to avoid activities that aggravate the symptoms and to practice good posture during daily activities.Prognosis:With appropriate treatment and adherence to the recommended exercises and lifestyle modifications, the patient's symptoms are expected to improve gradually. However, it is important to note that sciatica can be a recurrent condition, and long-term management may be required to prevent future episodes.中文回答：患者姓名，[患者姓名]出生日期，[患者出生日期]性别，[患者性别]就诊日期，[就诊日期]主诉：患者主诉严重的疼痛从腰部向下放射到腿部，特别是沿坐骨神经的路径。
NEUROLOGICAL EXAMINATION分析课件 共207页
Mental State & Cognitive
Function
-Cognitive function check list
• D. Calculations: Serial sevens: count
backward from 100, taking away 7 each time. Real-life problem
Neurooncology Neuroanatomoy
Neuropathology (biopsy,autopsy and
Neurophysiology
experimental)
Neurobiology
Clinical Approach to Neurological Disetivating System
• Receives multiple
sensory inputs
• Mediates
wakefulness
Mental State & Cognitive Function
-Level of consciousness( Mental State)
Headache History
• Location
– Unilateral ~ migraine – Periorbital ~ glaucoma/uveitis – Parietal/Occipital ~ tension – Neck ~ meningitis or Subarachnoid hemorrhage
60% Left-handed persons
-
Left dominant
30% Left-handed persons
-
Mixed dominant
全身体格检查英语介绍作文
全身体格检查英语介绍作文Title: A Comprehensive Physical Examination。
A comprehensive physical examination is a thorough assessment of an individual's overall health and well-being. It involves a series of tests and evaluations to detect any potential health issues and provide insights into aperson's current physical condition. In this essay, we will delve into the various components of a full-body physical examination.1. Patient Information and History Taking: The examination typically begins with the collection of basic patient information such as age, gender, and medical history. This includes details about past illnesses, surgeries, allergies, medications, and family medical history. Understanding this background helps the healthcare provider tailor the examination to the specific needs and risks of the individual.2. Vital Signs Assessment: Vital signs, including blood pressure, heart rate, respiratory rate, and body temperature, are fundamental indicators of overall health. These measurements provide valuable insights into cardiovascular function, respiratory status, and potential fever or infection.3. General Appearance and Observation: A visual assessment of the patient's general appearance can reveal important clues about their health. This includes observing their posture, skin color and condition, overall demeanor, and any signs of distress or discomfort.4. Head and Neck Examination: This part of the examination involves assessing the head, face, eyes, ears, nose, mouth, throat, and neck. It includes examinations such as checking for abnormalities in the cranial nerves, assessing vision and hearing, and examining the lymph nodes for any signs of inflammation or enlargement.5. Cardiovascular Examination: The cardiovascular examination focuses on evaluating the heart and bloodvessels. This may involve auscultation of the heart sounds, palpation of peripheral pulses, assessment of jugular venous pressure, and examination of the legs for signs of peripheral edema.6. Respiratory Examination: The respiratory examination assesses the lungs and respiratory system. It includes auscultation of breath sounds, percussion of lung fields, assessment of respiratory effort, and evaluation of oxygen saturation using pulse oximetry.7. Abdominal Examination: The abdominal examination involves inspection, auscultation, percussion, and palpation of the abdomen to assess the organs andstructures within. This includes examining the liver, spleen, kidneys, and intestines for any abnormalities or tenderness.8. Musculoskeletal Examination: The musculoskeletal examination evaluates the muscles, bones, and joints for any signs of injury, deformity, or dysfunction. This may include assessing range of motion, muscle strength, jointstability, and performing specific maneuvers to elicit pain or discomfort.9. Neurological Examination: The neurological examination assesses the function of the nervous system, including the brain, spinal cord, and peripheral nerves. This may involve testing reflexes, sensation, coordination, balance, and cognitive function.10. Skin Examination: The skin examination involves inspecting the skin for any abnormalities, lesions, rashes, or