The Neuro Exam

Mental Status

• Alert and oriented to name, place, year
• Naming/Recall/Repetition

Cranial Nerve

• CN II: vision in tact; No Afferent Pupillary Defect (swinging light test); pupils constrict
• CN III, IV, VI: Extraocular muscles intact; pupils constrict
• CN V: Facial sensation is symmetric
• CN VII: Smile, facial muscles symmetric (forehead moving?)
• CN VIII: Hearing intact
• CN IX, X: Palate midline
• CN XI: Shoulder shrug, Sternocleidomastoid.
• CN XII: tongue midline

Motor

Tone: muscle bulk, fasciculations, rigidity, flacid

Strength (0-5)

• Upper/Lower extremities
• 0 (no contraction)
• 1 (muscle flicker)
• 2 (movement- but not against gravity)
• 3 (movement against gravity, but not against resistance)
• 4 (movement against some resistance, but not normal
• 5 (normal strength)

Pronator Drift

Sensory

• Pain, temperature, vibration

Cerebellar/Coordination

• Finger to Nose
• Rapid alternating movements
• Heal to shin

Reflexes: (0, 1+, 2+, 3+)

• Biceps, brachialis
• Patellar, achiles
• Up going toes
• Hoffman sign

Gate

• normal/tandem