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Organization of the neurologic examination

A. Mental status C. Motor

1. Level of alertness 1. Gait

2. Language 2. Coordination

a. Fluency 3. Involuntary movements

b. Comprehension 4. Pronator drift
c. Repetition 5. Individual muscles
d. Naming
a. Strength
e. Reading
b. Bulk
f. Writing
c. Tone (resistance to passive manipulation)
3. Memory
D. Reflexes
a. Immediate
1. Tendon reflexes
b. Short-term
2. Plantar responses
c. Long-term

i. Recent (including orientation to place and time)

3. Superficial reflexes

ii. Remote 4. "Primitive" reflexes

4. Calculation E. Sensory
5. Construction 1. Light touch
6. Abstraction 2. Pain/temperature

B. Cranial nerves 3. Joint position sense

1. Olfaction (CN I) 4. Vibration

2. Vision (CN II) 5. Double simultaneous stimulation

a. Visual fields 6. Graphesthesia

b. Visual acuity 7. Stereognosis

c. Funduscopic examination

3. Pupillary light reflex (CNs II, III)

4. Eye movements (CNs III, IV, VI)

5. Facial sensation (CN V)

6. Facial strength
a. Muscles of mastication (CN V)

b. Muscles of facial expression (CN VII)

7. Hearing and vestibular function (CN VIII)

8. Palatal movement (CNs IX, X)

9. Dysarthria (CNs IX, X, XII)

10. Head rotation (CN XI)

11. Shoulder elevation (CN XI)

12. Tongue movements (CN XII)

With permission from: Gelb DJ. The Neurologic Examination. In: Introduction to Clinical Neurology. Woburn, MA, Butterworth-Heinemann 2000.

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