signs of infection. This includes assessing skin color, texture, moisture, temperature, and the presence of any moles or lesions that may indicate skin cancer.11. Genitourinary Examination: The genitourinary examination assesses the reproductive and urinary systems. This may involve a pelvic examination for females or a genital examination for males, as well as assessing urinary function and performing relevant tests such as urine analysis.12. Psychosocial Assessment: In addition to the physical examination, it's important to consider the patient's psychosocial well-being. This includes assessing their mental health, emotional state, social support network, and any factors that may impact their overall health and quality of life.In conclusion, a comprehensive physical examination encompasses a wide range of assessments and evaluations to provide a holistic view of an individual's health. By systematically examining each aspect of the body, healthcare providers can identify potential health issues early, implement appropriate interventions, and promote overall well-being and longevity.。
十二对脑神经 知识点英语
十二对脑神经知识点英语The Twelve Cranial Nerves: A Comprehensive Overview.The cranial nerves are twelve pairs of nerves that emerge directly from the brain, innervating various structures in the head and neck. They play a crucial role in sensory perception, motor function, and autonomic regulation. Understanding the anatomy and functions of these nerves is essential for a comprehensive understanding of neurology.Classification of Cranial Nerves.The cranial nerves are classified into two main types: sensory and motor. Sensory nerves transmit sensory information from the periphery to the brain, while motor nerves carry motor commands from the brain to muscles and glands.Sensory Cranial Nerves.Olfactory Nerve (CN I): Responsible for the sense of smell.Optic Nerve (CN II): Transmits visual information from the retina to the brain.Oculomotor Nerve (CN III): Innervates muscles responsible for eye movements, pupillary constriction, and eyelid closure.Trochlear Nerve (CN IV): Innervates the superior oblique muscle of the eye, controlling downward and outward eye movements.Trigeminal Nerve (CN V): Provides sensory innervation to the face, including the skin, teeth, and mucous membranes. It also innervates the muscles of mastication.Abducens Nerve (CN VI): Innervates the lateral rectus muscle of the eye, controlling outward eye movements.Facial Nerve (CN VII): Innervates the muscles offacial expression, lacrimal glands, and taste buds on the anterior two-thirds of the tongue.Vestibulocochlear Nerve (CN VIII): Transmits auditory and vestibular information from the inner ear to the brain.Motor Cranial Nerves.Hypoglossal Nerve (CN XII): Innervates the muscles of the tongue, controlling its movements for speech and swallowing.Glossopharyngeal Nerve (CN IX): Innervates the muscles of the pharynx and soft palate, plays a role in swallowing, and provides taste sensation to the posterior third of the tongue.Vagus Nerve (CN X): The longest cranial nerve, it innervates structures throughout the thorax and abdomen, including the heart, lungs, digestive system, and vocal cords.Accessory Nerve (CN XI): Innervates the sternocleidomastoid and trapezius muscles, controlling head and neck movements.Autonomic Cranial Nerves.The vagus nerve and glossopharyngeal nerve are considered autonomic cranial nerves, as they contain both sensory and motor fibers involved in regulating involuntary functions such as heart rate, digestion, and salivation.Innervation Territories.Each cranial nerve supplies a specific region of the head and neck, known as its innervation territory. Knowledge of these territories is essential for diagnosing and treating neurological conditions.Clinical Significance.Damage to the cranial nerves can result in a wide rangeof neurological symptoms, depending on the affected nerve. Examples include:Olfactory nerve: Loss of smell (anosmia)。
Neurological Examination
Verbal
None Sounds Words Confused Oriented
Motor response
None Decerebrate Decorticate Withdraw to pain Localizing to pain Obey commands
Orientation & Judgement
• Conscious content: awareness (confusion)
Cortical and subcortical structure
Glasgow Coma Scale
Eye opening
1 2 3 4 5 6 None To pain To speech Spontaneous
Orientation • Person • Place • Time Judgement • What to do when smelled smoke in theater?
