840:
40:
136:. It can be used both as a screening tool and as an investigative tool, the former of which when examining the patient when there is no expected neurological deficit and the latter of which when examining a patient where you do expect to find abnormalities. If a problem is found either in an investigative or screening process, then further tests can be carried out to focus on a particular aspect of the nervous system (such as
343:(I-XII): sense of smell (I), visual fields and acuity (II), eye movements (III, IV, VI) and pupils (III, sympathetic and parasympathetic), sensory function of face (V), strength of facial (VII) and shoulder girdle muscles (XI), hearing (VII, VIII), taste (VII, IX, X), pharyngeal movement and reflex (IX, X), tongue movements (XII). These are tested by their individual purposes (e.g. the visual acuity can be tested by a
231:
that is responsible for language). As patients answer questions, it is important to gain an idea of the complaint thoroughly and understand its time course. Understanding the patient's neurological state at the time of questioning is important, and an idea of how competent the patient is with various
702:
Establishing the lesion's location. If the process involves the CNS, clarifying if it is cortical, subcortical, or multifocal. If subcortical, clarifying whether it is white matter, basal ganglia, brainstem, or spinal cord. If the process involves the PNS then determining whether it localizes to the
195:
A patient's history is the most important part of a neurological examination and must be performed before any other procedures unless impossible (i.e., if the patient is unconscious certain aspects of a patient's history will become more important depending upon the complaint issued). Important
698:
Determining whether the process involves the peripheral nervous system (PNS), central nervous system (CNS), or both. Considering if the finding (or findings) can be explained by a single lesion or whether it requires a multifocal
711:
may then be constructed that takes into account the patient's background (e.g., previous cancer, autoimmune diathesis) and present findings to include the most likely causes. Examinations are aimed at ruling
175:. Finally, it is the role of the physician to find the cause for why such a problem has occurred, for example finding whether the problem is due to inflammation or is congenital.
232:
tasks and his/her level of impairment in carrying out these tasks should be obtained. The interval of a complaint is important as it can help aid the diagnosis. For example,
1531:
1007:
854:
Betts, J Gordon; Desaix, Peter; Johnson, Eddie; Johnson, Jody E; Korol, Oksana; Kruse, Dean; Poe, Brandon; Wise, James; Womble, Mark D; Young, Kelly A (June 5, 2023).
239:
Carrying out a 'general' examination is just as important as the neurological exam, as it may lead to clues to the cause of the complaint. This is shown by cases of
236:
disorders (such as strokes) occur very frequently over minutes or hours, whereas chronic disorders (such as
Alzheimer's disease) occur over a matter of years.
716:
the most clinically significant causes (even if relatively rare, e.g., brain tumor in a patient with subtle word-finding abnormalities but no increased
633:
1524:
1000:
71:
450:– is resistance to passive change, where the strength of antagonist muscles increases with increasing examiner force. More common in dementia.
900:
Medical
Research Council (1976). "Medical Research Council scale. Aids to examination of the peripheral nervous system. Memorandum no. 45".
159:
or there is another diffuse process that is troubling the patient. Once the patient has been thoroughly tested, it is then the role of the
662:
618:
1517:
993:
695:
Looking for side to side symmetry: one side of the body serves as a control for the other. Determining if there is focal asymmetry.
227:
Handedness is important in establishing the area of the brain important for language (as almost all right-handed people have a
863:
935:, First Edition. Stern TA, Rosenbaum JF, Fava M, Rauch S, Biederman J. (eds.) Philadelphia: Mosby/Elsevier. April 25, 2008.
1453:
1471:
1394:
684:. This may be diffuse (e.g., neuromuscular diseases, encephalopathy) or highly specific (e.g., abnormal sensation in one
948:
1382:
1293:
822:
17:
1466:
1415:
1275:
372:
grades 4−, 4 and 4+ maybe used to indicate movement against slight, moderate and strong resistance respectively.
