Neurology

  1. The Neurological Examination
    1. Approach to the Neurological Patient
      1. Patient History
        1. Chief Complaint
          1. History of Present Illness
            1. Onset and Progression
              1. Associated Symptoms
                1. Precipitating Factors
                  1. Relieving Factors
                  2. Past Medical History
                    1. Previous Neurological Events
                      1. Medications
                        1. Allergies
                        2. Family History
                          1. Hereditary Neurological Disorders
                            1. Stroke Risk Factors
                            2. Social History
                              1. Alcohol and Drug Use
                                1. Occupational Exposures
                                  1. Travel History
                                  2. Review of Systems
                                    1. Neurological Symptoms
                                      1. Systemic Symptoms
                                    2. General Physical Examination
                                      1. Vital Signs
                                        1. Cardiovascular Examination
                                          1. Pulmonary Examination
                                            1. Skin Examination
                                          2. Mental Status Examination
                                            1. Level of Consciousness
                                              1. Alertness
                                                1. Arousal
                                                  1. Attention
                                                    1. Altered States
                                                      1. Lethargy
                                                        1. Obtundation
                                                          1. Stupor
                                                            1. Coma
                                                          2. Orientation
                                                            1. Person
                                                              1. Place
                                                                1. Time
                                                                  1. Situation
                                                                  2. Attention and Concentration
                                                                    1. Sustained Attention
                                                                      1. Selective Attention
                                                                        1. Testing Methods
                                                                          1. Digit Span Forward
                                                                            1. Digit Span Backward
                                                                              1. Serial Sevens
                                                                                1. Months Backward
                                                                              2. Language Assessment
                                                                                1. Spontaneous Speech
                                                                                  1. Fluency
                                                                                    1. Rate
                                                                                      1. Rhythm
                                                                                        1. Volume
                                                                                        2. Comprehension
                                                                                          1. Simple Commands
                                                                                            1. Complex Commands
                                                                                            2. Repetition
                                                                                              1. Words
                                                                                                1. Phrases
                                                                                                  1. Sentences
                                                                                                  2. Naming
                                                                                                    1. Confrontation Naming
                                                                                                      1. Category Fluency
                                                                                                        1. Letter Fluency
                                                                                                        2. Reading
                                                                                                          1. Comprehension
                                                                                                            1. Aloud Reading
                                                                                                            2. Writing
                                                                                                              1. Spontaneous Writing
                                                                                                                1. Dictation
                                                                                                                  1. Copying
                                                                                                                  2. Aphasia Classification
                                                                                                                    1. Broca's Aphasia
                                                                                                                      1. Wernicke's Aphasia
                                                                                                                        1. Conduction Aphasia
                                                                                                                          1. Global Aphasia
                                                                                                                            1. Transcortical Aphasias
                                                                                                                              1. Anomic Aphasia
                                                                                                                              2. Dysarthria
                                                                                                                                1. Types
                                                                                                                                  1. Assessment
                                                                                                                                2. Memory Assessment
                                                                                                                                  1. Immediate Memory
                                                                                                                                    1. Digit Span
                                                                                                                                      1. Word Lists
                                                                                                                                      2. Short-term Memory
                                                                                                                                        1. Delayed Recall
                                                                                                                                          1. Recognition
                                                                                                                                          2. Long-term Memory
                                                                                                                                            1. Remote Memory
                                                                                                                                              1. Autobiographical Memory
                                                                                                                                              2. Memory Types
                                                                                                                                                1. Episodic Memory
                                                                                                                                                  1. Semantic Memory
                                                                                                                                                    1. Procedural Memory
                                                                                                                                                  2. Visuospatial Function
                                                                                                                                                    1. Constructional Tasks
                                                                                                                                                      1. Clock Drawing
                                                                                                                                                        1. Cube Copying
                                                                                                                                                          1. Intersecting Pentagons
                                                                                                                                                          2. Spatial Orientation
                                                                                                                                                            1. Visual Perception
                                                                                                                                                              1. Neglect Assessment
                                                                                                                                                              2. Executive Function
                                                                                                                                                                1. Abstract Thinking
                                                                                                                                                                  1. Similarities
                                                                                                                                                                    1. Proverb Interpretation
                                                                                                                                                                    2. Problem Solving
                                                                                                                                                                      1. Trail Making Test
                                                                                                                                                                        1. Wisconsin Card Sorting Test
                                                                                                                                                                        2. Judgment
                                                                                                                                                                          1. Practical Judgment
                                                                                                                                                                            1. Social Judgment
                                                                                                                                                                            2. Insight
                                                                                                                                                                              1. Planning and Organization
                                                                                                                                                                            3. Cranial Nerve Examination
                                                                                                                                                                              1. Olfactory Nerve
                                                                                                                                                                                1. Testing Methods
                                                                                                                                                                                  1. Common Abnormalities
                                                                                                                                                                                  2. Optic Nerve
                                                                                                                                                                                    1. Visual Acuity
                                                                                                                                                                                      1. Visual Fields
                                                                                                                                                                                        1. Confrontation Testing
                                                                                                                                                                                          1. Perimetry
                                                                                                                                                                                          2. Fundoscopy
                                                                                                                                                                                            1. Optic Disc Assessment
                                                                                                                                                                                              1. Retinal Examination
                                                                                                                                                                                              2. Pupillary Responses
                                                                                                                                                                                                1. Direct Light Reflex
                                                                                                                                                                                                  1. Consensual Light Reflex
                                                                                                                                                                                                    1. Accommodation Reflex
                                                                                                                                                                                                      1. Relative Afferent Pupillary Defect