Memory
• Immediate memory & attention
~ Digit span: Normal seven forward, five backward
<Sensation>
•
Cranial nerve vII: Facial nerve
<Motor> • Inspection: 看臉是否對稱，觀察 forehead wrinkles, 看臉是否對稱， 及兩邊嘴角- 請你眼睛看天花板( nasolabial folds, 及兩邊嘴角-> 請你眼睛看天花板(看 frontalis)-> 請說： oris)；「說 frontalis 請說：『一』」(看orbicularis oris)；「說『 嗚』」->用力鼓起臉頰 (看buccinator) • Palpation：請病人用力閉緊你的雙眼, 用力扳開眼皮 Palpation：請病人用力閉緊你的雙眼, <Sensation> • External auditory meatus sensation and Taste: • 用棉棒分別沾糖水和鹽水，用棉棒去沾舌頭兩側的前2/3 用棉棒分別沾糖水和鹽水，用棉棒去沾舌頭兩側的前2/3 看病人有沒有辦法判別。 看病人有沒有辦法判別。 <Parasympathetic> • Tearing
脑性瘫痪的病因学诊断策略专家共识(完整版)
脑性瘫痪的病因学诊断策略专家共识（完整版）脑性瘫痪（以下简称脑瘫）是儿童时期最常见的运动障碍性疾病，全球范围内报道的患病率为0.15%~0.40%[1,2,3]。
临床中发现，脑瘫被普遍作为"中枢性运动和姿势发育障碍"的"伞式"诊断，其中不乏一些原因不明的疾病。
尽管早产和缺氧-缺血性脑损伤被公认为脑瘫的病因，但多达1/3的脑瘫患儿缺乏传统高危因素、存在潜在某些神经系统遗传病或代谢病，对这部分患儿需要积极查找、识别和确定病因，避免因延误诊断而造成的不适当管理和不利后果。
近年来快速进展的神经科学和遗传学为脑瘫患儿提供了精确诊断、精准治疗和预后判断的机会[4]。
大量文献报道，高达30%的脑瘫患儿存在拷贝数变异（copy number variations，CNVs）或单基因变异，但由于研究的样本量小、验证性研究少以及受遗传异质性的影响，有些变异的致病性还很难得出明确结论[5,6]。
一些临床管理指南并不推荐将遗传学检测作为脑瘫的常规性检测项目[7]，有关脑瘫病因学诊断方面还缺乏一致性的可操作流程。
我国脑瘫防治工作尚在初级阶段，康复机构复杂多样，人员资质和诊疗技术水平参差不齐，特别是在脑瘫的临床规范化诊断及病因研究流程上存在较多问题。
为此，中华医学会儿科学分会康复学组自2018年6月成立专家组，参考近10年来有关脑瘫病因学、遗传和代谢组学技术进展、脑瘫诊断与鉴别诊断等领域的国内外研究进展，历经8个月的时间讨论并提出中国脑瘫的病因学诊断策略专家共识，以期规范脑瘫的诊断和鉴别诊断思路及相关医疗行为，避免漏诊和误诊，指导脑瘫和类脑瘫疾病的科学规范管理、预后评估及遗传咨询。
一、脑瘫的定义、分型及临床诊断信息脑瘫是一组由于发育中的胎儿或婴儿脑非进行性损伤所引起的持续存在的运动和姿势发育障碍症候群，导致活动受限，常伴有感觉、知觉、认知、沟通和行为障碍以及癫痫和继发性肌肉骨骼问题[8]。
神经内科常用英语
神经内科常用英语摘要神经内科是一门研究神经系统结构、功能和疾病的医学专业，涉及到大脑、脊髓、周围神经和肌肉等部位。
神经内科医生需要掌握一定的英语知识，以便与国际同行交流，阅读最新的文献，参与国际会议，以及与外国患者沟通。
本文旨在介绍神经内科常用的英语词汇、短语和句型，包括以下几个方面：神经系统的解剖结构和功能神经系统的检查方法和仪器神经系统的常见疾病和诊断神经系统的治疗方法和药物神经内科医生与患者的对话示例神经系统的解剖结构和功能神经系统（nervous system）是机体内对生理功能活动的调节起主导作用的系统，主要由神经组织组成，分为中枢神经系统（central nervous system, CNS）和周围神经系统（peripheral nervous system, PNS）两大部分。
中枢神经系统又包括脑（brain）和脊髓（spinal cord），是神经活动的中枢和指挥部。
脑又分为大脑（cerebrum），小脑（cerebellum）和脑干（brainstem）。
大脑是最高级的神经中枢，负责思维、记忆、情感、意识、语言等高级功能。
小脑是协调运动和维持平衡的重要结构。
脑干连接大脑和脊髓，控制呼吸、心跳、血压等基本生命活动。
周围神经系统包括颅神经（cranial nerves）和脊神经（spinal nerves），是中枢神经系统与身体其他部分的联系纽带。
颅神经共有12对，主要分布在头颈部，传递视觉、听觉、嗅觉、味觉等特殊感觉，以及面部表情、咀嚼、吞咽等运动。
脊神经共有31对，从脊髓出发，分布在胸、腹、盆腔和四肢等部位，传递皮肤、肌肉、关节等一般感觉，以及四肢和躯干等运动。
下表列出了一些常见的神经系统解剖结构及其英文名称和缩写：中文英文缩写神经元neuron轴突axon树突dendrite突触synapse神经胶质细胞glial cell胼胝体corpus callosum CC大脑半球cerebral hemisphere额叶frontal lobe FL顶叶parietal lobe PL颞叶temporal lobe TL枕叶occipital lobe OL岛叶insular lobe IL皮质cortex基底神经节basal ganglia BG海马hippocampus中文英文缩写杏仁核amygdala丘脑thalamus下丘脑hypothalamus HT脑桥pons延髓medulla oblongata MO脑膜meninges脑室ventricle脊髓spinal cord SC颅神经cranial nerve CN脊神经spinal nerve SN神经系统的检查方法和仪器神经系统的检查方法主要分为两类：一类是神经功能检查（neurological examination），即通过观察和测试患者的神经系统各个方面的表现，来评估其神经功能的正常与否。
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9/12, and persists!
