SECTION 1: Mental status
Mental status
Level of Consciousness The level of consciousness is described in terms of the patient’s
apparent state of wakefulness and response to stimuli. Normal: awake, alert, verbal responses Impaired:
Neurological Examination Junior Course
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Introduction
A way to diagnose diseases of nervous system. Quite different from traditional physical
Comprehension: “Close your eyes”, “show your left hand” etc
Repetition: ask the patient to repeat three common nouns
Naming: by asking the patient to name items as you piont to them
of unconsciousness, motionletive functioning The examiner must have some way (recent work history, observations
of family, etc) of assessing the patient’s cognitive status before onset of the present illness. Assessment should include: Orientation to Person, Place and time: “Do you know who is in the room now? Who are you, name?” :“Where are you?”“Do you know the year, season ,day, and date?” Memory: Short-term memory (three common objects, then name them again after 5min ) and long-term Calculations: count backward from 100, taking away 7 each time Verbal fluency
Aphasias：
The most important function of the dominant hemisphere is language. Language skills include:
Fluency: listen to the patient's spontaneous speech
Reading: reading a paragraph in newspaper
Writing Broca’s aphasia? Wernick aphasia? --- difficulties both in understanding others' speech
and in the production of language. The disorder is characterized by speech that sounds fluent but makes no senses
etiologic diagnosis: + mode of onset, other medical and demographic data, lab tests.
Contents
1. Mental status 2. Cranial nerves 3. Sensory function examination 4. Motor examination 5. Reflexes 6. Signs of meningeal irritation
Mini - mental state examination
SECTION 2: Cranial Nerve
Cranial Nerve Examination
12 pairs of cranial nerves.
1.Olfactory N. 2.Optic N. 3.Oculomotor N. 4. Trochlear N. 5. Trigeminal N 6. Abducens N 7. Facial N. 8. Acoustic N. 9. Glossopharyngeal N. 10. Vagus N. 11. Accessory N. 12. Hypoglossal N.
examination (inspection, palpation, percussion, and auscultation). Knowledge of nervous system anatomy and physiology is of key importance in deducing the site of lesion.
drowsiness: easily aroused when spoken to stupor : Responsive only to vigorous stimulation Coma: Unarousable to verbal or physical stimuli, deepest state
Disgnosis of neurologic disease
History+neurologic exam
anatomic diagnosis syndromic diagnosis: peripheral neuropathy, acute
encephlopathy parkinsonian syndrome, et al.