                                                                                                                                                                                                    2. Oculomotor System
                                                                                                                                                                                                      1. Extraocular Movements
                                                                                                                                                                                                        1. Six Cardinal Directions
                                                                                                                                                                                                          1. Smooth Pursuit
                                                                                                                                                                                                            1. Saccades
                                                                                                                                                                                                            2. Eyelid Function
                                                                                                                                                                                                              1. Pupillary Function
                                                                                                                                                                                                                1. Diplopia Assessment
                                                                                                                                                                                                                  1. Nystagmus
                                                                                                                                                                                                                    1. Types
                                                                                                                                                                                                                      1. Direction
                                                                                                                                                                                                                        1. Amplitude
                                                                                                                                                                                                                      2. Trigeminal Nerve
                                                                                                                                                                                                                        1. Sensory Testing
                                                                                                                                                                                                                          1. Light Touch
                                                                                                                                                                                                                            1. Pain
                                                                                                                                                                                                                              1. Temperature
                                                                                                                                                                                                                                1. Corneal Reflex
                                                                                                                                                                                                                                2. Motor Testing
                                                                                                                                                                                                                                  1. Jaw Opening
                                                                                                                                                                                                                                    1. Jaw Closing
                                                                                                                                                                                                                                      1. Lateral Jaw Movement
                                                                                                                                                                                                                                      2. Jaw Jerk Reflex
                                                                                                                                                                                                                                      3. Facial Nerve
                                                                                                                                                                                                                                        1. Motor Function
                                                                                                                                                                                                                                          1. Upper Facial Muscles
                                                                                                                                                                                                                                            1. Lower Facial Muscles
                                                                                                                                                                                                                                              1. Voluntary vs. Emotional Expression
                                                                                                                                                                                                                                              2. Taste Testing
                                                                                                                                                                                                                                                1. Hyperacusis Assessment
                                                                                                                                                                                                                                                2. Vestibulocochlear Nerve
                                                                                                                                                                                                                                                  1. Hearing Assessment
                                                                                                                                                                                                                                                    1. Weber Test
                                                                                                                                                                                                                                                      1. Rinne Test
                                                                                                                                                                                                                                                        1. Audiometry
                                                                                                                                                                                                                                                        2. Vestibular Function
                                                                                                                                                                                                                                                          1. Nystagmus
                                                                                                                                                                                                                                                            1. Head Impulse Test
                                                                                                                                                                                                                                                              1. Dix-Hallpike Maneuver
                                                                                                                                                                                                                                                                1. Caloric Testing
                                                                                                                                                                                                                                                              2. Glossopharyngeal and Vagus Nerves
                                                                                                                                                                                                                                                                1. Gag Reflex
                                                                                                                                                                                                                                                                  1. Palatal Movement
                                                                                                                                                                                                                                                                    1. Voice Quality
                                                                                                                                                                                                                                                                      1. Swallowing Assessment
                                                                                                                                                                                                                                                                        1. Taste Testing
                                                                                                                                                                                                                                                                        2. Accessory Nerve
                                                                                                                                                                                                                                                                          1. Sternocleidomastoid Function
                                                                                                                                                                                                                                                                            1. Trapezius Function
                                                                                                                                                                                                                                                                            2. Hypoglossal Nerve
                                                                                                                                                                                                                                                                              1. Tongue Protrusion
                                                                                                                                                                                                                                                                                1. Tongue Movement
                                                                                                                                                                                                                                                                                  1. Tongue Strength
                                                                                                                                                                                                                                                                                    1. Fasciculations
                                                                                                                                                                                                                                                                                  2. Motor System Examination
                                                                                                                                                                                                                                                                                    1. Inspection
                                                                                                                                                                                                                                                                                      1. Muscle Bulk
                                                                                                                                                                                                                                                                                        1. Atrophy
                                                                                                                                                                                                                                                                                          1. Hypertrophy
                                                                                                                                                                                                                                                                                            1. Pseudohypertrophy
                                                                                                                                                                                                                                                                                            2. Fasciculations
                                                                                                                                                                                                                                                                                              1. Fibrillations
                                                                                                                                                                                                                                                                                                1. Posture
