Personal history

• Name
• Age
• Sex
• Marital status
• Occupation
• Residence
 Health History

I. Present History :
•Reason
I. : for Hospitalization
•Chief Complain
Onset
Duration
Aggravating factors
Alleviating factors
Associated manifestations
Associated Diseases
 Past History
• Trauma
• Previous Neurological Problem
Change in consciousness
Change in vision
Change in speech
Persistent headache
Dizziness
Vertigo
Family History

History of Medications
• Over the counter medications
• Prescribed medication
Assess Pain
Posture
• Normal - Comfortably
erect, Look for
straight lines
across body parts
 Abnormal Posture
Lordosis : Increased anterior
Curvature of the lumber Spine
Kyphosis :is
: a exaggerated posterior
curvature of the spine
Scoliosis :lateral curvature of
the spine away from middle.
 Equipments
• Tuning Forks • Flavored non irritant
• Cotton Swabs substances as coffee.
• Safety pins • Test tubes of hot and cold
water
• Penlight
• Tongue blade
 Neurological examination

• Assessment of the Cerebral functions.

• Assessment of the Cranial nerves
• Assessment of the Motor function
• Assessment of the Sensory function
• Assessment of the Cerebellar function
LEVEL OF CONSCIOUSNESS

Alert Confused

Drowsy

Stupor Coma
Manner Speech
 Aphasia

Receptive Expressive

Paraphasia
Dysarthria: defective articulation of
speech .
Memory
 Mood and affect
Depressed
Anxious
Angry
Irritable
Apathetic
Euphoric
Perception
Color agnosia: inability to recognize
significance of color.
Visual agnosia
inability to recognize objects visually.
Tactile agnosia: inability to recognize
familiar objects by touch
Auditory agnosia: inability to recognize
significance of sounds.
 CN I. olfactory nerve

Sensory Smell
Anosmia: inability to smell
CN II. Optic nerve:
CN III Oculomotor, IV Trochlear,
VI Abducens.
Eye abnormalities
• Squint, hetotropia: deviation of the eye from its
normal direction.
Diplopia: double vision.
Nystagmus: an involuntary rapid
rhythmic movement of the eye ball,
one or both eyes in lateral or vertical
direction
Ptosis: drooping of the upper eye lids.
Trigeminal
CN V. Trigeminal nerve:
 Facial
Motor Muscles of facial expression

Sensory Taste anterior two-thirds of tongue

 Cranial Nerves Examination:

CN VIII. Vestibulocochlear
nerve(statoacoustic ):
- Vestibular part: Balance
- Cochlear part: Hearing acuity
CN IX. Glossopharyngeal nerve
 CN X. Vagus nerve:

- Motor: uvula
movement.
- Reflexes: Gag
reflex.
 CN XI. Accessory nerve:
Test Trapezius and
Sternomastoid muscles
CN XII. Hypoglossal nerve:
 III. Assessment of Motor function

•Muscle size:
•Muscle tone
•Muscle Strength
•
 Muscles Assessment:
• Muscle Size:

- By inspection or
measuring the muscle
circumference.
 Muscle size

Area Lt.(cm) Rt.(cm.)

Arm

Forearm

Thigh

Calf
Muscle tone
 Muscle tone
- Tested by passive flexion extension
movement of the wrist, elbow, hip, knee, and
ankle joints.
Abnormal Muscle tone
• Spastic
• Rigid
• Flaccid
 Muscle Strength
- The Strength should be tested in
all limbs, comparing each side.
- The muscle power is graded
from 0-5.
- Compare between upper and
lower motor neuron weakness.
Deltoid: abduction (elevation) of
upper arm (C5-6; axillary nerve).
Biceps
Triceps muscle
Wrist and finger
Hamstrings

quadriceps
 • Muscle Strength:
Complete Complete
range of range of
Complete
motion motion Complete Evidence of
ROM No
against against ROM with slight
Muscle without contraction
gravity with gravity with gravity contractility
gravity (0)
full some (3) (1)
(2)
resistance resistance
(5) (4)
RT
Deltoid
LF
RT
Biceps
LF
RT
Triceps
LF
RT
Wrist & finger
LF
RT
Hamstrings
LF
RT
Quadriceps
LF
RT
Ankle & foot
LF
 Motor dysfunction

Plegia Paresis

Hemi Para Mono Quadri

 V-Assessment of the Cerebellar
function
• Coordination
Hand coordination
• Rapid Alternating Movements
Hand position coordination
1.Finger to finger test
2. Finger to nose test
 Leg position coordination
1. Heel-to-knee test:

2. Heel-to-Toe Test
 Assessing Balance

Romberg test
 Gait
Ataxic gait
Scissor gait
steppage gait
Double step gait
Helicopod gait
Parkinsonian gait
Hemiplagic gait
steppage gait
Helicopod gait Parkinsonian gait
Assessment of the sensory system

Superficial sensation
a. light touch
b. pain (pinprick).
c. temperature.
D-position sense.