1797:
1041:
940:
531:
testing involves provoking sensations of fine touch, pain and temperature. Fine touch can be evaluated with a
1873:
1868:
1645:
588:– 2 out of the following 3 must be intact to maintain balance: i. vision ii. vestibulocochlear system iii.
366:
301:
297:
187:. Any new symptom of any neurological order may be an indication for performing a neurological examination.
491:
844:
183:
A neurological examination is indicated whenever a healthcare provider suspects that a patient may have a
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1389:
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1078:
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1509:
918:
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78:
1807:
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nerve root, plexus, peripheral nerve, neuromuscular junction, muscle or whether it is multifocal.
1763:
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1433:
708:
522:
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905:
717:
318:
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184:
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1016:
576:
378:
125:
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8:
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1083:
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628:
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385:
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201:
163:
to determine whether these findings combine to form a recognizable medical syndrome or
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66:
50:
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1187:
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327:
205:
147:
In general, a neurological examination is focused on finding out whether there are
975:
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1769:
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1344:
1205:
1036:
1028:
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685:
503:
487:
228:
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129:
84:
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with a nylon monofilament to detect any subjective absence of touch perception.
1699:
1544:
1323:
1210:
1182:
1096:
964:
680:
The results of the examination are taken together to anatomically identify the
528:
514:
475:
434:
340:
121:
109:
880:
1862:
1839:
1605:
1088:
758:
561:
507:
479:
471:
421:
344:
283:
831:
39:
1280:
1222:
1144:
776:
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355:
133:
113:
1610:
1410:
1359:
1164:
400:
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390:
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Time of onset, duration and associated symptoms (e.g., is the complaint
94:
1313:
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1177:
1061:
603:
429:
314:
243:
141:
1539:
1149:
1106:
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613:
160:
57:
258:
Specific tests in a neurological examination include the following:
1438:
688:
due to compression of a specific spinal nerve by a tumor deposit).
474:: masseter, biceps and triceps tendon, knee tendon, ankle jerk and
240:
233:
1056:
416:
369:
scale 0 to 5 (i.e., 0 = Complete
Paralysis to 5 = Normal Power).
743:"Clinical neurology: why this still matters in the 21st century"
1668:
1101:
408:
362:
247:
148:
117:
1354:
499:
444:
Cogwheeling (abnormal tone suggestive of
Parkinson's disease)
1131:
666:
1015:
482:). Globally, brisk reflexes suggest an abnormality of the
931:
853:
27:
Assessment to determine if the nervous system is impaired
899:
490:, while decreased reflexes suggest abnormality in the
196:
factors to be taken in the medical history include:
972:- "Neurological History and Physical Examination"
246:where the initial complaint was of a mass in the
1860:
881:"Neurological History and Physical Examination"
740:
1525:
1001:
858:. Houston: OpenStax CNX. 16.0 Introduction.
1532:
1518:
1008:
994:
211:Age, gender, and occupation of the patient
38:
766:
872:
741:Nicholl DJ, appleton JP (May 29, 2014).
808:
806:
132:, but not deeper investigation such as
124:is impaired. This typically includes a
14:
1861:
812:
804:
802:
800:
798:
796:
794:
792:
790:
788:
786:
734:
598:"intact to sharp and dull throughout"
1513:
989:
307:Global assessment of higher functions
817:. Churchill Livingstone. p. 1.
461:"strength 5/5 throughout, tone WNL"
190:
1578:
1395:Upper limb neurological examination
783:
317:; this also enables assessment for
24:
878:
815:Neurological Examination Made Easy
214:Handedness (right- or left-handed)
25:
1885:
957:
933:Comprehensive Clinical Psychiatry
675:
843: This article incorporates
838:
253:
1416:Ballard Maturational Assessment
1276:Peripheral vascular examination
1042:History of the present illness
925:
893:
365:strength, often graded on the
178:
128:and a review of the patient's
13:
1:
1383:Mini–mental state examination
1294:Ankle–brachial pressure index
747:J Neurol Neurosurg Psychiatry
727:
302:mini mental state examination
298:abbreviated mental test score
691:General principles include:
7:
120:, to determine whether the
10:
1890:
1646:Charcot's neurologic triad
634:Rapid pronation-supination
510:is used for this testing.
