Neurological Screening
Sample Question for Examining
Orientation and Awareness
• Person
– What is your name?
– How old are you?
– When were you born?
• Place
– Do you know where you are right know?
– What kind of place is this?
– What city or town do you live in?
• Time
– What is today’s date?
– What day of the week is it?
– What year is it?
• Circumstance
– Do you know why you are here?
http://www.maturespine.com/symptoms/weakness.html
Upper Quarter Myotomes
Level
Action to Be Tested
Muscle
C5
Shoulder shrug
Deltoid
C5, C6
Elbow flexion
Biceps
C6,C7
Wrist extension
Wrist extensors
C7
Elbow extension, wrist
flexion
Triceps, wrist flexors
C8
Thumb extension
Abductor pollicis longus,
extensor pollicis longus,
extensor pollicis brevis
T1
Digit abduction/adduction
Interossei
Lower Quarter Myotomes
Level
Action to Be Tested
Muscle
L2, L3
Hip flexion
Iliopsoas
L3
Knee extension
Quadriceps
L4
Dorsiflexion
Anterior Tibialis
L5
Great toe extension
Extensor hallicus longus
S1
Plantarflexion
Gastronemius
S2
Knee flexion
Hamstrings
Proprioception
Upper Extremity
Lower Extremity
Shoulder
Hip
Elbow
Knee
Wrist
Ankle
Distal phalanx of thumb
Distal phalanx of great toe
Deep Tendon Reflexes
Upper quarter:
Lower quarter:
Root Level
Muscle
CN V
Muscle of
mastication
C1-4
Upper trapezius,
levator scapula,
deltoid
C5-6
Biceps
C5-6
Brachioradialis
C7
Triceps
C8, T1
Hypothenar
L3-4
Quadriceps
S1
Gastrnemius
0=absent; 1=hyporeflexia; 2=normal; 3=hyperreflexia; 4=clonus
Babinski
http://meded.ucsd.edu/clinical
med/neuro3.htm
http://academic.scranton.edu/faculty/kosmahle
1/courses/pt351/lab351/babinski.htm
Test positive with splaying of the toes and extension of the great toe.
Cranial Nerve Integrity
Cranial Nerve
Function
CN II, optic radiation, visual cortex
Visual field
CN II
Visual acuity
CN III
Pupillary reflex
CN III, IV, VI
Extraocular movements
CN V, VII
Facial sensation
CN VIII
Labyrinthine/Auditory
CN IX
Swallow
CN X
Voice—if deficit may be characterized by
hoarseness
CN XI
Shoulder shrug
CN XII
Tongue
NOTE: Ocular motility disturbances may be present with brainstem strokes, such as
diplopia, oscillopsia, visual distortions, or paralysis of conjugate gaze.
O'Sullivan S, Schmitz T. Physical Rehabilitation. 5th ed2007.