Neurological Exam

  1. Three major units of the brain and their function?
    • Cerebrum:
    • Language, Sensory Processing, Movement, Learning and Memory

    • Cerebellum:
    • Balance, motor learning, posture, sensorimotor relationships

    • Brainstem:
    • Connects motor and sensory signals from brain to rest of body- pain,
    • temperature, touch, pressure reception, (medulla oblongata) CN III-XII; cardiac
    • and respiratory function; consciousness, sleep cycle
  2. Cerebrum Lobes
    • Frontal
    • Parietal
    • Occipital
    • Temporal
    • Limbic system
  3. Frontal Lobe
    • •Voluntary skeletal movement
    • •Fine repetitive movement
    • •Control of eye movement
    • •Emotions/Personality
  4. Parietal Lobe
    • Processes sensory data
    • --touching; soft/rough
  5. Occipital Lobe
    Interprets visual data
  6. Temporal Lobe
    • •Perception and interpretation of sounds
    • •Integration of taste, smell, and balance
    • ---seizure disorder: focus here; they may feel aura, taste along with it
  7. Limbic system
    • •Mediates behavior patterns for survival
    • •Sense of smell
    • --Emotions and instincts
  8. Cerebellum
    • •Aids in integration of voluntary movement
    • •Processes sensory information
    • •Uses sensory data for reflex control
    • •Muscle tone
    • •Equilibrium
    • •Posture
    • --Controls voluntary movement, balance, reflex control; injury causes ataxia
  9. Brainstem
    • •Pathway between cerebral cortex and spinal cord
    • •Controls many involuntary functions
    • •Sympathetic nervous system
    • •Parasympathetic nervous system (involuntary)
  10. Cranial Nerve I
    • Olfactory
    • Fx- sensory: smell

    • Test ability to identify familiar aromatic odors
    • Anosmia
  11. Cranial Nerve II
    • Optic
    • Fx-Sensory:vision

    • Test vision with Snellen chart
    •    -visual acuity & fields, gross vision
    • Include periphery - make an H to hit all locations
  12. Cranial Nerve III
    • Oculomotor
    • Fx-Motor: extraocular movement, upper eyelid; Parasympathetic: adjusts lens and pupil constriction

    • Raise eyelids, extraocular movements, pupillary constriction (penlight), change lens shape
    • PERRLA (III, IV, VI)
  13. Cranial Nerve IV
    • Trochlear
    • Fx-Motor: downward and inward movement of the eye
    • Sensory: muscle sense

  14. Cranial Nerve V
    • Trigeminal
    • Fx-Motor: muscles of mastication
    • Sensory: touch, pain, and temperature in the eye, mucous membranes of the mouth and nose, scalp

    • Inspect the face for atrophy, palpate jaw, test pain/sensation, corneal reflex with cotton whisk
    • Sensory: cornea, iris, lacrimal glands, eyelids, forehead, nose, mouth, teeth, tongue, ear, facial skins
  15. Cranial Nerve VI
    • Abducens
    • Fx-Motor: lateral movement of eye
    • Sensory: muscle sense (like trochlear)

  16. Cranial Nerve VII
    • Facial
    • Fx-Motor: facial movements, close eye and mouth
    • Sensory: anterior two thirds of tongue, taste

    Inspect facial symmetry, test tongue for salt and sweet; secretions (saliva, tears-don't norm test unless they say something)
  17. Cranial Nerve VIII
    • Vestibulocochlear (Acoustic)
    • Fx-Sensory: hearing and balance

    Test hearing, compare bone/air conduction with Weber/Rinne (tuning fork), vestibular function (Romberg test)
  18. Cranial Nerve IX
    • Glossopharyngeal
    • Fx-Motor:  swallowing, salivary glands
    • Sensory: pharynx and posterior third of tongue, tase, carotid reflex

    Voluntary muscles, gag reflex, taste (sour/bitter), secretion of salivary glands
  19. Cranial Nerve X
    • Vagus
    • Fx-Motor: palate, pharynx, larynx
    • Sensory: general sensation from pharynx, viscera, external auditory canal
    • Autonomic: gastrointestinal, cardiac

    • Sensation behind ear & external ear canal, digestive enzyme secretion, carotid reflex (HTN crisis; slow HR), involuntary action of heart, lungs, GI tract
    • Inspect palate/uvula for symmetry, swallow difficulty, evaluate speech sounds
  20. Cranial Nerve XI
    • Accessory
    • Fx-Motor: voluntary swallowing, sternocleidomastoid, and trapezius muscles

    Test trapezius and sternocleidomastoid strength
  21. Cranial Nerve XII
    • Hypoglossal
    • Fx-Motor: movements of the tongue

    Inspect tongue for symmetry/tremors/atrophy, test tongue movement & strength, evaluate lingual speech sounds
Card Set
Neurological Exam
cranial nerves, tests