3) Child with NeuroDisability
• Alertness • Examination tests depend on level of disability
• Speak to these children directly, introduce yourself – do they respond / react?
– OFC & plot on centile chart – Skeleton, spine, hands & feet (deformities) – Skin, genitalia, eyes
• • • • • • •
Position, Posture & Movement (Muscle bulk etc.) OFC, shape, sutures & fontanelle (? VP shunt?) Comment; (eyes; open/movements? feeding/sucking) Tone; position, fisting, head control, floppy? etc. Spinal Reflexes; knee jerk, clonus etc. Spine / Natal cleft Primitive Reflexes (* moro at end; it‟s upsetting)
2) Infant
• • • • Alertness Dysmorphism (as before) Position, Posture & Movement CN; Eyes - ? Fixing & following
• Face; smiling, crying? Symmetrical? • Bulbar; feeding & making sounds
Disappears at
2/12 4/12 4/12 4/12 4-6/12 4-8/12 until 1 yr old
Primitive Reflexes
• Brainstem-mrole • Disappear with Cortical Inhibition
• Examine relative to child‟s understanding • May need to improvise • Remember what your testing;
– Eyes (vision, movement, pupils) – Face – Hearing – Speech (making sounds) & Swallow
Upper limb Lower limb
4) Co-ordination, Gait, Cerebellar signs 5) Developmental 6) Higher functioning
Cognitive & Behavioural
1) 2) 3) 4)
Neonate Infant/toddler Child with Neuro-disability Older Child (age & ability - appropriate tests) [* that‟s the child‟s ability, not the examiners!*]
• Parachute reflex; support child‟s trunk & lower him/her
suddenly down towards bed/surface. Child will throw out arms to protect him/her-self appears ~
Neurological examination
Dr. D. Barry
Many Parts in Full Neuro Exam
1) Inspection – alertness/GCS
Dysmorphia (syndrome?)
2) Cranial Nerves 3) Peripheral Nerves
• Head-righting reflexes;
Horizontal suspension (extension of head, spine & legs) ~ 3-6/12 Vertical to horizontal position (? Knees flex & head corrects) ~ 6/12
• Examination texts/technique should be age-appropriate • CN II – XII > 5 years • ↑↓ with co-operation, sociability etc.
1) Neonate
• Alertness • Expose & observe • Dysmorphism; facies
May be asked…
• Examine this child‟s lower limbs • Examine this child‟s gait • Examine this patient‟s visual fields / eye movements / for squint • Demonstrate this child‟s reflexes • Examine this child for signs of cerebellar dysfunction
with toys etc.
Postural Reactions
As opposed to primitive reflexes which neonate is born with, these evolve early in infancy Many doctors include them together with primitive reflexes, but they have very different underlying significance
• Primitive Reactions & Postural Reactions • Peripheral; Tone, Reflexes • Developmental Milestones; gross motor, fine motor (co-ord) – what are they doing & watch them playing
*Many books vary on exactly when these reflexes are lost, so it can be confusing, therefore at least have general rule; most gone by 6/12 (with motor dev. & voluntary movement takes over), All gone by 1 year (roughly) & in general, they are lost in a Cephaol-caudal direction *
• • • •
Dysmorphic features (nb OFC) Position, Posture Movements & Muscle Bulk External Supports nb. (?Catheter/urine bag/ splints/ etc.)
• if in a wheelchair / sitting out; “ideally I‟d like to examine them in the bed esp for spinal & lower limb exam & expose”
– Any individual / isolated part of neuro exam
General Neuro Inspection
• Dysmorphic features
– – – – Facies OFC (eg. Macrocephaly, microcephaly), shape Skeleton, spine (eg. scoliosis, spina bifida), hands & feet Skin (eg. Neurocutaneous syndromes), genitalia & eyes
• • • •
Posture Movement Muscle bulk +/- fasciculations Supports eg glasses / hearing aids / wheelchair etc. etc. etc.
1) Cranial Nerves
• I - olfactory Eyes; vision & movements • II – optic – visual acuity, fields, fundoscopy, • III - oculomotor • IV – trochlear • VI – abducens (false localising) Face (motor & sensory) • V – facial; muscles of facial expression • VII – trigeminal; sensory to face (& tongue) • VIII – vestibule-cochlear; hearing Bulbar (speech & swallow) • IX – glossopharyngeal • X – vagal • XI – accessory • XII – hypoglossus
Eyes; CN II, III, IV, VI