Post on 15-Jul-2015



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<p>NEUROLOGICAL EXAMINATIONS PROBLEM BASED LEARNING (PBL)</p> <p>1NEUROLOGICAL EXAMINATIONSPROBLEM BASED LEARNING (PBL)PREPARED BY: MUHAMMAD ARIFF B. MAHDZUBBACHELOR MEDICINE AND SURGERY (MBBS)UNIVERSITY COLLEGE SHAHPUTRA, KUANTAN</p> <p>WHAT IS NEUROLOGICAL EXAMINATIONS?COMPONENTSA) Appearance B) Attitude and behaviour c) Speech d) Perception TEST EXAMPLE :GCS</p> <p>TEST EXAMPLE : AMTS</p> <p>TEST EXAMPLE : MMSE</p> <p>2) Reflex examinationA)Tendon reflex</p> <p>B)Superficial reflex</p> <p>C)Pathological reflex</p> <p>3) Sensory examinationgraphesthesiaCranial nervemnemonics(function)OlfactoryOhSomeOpticOhSayOculomotorOhMarryTrochlearToMoneyTrigeminalTakeButAbducentAMy FacialFamilyBrotherVestibulocochlearVacation!SaysGlossopharyngealGoBigVagusVegasBrainAccessoryAndMatterHypoglossal Hawaii Most </p> <p>XI Spinal Accessory NerveThe spinal accessory supplies the trapezius and sternocleidomastoid muscles.</p> <p>observe for atrophy or asymmetry of the muscles.quickness of shoulder shrug</p> <p>XII Hypoglossal NerveThe hypoglossal nerve is motor to the tongue.</p> <p>Normal Response:the tongue should be able to protrude relatively straight. Minimal degrees of deviation (i.e. only millimeters) affecting only the tip are insignificant.Abnormal Response:with tongue weakness, the tongue deviates towards the weak side.</p> <p>Motor ExaminationMRC ScaleGradeDescription0no contraction1flicker or trace of contraction2active movement with gravity eliminated3active movement against gravity4*active movement against gravity and resistance5normal powerCoordination &amp; GaitCoordination To perform tasks of co-ordination one requires normal motor, sensory, and cerebellar systems. Lesions affecting any of these areas could give rise to abnormal tests of co-ordination.Examine Upper extremitiesLower extremitiesGait observe the patient walk.if there is a subtle abnormality this may be made more obvious by asking the patient to run.ask the patient to perform tandem gait by walking heel to toe (eyes open).</p>