II. Learning Unit: Neurological Patient Examination
Imre Szirmai, Dániel Bereczki
The aim of this chapter is to provide help in learning neurological examination techniques. The chapter follows the logical sequence of patient examination, first discussing the special aspects of history taking, and then summarizes different examination techniques. At each examination technique, first an anatomical introduction, then details of the examination itself are provided. This is followed by a description of normal and abnormal findings.
Skills and competencies
After studying this chapter, students will become familiar with the methods of history taking and neurological physical examination, will be able to interpret the findings of physical examination, and to describe normal and abnormal findings with the appropriate terms.
Together with the knowledge of the other chapters of this learning aid, students should be able to answer the following four questions after having examined a given patient:
1. Is a neurological disorder suspected?
2. If yes, which part of the nervous system is affected?
3. Which neurological disorders are likely to cause damage in the given localisation?
4. From these disorders, which is the most probable one in the given patient?
This chapter gives an overview of neurological history taking and physical examination. For further details, please refer to the sources given below.
Key words: history, physical examination, normal findings, abnormal findings
References
Duus, P.: Topical diagnosis in neurology. Georg Thieme VlG; Stuttgart New York, 1989
Study time
Nine weeks are allocated for learning neurological patient examination during the first semester. To benefit most from practical, bed-side teaching sessions, 2 hours of preparation is recommended before each session. Therefore, about 18 hours are required for learning this chapter.
Contents:
II./1. Neurological history
II./1.1. Relationship of symptoms, localisation and causes II./1.2. Special aspects of history taking
II./ 2. Physical examination and symptoms II./2.1. Examination of the skull and spine II./2.2. Meningeal signs
II./2.3. Examination of cranial nerves
II./2.4.-5. Examination of the motor system and reflexes II./2.6. Examination of the sensory system
II./2.7. Examination of motor coordination II./2.8. Autonomic functions
II./2.9. Higher cerebral functions: aphasia, apraxia, agnosia
II./2.10. Examination of the mental state of a neurological patient
II./1.11. Special situations
II./2.11.1. Damage of the spinal cord II./2.11.2. Damage of peripheral nerves
II./2.11.3. Examination of the unconscious patient II./1.11.4. Examination of a parkinsonian patient
