The document provides guidance on performing a neurologic examination, beginning with the mental status exam and covering tests of the cranial nerves and other neurologic functions. It emphasizes that the history guides the focused examination and different pathologies require evaluating specific symptoms, motor or sensory systems. Tests are described to assess functions like orientation, memory, speech, eye movements, facial sensation and expression, hearing, and balance. References to additional resources on neurologic examination techniques are also provided.

1. The Neurologic Examination Steven A. Glyman MD July 8, 2008 July 8, 2008 July 8, 2008

4. A proper neurologic examination begins with a careful clinical history.

5. http://www.cbu.edu/~mcondren/IRM/Stop-Look-Listen-sign-IRM-7-7-07.jpg

6. You must do a minimum basic examination on every patient but you don’t need to do every test

7. A mechanic does not need to use every tool on every project

8. The history guides the neurologic examination

11. The history and preliminary observations focus attention on specific symptoms, motor or sensory systems, cranial nerves,or cerebral functions. If the history suggests a spinal lesion, then carefully test each dermatome for a sensory level. If the history suggests a cerebral lesion,emphasize tests for memory, aphasia, apraxia, and agnosia If the history suggests a cerebral lesion,emphasize tests for memory, aphasia, apraxia, and agnosia If the history suggests a cerebral lesion,emphasize tests for memory, aphasia, apraxia, and agnosia The Technique of the Neurologic Examination by William DeMyer Fifth Edition 2004 McGraw Hill Publisher

12. The Technique of the Neurologic Examination by William DeMyer McGraw Hill 2004

13. Tools of the trade

14. http://www.ptup.org/files/2007-SJ-Monterey-Tour/TheWholeEnchilada.jpg

26. http://www.mrc-cbu.cam.ac.uk/research/rehabilitation/research.html

29. Perseveration

32. The Cranial Nerves

34. http://commons.wikimedia.org/wiki/Image:Head_olfactory_nerve.jpg http://www.braininjury.com/images/cranialnerveinjury.jpg

36. http://www.merck.com/media/mmhe2/figures/MMHE_20_235_01_eps.gif http://arapaho.nsuok.edu/~fulk/Images/Img0013.JPG

38. Pupillary Size is determined by the light input, sympathetic and parasympathetic tone Text http://www.psych.ndsu.nodak.edu/mccourt/Psy460/Central%20visual%20pathways/pupillary%20light%20reflex.gif http://www.abdn.ac.uk/~opt065/Web%20pages%20only/drh-g085.gif

41. http://www.healthatoz.com/healthatoz/Atoz/images/ency/00044039.jpg http://www.dalcross.com/staging/_images/trigeminal.JPG

49. Hypoglossal Nerve Injury

50. Motor Examination

54. Note the parkinsonian stare,masked facies,flexed posture,hypokinesia typical of extrapyramidal disorders http://www.ananova.com/news/story/sm_1417224.html

58. http://commons.wikimedia.org/wiki/Image:Babinski's_sign01.jpg