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A neurological examination is the assessment of sensory neuron and motor responses, especially reflexes, to determine whether the nervous system is impaired. This typically includes a physical examination and a review of the patient's medical history , [ 1 ] but not deeper investigation such as neuroimaging .
The test can be performed by tapping the triceps tendon [3] [note 1] with the sharp end of a reflex hammer while the forearm is hanging loose at a right angle to the arm. A sudden contraction of the triceps muscle causes extension, [note 2] and indicates a normal reflex.
Unilateral loss indicates a possible nerve lesion or deviated septum. This test is usually skipped on a cranial nerve exam. [1] The short axons of the first cranial nerve regenerate on a regular basis. The neurons in the olfactory epithelium have a limited life span, and new cells grow to replace the ones that die off.
Romberg's test, Romberg's sign, or the Romberg maneuver is a test used in an exam of neurological function for balance. The exam is based on the premise that a person requires at least two of the three following senses to maintain balance while standing: proprioception (the ability to know one's body position in space)
An upper limb neurological examination is part of the neurological examination, and is used to assess the motor and sensory neurons which supply the upper limbs. This assessment helps to detect any impairment of the nervous system, being used both as a screening and an investigative tool.
American neurologist Morris Lewis (1852–1928) first described the jaw jerk. But several textbooks of neurology and clinical neurophysiology attribute discovery of the jaw jerk reflex to Armand de Watteville (1846–1925) as he correctly predicted that the jaw jerk would be valuable to detect disease affecting bulbar nuclei. [10]
For an adequate test, vision must not be entirely lost. In dim room light, the examiner notes the size of the pupils. The patient is asked to gaze into the distance, and the examiner swings the beam of a penlight back and forth from one pupil to the other, and observes the size of pupils and reaction in the eye that is lit.
The patellar reflex (knee jerk) is an example of the stretch reflex and it is used to determine the sensitivity of the stretch reflex. Reflexes can be tested as part of a neurological examination, often if there is an injury to the central nervous system. To test the reflex, the muscle should be in a neutral position.