350:"CNII-XII grossly intact"
157:peripheral nervous systems
1832:
1816:
1785:
1750:
1743:
1723:
1692:
1676:
1667:
1660:Peripheral nervous system
1658:
1619:
1569:
1561:Cranial nerve examination
1551:
1484:
1452:
1424:
1403:
1390:Cranial nerve examination
1368:
1332:
1304:
1261:
1243:
1196:
1163:
1129:
1120:
1027:
513:"2+ symmetric, downgoing
377:Muscle tone and signs of
336:Cranial nerve examination
294:Mental status examination
276:Mental status examination
223:Family and social history
91:
77:
65:
49:
37:
32:
1556:Neurological examination
856:Anatomy & Physiology
813:Fuller, Geraint (2004).
759:10.1136/jnnp-2013-306881
724:the most likely causes.
573:Two-point discrimination
326:"A&O x 3, short and
106:neurological examination
44:The human nervous system
33:Neurological examination
1462:Athletic heart syndrome
1764:carpal tunnel syndrome
1571:Central nervous system
1499:Differential diagnosis
1434:Well-woman examination
981:Simplified Motor Score
913:Cite journal requires
709:differential diagnosis
296:, often including the
116:responses, especially
1628:Intracranial pressure
718:intracranial pressure
623:Ankle-over-tibia test
319:microvascular disease
311:Intracranial pressure
185:neurological disorder
173:motor neurone disease
165:neurological disorder
108:is the assessment of
1874:Physical examination
1869:Neurology procedures
1808:Trendelenburg's sign
1467:Sudden cardiac death
1350:Shoulder examination
1289:Abdominojugular test
1122:Physical examination
1069:Past medical history
879:Oommen, Kalarickal.
847:available under the
577:discriminative sense
467:Deep tendon reflexes
217:Past medical history
126:physical examination
1684:Jendrassik maneuver
1486:Assessment and plan
1271:Cardiac examination
1216:Swinging light test
1084:Psychiatric history
1017:Medical examination
619:Finger-to-nose test
610:Cerebellar testing
590:epicritic sensation
535:, touching various
413:Abnormal movements
169:Parkinson's disease
1803:Straight leg raise
1541:Signs and symptoms
1444:Breast examination
1319:Rectal examination
1253:Respiratory sounds
1052:Nursing assessment
976:Glasgow Coma Scale
643:Assessment of gait
629:Dysdiadochokinesis
288:Glasgow Coma Scale
286:, often using the
282:The assessment of
1856:
1855:
1852:
1851:
1848:
1847:
1739:
1738:
1731:Hoffmann's reflex
1654:
1653:
1507:
1506:
1494:Medical diagnosis
1480:
1479:
1355:Elbow examination
865:978-1-947172-04-3
673:
672:
533:monofilament test
313:is estimated by
191:Patient's history
102:
101:
18:Neurological exam
16:(Redirected from
1881:
1748:
1747:
1710:Oppenheim's sign
1674:
1673:
1665:
1664:
1641:Lhermitte's sign
1576:
1575:
1543:relating to the
1534:
1527:
1520:
1511:
1510:
1340:Knee examination
1188:Respiratory rate
1127:
1126:
1010:
1003:
996:
987:
986:
951:
929:
923:
922:
916:
911:
909:
901:
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891:
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888:
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876:
870:
869:
842:
835:
829:
828:
810:
781:
780:
770:
738:
651:Intention tremor
328:long-term memory
261:
260:
138:lumbar punctures
95:edit on Wikidata
87:
61:
60:
42:
30:
29:
21:
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1857:
1844:
1828:
1812:
1781:
1775:Phalen maneuver
1735:
1719:
1715:Westphal's sign
1705:Chaddock reflex
1688:
1650:
1634:Cushing's triad
1615:
1565:
1547:
1538:
1508:
1503:
1476:
1448:
1420:
1399:
1364:
1345:Hip examination
1333:Musculoskeletal
1328:
1300:
1257:
1239:
1206:Eye examination
1192:
1159:
1116:
1037:Chief complaint
1029:Medical history
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832:
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811:
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678:
654:Staccato speech
504:motor end plate
488:pyramidal tract
384:Examination of
256:
229:left hemisphere
193:
181:
130:medical history
98:
83:
56:
55:
45:
28:
23:
22:
15:
12:
11:
5:
1887:
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1871:
1854:
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1760:
1758:Froment's sign
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1737:
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1734:
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1727:
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1720:
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1707:
1702:
1700:Plantar reflex
1696:
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1638:
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1623:
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1603:
1601:Myerson's sign
1598:
1596:Macewen's sign
1593:
1588:
1582:
1580:
1573:
1567:
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1564:
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1558:
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1548:
1545:nervous system
1537:
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1522:
1514:
1505:
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1502:
1501:
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1301:
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1291:
1283:
1278:
1273:
1267:
1265:
1263:Cardiovascular
1259:
1258:
1256:
1255:
1249:
1247:
1241:
1240:
1238:
1237:
1236:
1235:
1230:
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1219:
1218:
1213:
1211:Ophthalmoscopy
1202:
1200:
1194:
1193:
1191:
1190:
1185:
1183:Blood pressure
1180:
1175:
1169:
1167:
1161:
1160:
1158:
1157:
1152:
1147:
1142:
1136:
1134:
1124:
1118:
1117:
1115:
1114:
1113:
1112:
1109:
1104:
1099:
1091:
1089:Progress notes
1086:
1081:
1079:Social history
1076:
1074:Family history
1071:
1066:
1065:
1064:
1054:
1049:
1047:Systems review
1044:
1039:
1033:
1031:
1025:
1024:
1021:history taking
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1012:
1005:
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990:
984:
983:
978:
973:
959:
958:External links
956:
953:
952:
949:978-0323047432
924:
915:|journal=
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731:
729:
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705:
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696:
677:
676:Interpretation
674:
671:
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663:finger-to-nose
659:
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592:
583:
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570:
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559:
558:Position sense
556:
553:
550:
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529:Sensory system
525:
519:
518:
515:plantar reflex
511:
469:
463:
462:
459:
458:
457:
456:
455:
454:
453:
452:
451:
445:
439:
438:
437:
435:Pronator drift
424:
422:Fasciculations
419:
411:
405:
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375:
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341:Cranial nerves
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122:nervous system
110:sensory neuron
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63:
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53:
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2:
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1870:
1867:
1866:
1864:
1841:
1840:Pain stimulus
1838:
1837:
1835:
1831:
1825:
1824:Beevor's sign
1822:
1821:
1819:
1815:
1809:
1806:
1804:
1801:
1799:
1798:Hoover's sign
1796:
1794:
1793:Gowers's sign
1791:
1790:
1788:
1784:
1776:
1773:
1771:
1768:
1767:
1766:
1765:
1761:
1759:
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1622:
1618:
1612:
1609:
1607:
1604:
1602:
1599:
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1594:
1592:
1591:Kernig's sign
1589:
1587:
1586:Battle's sign
1584:
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1577:
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1568:
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1429:
1427:
1426:Gynecological
1423:
1417:
1414:
1412:
1409:
1408:
1406:
1402:
1396:
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1391:
1388:
1384:
1381:
1380:
1379:
1378:Mental status
1376:
1375:
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1371:
1367:
1361:
1358:
1356:
1353:
1351:
1348:
1346:
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1217:
1214:
1212:
1209:
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1203:
1201:
1199:
1195:
1189:
1186:
1184:
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1170:
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834:
826:
824:0-443-07420-8
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797:
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764:
760:
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753:(2): 229–33.