                                                                                                                                                                                                                                                                                                2. Muscle Tone Assessment
                                                                                                                                                                                                                                                                                                  1. Passive Movement Testing
                                                                                                                                                                                                                                                                                                    1. Abnormal Tone
                                                                                                                                                                                                                                                                                                      1. Hypotonia
                                                                                                                                                                                                                                                                                                        1. Spasticity
                                                                                                                                                                                                                                                                                                          1. Rigidity
                                                                                                                                                                                                                                                                                                            1. Paratonia
                                                                                                                                                                                                                                                                                                          2. Muscle Strength Testing
                                                                                                                                                                                                                                                                                                            1. Manual Muscle Testing
                                                                                                                                                                                                                                                                                                              1. MRC Grading Scale
                                                                                                                                                                                                                                                                                                                1. Grade 0 (No Contraction)
                                                                                                                                                                                                                                                                                                                  1. Grade 1 (Flicker)
                                                                                                                                                                                                                                                                                                                    1. Grade 2 (Movement without Gravity)
                                                                                                                                                                                                                                                                                                                      1. Grade 3 (Movement against Gravity)
                                                                                                                                                                                                                                                                                                                        1. Grade 4 (Movement against Resistance)
                                                                                                                                                                                                                                                                                                                          1. Grade 5 (Normal Strength)
                                                                                                                                                                                                                                                                                                                          2. Proximal vs. Distal Weakness
                                                                                                                                                                                                                                                                                                                            1. Symmetry Assessment
                                                                                                                                                                                                                                                                                                                            2. Involuntary Movements
                                                                                                                                                                                                                                                                                                                              1. Tremor
                                                                                                                                                                                                                                                                                                                                1. Rest Tremor
                                                                                                                                                                                                                                                                                                                                  1. Action Tremor
                                                                                                                                                                                                                                                                                                                                    1. Intention Tremor
                                                                                                                                                                                                                                                                                                                                      1. Frequency and Amplitude
                                                                                                                                                                                                                                                                                                                                      2. Chorea
                                                                                                                                                                                                                                                                                                                                        1. Characteristics
                                                                                                                                                                                                                                                                                                                                          1. Distribution
                                                                                                                                                                                                                                                                                                                                          2. Dystonia
                                                                                                                                                                                                                                                                                                                                            1. Focal Dystonia
                                                                                                                                                                                                                                                                                                                                              1. Generalized Dystonia
                                                                                                                                                                                                                                                                                                                                                1. Task-Specific Dystonia
                                                                                                                                                                                                                                                                                                                                                2. Myoclonus
                                                                                                                                                                                                                                                                                                                                                  1. Cortical Myoclonus
                                                                                                                                                                                                                                                                                                                                                    1. Subcortical Myoclonus
                                                                                                                                                                                                                                                                                                                                                      1. Spinal Myoclonus
                                                                                                                                                                                                                                                                                                                                                      2. Tics
                                                                                                                                                                                                                                                                                                                                                        1. Motor Tics
                                                                                                                                                                                                                                                                                                                                                          1. Vocal Tics
                                                                                                                                                                                                                                                                                                                                                            1. Simple vs. Complex
                                                                                                                                                                                                                                                                                                                                                            2. Ballismus
                                                                                                                                                                                                                                                                                                                                                              1. Athetosis
                                                                                                                                                                                                                                                                                                                                                            3. Sensory System Examination
                                                                                                                                                                                                                                                                                                                                                              1. Primary Sensory Modalities
                                                                                                                                                                                                                                                                                                                                                                1. Light Touch
                                                                                                                                                                                                                                                                                                                                                                  1. Testing Technique
                                                                                                                                                                                                                                                                                                                                                                    1. Distribution Patterns
                                                                                                                                                                                                                                                                                                                                                                    2. Pain Sensation
                                                                                                                                                                                                                                                                                                                                                                      1. Sharp vs. Dull
