Loyola Full Neurological Exam Part 1

Okay, good afternoon. I'm Dr. Merchit and we're going to perform the neurological screening examination. We've already taken the history and spoken with our patient and she's changed into an exam gown. Just a couple of basic steps to remember about the exam we're going to do. It's a screening exam, a basic exam that you will modify based on some of the signs or symptoms that a patient has. So this is kind of a for everyone exam. You can remember it, the steps perhaps a little bit better, thinking of it as a head to toe exam.

So we can check gait at the beginning or the end, then we can start up by the head by checking a vision, the eyes, the fundoscopic exam, the cranial nerves, and moving there on out. And generally I tend to leave the sensory exam near the end because that's the most subjective part of the exam and in some respects the least important. So we're going to start and here's our patient. Hello. We're going to do the neurological exam. So if you could do a few things for me,

I'm going to move over here. And what I'd like you to do, just let your arms go loose. And can you just walk back and forth like you're walking at home, back up to the sink there, turn around, walk back to the door. Okay, turn around. Could you walk on tiptoe towards the sink? That's great. Okay, turn around. Can you walk on your heels towards the door? Okay, and last but not least, can you walk like this one foot in front of the other like you're walking

a tightrope towards the sink? Excellent. Okay. All right, now if you could just stand still there for a minute, put your feet together. That's great. Hands at your side and stand up straight and just, when you think behind you, close your eyes. Okay, very good. Open your eyes. So now I'm going to start with the head here, and maybe I better get on this side. We're going to look at your vision. So if you could just stare at my nose, okay, we're facing one another. I'm going to hold my fingers up,

point where you see my finger wiggle. Okay, both. All right, how about now? Both. Both. Okay, terrific. We're going to look in your eye with a light, okay? So I'm going to dim the light, and if you could just keep staring at a spot on the wall there straight ahead for me, just ignore me. I'm going to shine a little light in your eye. Okay, and over here. Back to this one and this one. Very good. And we're going to use one other light. So you're doing great.

And then you're going to blink and just keep staring, focused on that spot straight ahead. Ignore me if my head gets in your way, okay? And you can blink all you want. That's great. And I'm going to switch over to your other eye. And you can keep on staring straight ahead and blink. As you will. That's great. Excellent. Okay, lights back on. And I'm going to swing it around you. Okay, I'm going to check a few other things with your eyes. Hold your head still. Look at my finger.

Your file on my finger with your eyes. That way. Okay, that's very good. And I've got a little piece of cotton on this stick. And I want to test the sensation on your face real gently. Can you close your eyes for us? Okay, where do you feel me there? Over right one. Left one. And those feel pretty equal? Yes. How about here? Cheap. Pretty similar? Yes. Long your jaws pretty equal? Yes. Very good. Okay. And one more time. This is pointy. Pointy on both sides. Yes. Very good.

Okay. And open your eyes for us. Can I see a big smile? Raise your eyebrows up. Squeeze and shot real tight. Excellent. Okay, very good. I want to check your hearing a little bit. So close your eyes. Hear anything there? I'm rubbing by your left ear. I'm rubbing by your left ear.