752:
748:
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733:
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723:
720:) and ruling
719:
715:
710:
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697:
694:
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689:
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584:
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565:
563:
562:Graphesthesia
560:
557:
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551:
548:
545:
544:
542:
541:
540:
538:
534:
530:
526:
524:
521:
520:
516:
512:
509:
508:reflex hammer
505:
501:
497:
493:
492:anterior horn
489:
485:
481:
480:Babinski sign
477:
473:
470:
468:
465:
464:
460:
449:
446:
443:
442:
440:
436:
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345:Snellen chart
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329:
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312:
309:
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299:
295:
292:
289:
285:
284:consciousness
281:
280:
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277:
274:
273:
269:
266:
263:
262:
259:
254:List of tests
251:
249:
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210:
207:
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199:
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96:
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80:
76:
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68:
64:
59:
54:
52:
48:
41:
36:
31:
19:
1770:Tinel's sign
1762:
1626:
1555:
1370:Neurological
1369:
1324:Bowel sounds
1281:Heart sounds
1145:Auscultation
963:
932:
927:
906:cite journal
895:
884:. Retrieved
874:
855:
837:
833:
814:
750:
746:
736:
721:
713:
706:
690:
681:
679:
586:Romberg test
567:Stereognosis
532:
527:
447:
356:Motor system
257:
238:
226:
220:Drug history
194:
182:
146:
134:neuroimaging
105:
103:
1677:Combination
1611:Hirano body
1606:Stroop test
1411:Apgar score
1360:GALS screen
1245:Respiratory
1173:Temperature
1165:Vital signs
1062:Medications
552:Temperature
546:Light touch
448:Gegenhalten
401:Hemiparetic
396:Decorticate
391:Decerebrate
179:Indications
142:blood tests
1863:Categories
1314:Liver span
1178:Heart rate
1155:Percussion
1140:Inspection
1093:Mnemonics
941:0323047432
886:2008-04-22
728:References
604:Cerebellum
582:Extinction
537:dermatomes
430:Spasticity
315:fundoscopy
300:(AMTS) or
244:metastases
1306:Abdominal
1150:Palpation
1057:Allergies
970:eMedicine
965:neuro/632
849:CC BY 4.0
686:dermatome
648:Nystagmus
614:Dysmetria
555:Vibration
523:Sensation
441:Rigidity
264:Category
161:physician
58:neurology
51:Specialty
1669:Reflexes
1439:Pap test
1404:Neonatal
1130:General/
1111:COASTMAP
851:license.
777:24879832
699:process.
661:"intact
543:Sensory
472:Reflexes
407:Resting
379:rigidity
330:intact"
270:Example
241:cerebral
234:vascular
167:such as
118:reflexes
67:ICD-9-CM
1833:General
1223:Hearing
768:4316836
640:Ataxia
478:(i.e.,
476:plantar
417:Seizure
409:tremors
386:posture
202:chronic
153:central
151:in the
149:lesions
85:D009460
1454:Sports
1285:Other
1102:OPQRST
1097:SAMPLE
947:
939:
862:
821:
775:
765:
682:lesion
363:Muscle
304:(MMSE)
267:Tests
248:breast
1817:Torso
1744:Other
1620:Other
1472:RED-S
1233:Rinne
1228:Weber
1198:HEENT
669:WNL"
575:(for
569:, and
500:nerve
426:Tone
290:(GCS)
206:acute
114:motor
93:[
72:89.13
1786:Legs
1751:Arms
1724:Arms
1693:Legs
1579:Head
1132:IPPA
1107:SOAP
1019:and
945:ISBN
937:ISBN
919:help
860:ISBN
845:text
819:ISBN
773:PMID
667:gait
549:Pain
506:. A
155:and
140:and
112:and
79:MeSH
968:at
763:PMC
755:doi
714:out
502:or
496:LMN
486:or
484:UMN
367:MRC
347:).
204:or
171:or
144:).
1865::
943:.
910::
908:}}
904:{{
785:^
771:.
761:.
751:86
749:.
745:.
722:in
707:A
665:,
517:"
498:,
494:,
250:.
104:A
1533:e
1526:t
1519:v
1009:e
1002:t
995:v
921:)
917:(
889:.
868:.
827:.
779:.
757::
579:)
381:.
321:.
208:)
97:]
20:)
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