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9 Cards in this Set

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Perform a screening neurologic exam on all new inpatients and on clinic patients who request a "full physical". This includes assessment of:
1.
2.
3.
4.
5.
6.
Perform a screening neurologic exam on all new inpatients and on clinic patients who request a "full physical". This includes assessment of:
1. mental status
2. cranial nerves
3. strength
4. sensation
5. reflexes
6. coordination

To facilitate exam, tell your patient why you are doing each step. For example, you can say, "I'm going to test your coordination now. Touch my finger, now touch your nose, now go back and forth".
What do you check for in

Mental status:
Mental status: alert and oriented to person, place and time
What do you check for in

Cranial nerves:
Cranial nerves: pupils equal, round, reactive to light, and accomodation (PERRLA), extraocular movements intact (EOMI), facial sensation and movement normal, palate elevation symmetric, tongue midline and strong (or cranial nerves 2 through 12 intact)
What do you check for in

Sensation:
Sensation: intact to vibration in toes and light touch in all four extremities
What do you check for in

Motor:
5 out of 5 strength in all four extremity muscle groups.
What do you check for in

Coordination:
Coordination: intact to finger-nose-finger, gait normal
What do you check for in

Reflexes:
Reflexes: symmetric and 2/4 at the biceps, triceps, knees, ankles; 1/4 at the brachioradialis; toes downgoing
How do you grade motor strength?
0 = no movement
1 = trace movement
2 = movement when the force of gravity removed
3 = able to move against gravity but not resistance
4 = able to move against resistance but weaker than expected for age and size
5 = full strength against resistance
When do I need to perform a more detailed neurologic exam?
If the screening neurologic exam is abnormal, or if the patient presents with a neurologic problem, a more detailed exam is warranted and can be tailored to fit the circumstances.