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DeGowin's Diagnostic Examination, 9e
The Neurologic Examination
Sections: Cranial Nerve Examination, Olfactory Nerve (CN I), Testing smell, Optic Nerve (CN II), Oculomotor Nerve (CN III), Testing for oculomotor paralysis, Trochlear Nerve (CN IV), Testing for trochlear paralysis, Trigeminal Nerve (CN V), Testing the trigeminal nerve, Abducens Nerve (Cranial VI), Testing for abducens paralysis, Facial Nerve (CN VII), Testing the facial nerve, Acoustic Nerve (CN VIII), Testing the acoustic nerve, Glossopharyngeal Nerve (CN IX), Testing the glossopharyngeal nerve, Vagus Nerve (CN X), Testing of the glossopharyngeal and vagus nerves, Accessory Nerve (CN XI), Testing of the accessory nerve, Hypoglossal Nerve (CN XII), Testing of the hypoglossal nerve, Motor Examination, Inspect for Muscle Wasting, Evaluate Muscle Tone, Test Muscle Strength, Examination of Reflexes, Brainstem Reflexes, Direct pupillary reaction to light, Consensual pupillary reaction to light, Ciliospinal reflex, Corneal reflex, Jaw reflex, Gag reflex, The Muscle Stretch Reflexes, General principles for eliciting muscle stretch reflexes, Reflex center at C5 to T1—pectoralis reflex (medial and lateral anterior thoracic nerves), Reflex center at C5 to C6: biceps reflex (musculocutaneous nerve), Reflex center at C5 to C6: brachioradialis reflex (radial nerve), Reflex center at C6 to C7: pronator reflex (median nerve), Reflex center at C7 to C8: triceps reflex (radial nerve), Reflex center at T8 to T9: upper abdominal muscle reflex, Reflex center at T9 to T10: middle abdominal muscle reflex, Reflex center at T11 to T12: lower abdominal muscles, Reflex center at L2 to L4: quadriceps reflex (femoral nerve), Reflex center at L2 to L4: adductor reflex (obturator nerve), Reflex center at L4 to S2: hamstring reflex (sciatic nerve), Reflex center at L5 to S2: Achilles reflex (tibial nerve), The Superficial (Skin) Reflexes, Reflex center at T5 to T8: upper abdominal skin reflex, Reflex center at T9 to T11: mid-abdominal skin reflex, Reflex center at T11 to T12: lower abdominal skin reflex, Reflex center at L1 to L2: cremasteric reflex, Reflex center at L4 to S2: plantar reflex, Reflex center at S1 to S2: superficial anal reflex (anal wink), Posture, Balance, and Coordination: The Cerebellar Examination, Test Station (Equilibratory Coordination), Test for Diadochokinesia, Test for Dyssynergia and Dysmetria, Testing Skilled Acts, Testing the Vestibular Apparatus, The Gait, SENSORY EXAMINATION, Basic Sensory Modalities, Testing pain and touch sense, Testing temperature sense, Testing tactile sense, Testing proprioception: position sense, Vibratory sense: pallesthesia, Pressure sense, Testing Higher Integrative Functions, Stereognosis, Two-Point discrimination, Perception of figures on the skin (graphesthesia), Testing Specific Peripheral Nerves, Exclusion test for major nerve injury in the upper limb, Testing the median nerve, Testing the ulnar nerve, Movements of Specific Muscles and Nerves.
Topics Discussed: abducens nerve; accessory nerve; achilles tendon reflex; anal reflex; ataxia; baresthesia; biceps reflex; cerebellar disease; ciliospinal reflex; coordination; corneal reflexes; cranial nerve examination; cutaneous sensation; dysdiadochokinesis; dysmetria, cerebellar ; examination of hamstring reflex; examination of thigh adductor reflex; facial nerve; fine motor skills; finger-to-nose test; foot ulcer; gagging; gait; gait analysis; glossopharyngeal nerve; grade of muscle power; graphesthesia; heel-to-knee test; hoover's test; hypoglossal nerve; injury of nerve of upper extremity; jaw reflex; joint position sensation; median nerve; median nerve injury; median neuropathy; motor function; motor testing; muscle strength; muscle tonus; muscular atrophy; musculoskeletal equilibrium; neurologic examination; oculomotor nerve; olfactory nerve; optic nerve; pain perception; proprioception; pupil light reflex; pupillary function; reflex; reflex, abdominal; reflex, babinski; reflex, cremasteric; reflex, knee; reflex, superficial; romberg sign; sensory testing; smell perception; stereognosis; supinator jerk reflex; symptomatic dermographism; temperature sense; tendon reflex; touch sensation; triceps jerk reflex; trigeminal nerve; trochlear nerve; two-point discrimination test; ulnar nerve; vagus nerve; vestibulocochlear nerve; vibratory sense.
Excerpt:"MENTAL STATUS SCREENING EXAMINATION: See Chapter 15, The Mental Status Evaluation for a complete discussion.The 12 pairs of CN emerge from the brain and pass through foramina in the base of the skull. They are designated by Roman numerals I to XII in relation to their position from forebrain to brainstem. The physical examination of several of the CN is contained in the discussion of the head and neck in Chapter 7.The olfactory mucosa lining the upper third of the nasal septum and the superior nasal concha contains the receptors and ganglion cells. Their fibers converge into approximately 20 branches that pierce the cribriform plate of the ethmoid bone and consolidate to form the olfactory tract.Evaluate the nasal passages for patency. With the eyes closed, test each nostril while the other is occluded, with familiar odors, such as coffee, cloves, or peppermint. Noxious chemicals such as ammonia or alcohol should not be used since they stimulate nociceptors from the trigeminal nerve giving a false positive response.See Chapter 7, Examination of the Eyes, Visual Fields and Visual Acuity.See Chapter 7, Examination of the Eyes, Visual Fields and Visual Acuity.Motor..."
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