                                                                                                                                                                                                                                                                                                                                                                        1. Pinprick Testing
                                                                                                                                                                                                                                                                                                                                                                        2. Temperature Sensation
                                                                                                                                                                                                                                                                                                                                                                          1. Hot vs. Cold
                                                                                                                                                                                                                                                                                                                                                                            1. Testing Methods
                                                                                                                                                                                                                                                                                                                                                                            2. Vibration Sensation
                                                                                                                                                                                                                                                                                                                                                                              1. Tuning Fork Testing
                                                                                                                                                                                                                                                                                                                                                                                1. Distal vs. Proximal
                                                                                                                                                                                                                                                                                                                                                                                2. Position Sense
                                                                                                                                                                                                                                                                                                                                                                                  1. Joint Position Testing
                                                                                                                                                                                                                                                                                                                                                                                    1. Finger-to-Nose with Eyes Closed
                                                                                                                                                                                                                                                                                                                                                                                  2. Cortical Sensory Functions
                                                                                                                                                                                                                                                                                                                                                                                    1. Two-Point Discrimination
                                                                                                                                                                                                                                                                                                                                                                                      1. Graphesthesia
                                                                                                                                                                                                                                                                                                                                                                                        1. Stereognosis
                                                                                                                                                                                                                                                                                                                                                                                          1. Extinction
                                                                                                                                                                                                                                                                                                                                                                                            1. Sensory Neglect
                                                                                                                                                                                                                                                                                                                                                                                            2. Sensory Distribution Patterns
                                                                                                                                                                                                                                                                                                                                                                                              1. Dermatomal Patterns
                                                                                                                                                                                                                                                                                                                                                                                                1. Peripheral Nerve Patterns
                                                                                                                                                                                                                                                                                                                                                                                                  1. Central Patterns
                                                                                                                                                                                                                                                                                                                                                                                                  2. Sensory Loss Patterns
                                                                                                                                                                                                                                                                                                                                                                                                    1. Stocking-Glove Distribution
                                                                                                                                                                                                                                                                                                                                                                                                      1. Saddle Anesthesia
                                                                                                                                                                                                                                                                                                                                                                                                        1. Suspended Sensory Loss
                                                                                                                                                                                                                                                                                                                                                                                                          1. Hemianesthesia
                                                                                                                                                                                                                                                                                                                                                                                                        2. Reflex Examination
                                                                                                                                                                                                                                                                                                                                                                                                          1. Deep Tendon Reflexes
                                                                                                                                                                                                                                                                                                                                                                                                            1. Biceps Reflex
                                                                                                                                                                                                                                                                                                                                                                                                              1. Brachioradialis Reflex
                                                                                                                                                                                                                                                                                                                                                                                                                1. Triceps Reflex
                                                                                                                                                                                                                                                                                                                                                                                                                  1. Patellar Reflex
                                                                                                                                                                                                                                                                                                                                                                                                                    1. Achilles Reflex
                                                                                                                                                                                                                                                                                                                                                                                                                      1. Reflex Grading
                                                                                                                                                                                                                                                                                                                                                                                                                        1. 0 (Absent)
                                                                                                                                                                                                                                                                                                                                                                                                                          1. 1+ (Hypoactive)
                                                                                                                                                                                                                                                                                                                                                                                                                            1. 2+ (Normal)
                                                                                                                                                                                                                                                                                                                                                                                                                              1. 3+ (Hyperactive)
                                                                                                                                                                                                                                                                                                                                                                                                                                1. 4+ (Hyperactive with Clonus)
                                                                                                                                                                                                                                                                                                                                                                                                                              2. Superficial Reflexes
                                                                                                                                                                                                                                                                                                                                                                                                                                1. Abdominal Reflexes
                                                                                                                                                                                                                                                                                                                                                                                                                                  1. Cremasteric Reflex
                                                                                                                                                                                                                                                                                                                                                                                                                                    1. Anal Reflex
                                                                                                                                                                                                                                                                                                                                                                                                                                    2. Pathological Reflexes
                                                                                                                                                                                                                                                                                                                                                                                                                                      1. Babinski Sign
                                                                                                                                                                                                                                                                                                                                                                                                                                        1. Chaddock Sign
                                                                                                                                                                                                                                                                                                                                                                                                                                          1. Oppenheim Sign
                                                                                                                                                                                                                                                                                                                                                                                                                                            1. Gordon Sign
                                                                                                                                                                                                                                                                                                                                                                                                                                              1. Hoffmann's Sign
                                                                                                                                                                                                                                                                                                                                                                                                                                                1. Jaw Jerk
                                                                                                                                                                                                                                                                                                                                                                                                                                                2. Primitive Reflexes
                                                                                                                                                                                                                                                                                                                                                                                                                                                  1. Grasp Reflex
                                                                                                                                                                                                                                                                                                                                                                                                                                                    1. Snout Reflex
                                                                                                                                                                                                                                                                                                                                                                                                                                                      1. Glabellar Reflex
                                                                                                                                                                                                                                                                                                                                                                                                                                                        1. Palmomental Reflex
                                                                                                                                                                                                                                                                                                                                                                                                                                                      2. Cerebellar Function Examination
                                                                                                                                                                                                                                                                                                                                                                                                                                                        1. Coordination Testing
                                                                                                                                                                                                                                                                                                                                                                                                                                                          1. Finger-to-Nose Test
                                                                                                                                                                                                                                                                                                                                                                                                                                                            1. Heel-to-Shin Test
                                                                                                                                                                                                                                                                                                                                                                                                                                                              1. Finger-to-Finger Test
                                                                                                                                                                                                                                                                                                                                                                                                                                                              2. Rapid Alternating Movements
                                                                                                                                                                                                                                                                                                                                                                                                                                                                1. Hand Patting
                                                                                                                                                                                                                                                                                                                                                                                                                                                                  1. Finger Tapping
                                                                                                                                                                                                                                                                                                                                                                                                                                                                    1. Foot Tapping
                                                                                                                                                                                                                                                                                                                                                                                                                                                                      1. Dysdiadochokinesia
                                                                                                                                                                                                                                                                                                                                                                                                                                                                      2. Rebound Phenomenon
                                                                                                                                                                                                                                                                                                                                                                                                                                                                        1. Cerebellar Speech
                                                                                                                                                                                                                                                                                                                                                                                                                                                                          1. Dysarthria
                                                                                                                                                                                                                                                                                                                                                                                                                                                                            1. Scanning Speech
                                                                                                                                                                                                                                                                                                                                                                                                                                                                            2. Cerebellar Eye Signs
                                                                                                                                                                                                                                                                                                                                                                                                                                                                              1. Nystagmus
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                1. Saccadic Dysmetria
                                                                                                                                                                                                                                                                                                                                                                                                                                                                              2. Gait and Station Assessment
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                1. Normal Gait Analysis
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  1. Stance Phase
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    1. Swing Phase
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      1. Cadence
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        1. Step Length
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          1. Base of Support
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          2. Abnormal Gait Patterns
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            1. Hemiplegic Gait
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              1. Parkinsonian Gait
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                1. Ataxic Gait
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  1. Cerebellar Ataxia
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    1. Sensory Ataxia
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    2. Steppage Gait
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      1. Waddling Gait
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        1. Antalgic Gait
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          1. Apraxic Gait
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          2. Stance Testing
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            1. Romberg Test
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              1. Tandem Stance
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                1. Single-Leg Stance
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                2. Special Gait Tests
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  1. Tandem Walking
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    1. Heel Walking
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      1. Toe Walking
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        1. Duck Walking

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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    Go to top

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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    4. Diagnostic Procedures in Neurology