ATENEO SCHOOL OF MEDICINE AND PUBLIC HEALTH

NEURO EXAM OSCE CHECKLIST

Name of Student : ___________________________________

Date of Exam : ___________________________________
Preceptor : ___________________________________

STATION ONE:
Examination of Mental Status and Higher Cortical Functions

3 points 2 points 1 point No point

MINOR ERROR POOR OR
DONE
OR NEEDED INCORRECT NOT DONE
CORRECTLY
Did the student… PRODDING TECHNIQUE
1. Greet the patient, ask for the patient’s name, and YES NO

introduce himself/herself
2. Describe the patient’s general behavior and
appearance
3. Describe the patient’s mood and affect
4. Describe the patient’s stream of talk and check
for aphasia
5. Describe the patient’s content of thought
6. Describe the patient’s intellectual capacity
7. Assess consciousness
8. Assess attention span
9. Check for orientation to time, place, and person
10. Assess fund of information and test for
immediate, recent, and remote memories
11. Test insight, judgment, and planning
12. Test calculation
Ask the student to perform two tests for higher
cortical function from the list below:
13.
14.
15. Converse with patient in a polite manner, using YES NO

appropriate language and tone of voice,

throughout the examination
16. Thank the patient at the end of the examination YES NO

SUBTOTALS

TOTAL SCORE
The maximum score for this station is 42
To pass, a student has to get a total score ≥ 28 (65%)

Selected tests for higher cortical function:

Agraphesthesia, astereognosis, right-left disorientation, sensory inattention, ideomotor/ideational apraxia, constructional
apraxia, finger agnosia, agraphia, anomia

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REB v01. Created April 2017. Based on DeMyer’s The Neurologic Examination, 6 ed.
 ATENEO SCHOOL OF MEDICINE AND PUBLIC HEALTH
NEURO EXAM OSCE CHECKLIST

Name of Student : ___________________________________

Date of Exam : ___________________________________
Preceptor : ___________________________________

STATION TWO:
Examination of Olfactory, Optic, Oculomotor, Trochlear, Trigeminal, and Abducens Nerves

3 points 2 points 1 point No point

MINOR ERROR POOR OR
DONE
OR NEEDED INCORRECT NOT DONE
CORRECTLY
Did the student… PRODDING TECHNIQUE
1. Greet the patient, ask for the patient’s name, and YES NO

introduce himself/herself
2. Check olfaction
Ask the patient to close the eyes, use a non-noxious
stimulus, and check one nostril at a time
3. Inspect for symmetry of the eyes
Look for ptosis and en-/exophthalmos
4. Demonstrate how to check for visual acuity
Ask if the patient wears corrective lenses. Ask the patient to
cover one eye and hold the Jaegger/Snellen chart at
recommended distance.
5. Test peripheral fields by confrontation
Sit/stand at the same level, ask patient to close L eye while
examiner closes R eye, and vice versa.
6. Check for direct and consensual light reflex
Report baseline size of pupils. Look for miosis, mydriasis, or
anisocoria. Then, instruct patient to look at a distant point,
beam a flashlight slowly from the sides to illuminate each eye
separately, observe for pupil constriction.
7. Do the swinging flashlight test
Alternately swing the light from one eye to the other and hold
it on the new eye for 3- to 5-second intervals.
8. Select the normal fundus from the set of images YES NO

provided
9. Check for ocular motility
Ask the patient to follow one’s finger through all fields of
gaze, one eye at a time AND both eyes at the same time.
For testing horizontal eye movements, hold the finger
vertically. For testing vertical movements, hold the finger
horizontally.
10. Check for convergence and accommodation
Ask the patient to stare at one’s finger as it is brought closer
at the midline. Eyes converge and pupils constrict.
11. Inspect the masseter and temporalis muscle
bulk
Inspect the temples and cheeks. Palpate the masseter
muscles when the patient bites.
12. Test for weakness of the lateral pterygoids
Ask the patient to forcefully open the jaw and move the jaw
from side to side. Attempt to push the jaw back to the center
with the heel of the palm, perform on both sides.
13. Elicit the corneal reflex
Use a free piece of cotton rolled to a fine point. Instruct the
patient to look to one side and a little up. Bring the cotton
directly in from the side to avoid entering field of vision.
Perform on one eye only, at most two attempts.

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REB v01. Created April 2017. Based on DeMyer’s The Neurologic Examination, 6 ed.
 14. Examine light touch over the face
Ask the patient to close the eyes. Compare the three
divisions of CN V, AND compare the left and right sides.
15. Thank the patient at the end of the examination YES NO

SUBTOTALS

TOTAL SCORE
The maximum score for this station is 39
To pass, a student has to get a total score ≥ 26 (65%)

Notes:
• Because of time constraints, the following are omitted:
o Asking the patient to read the letters on a Snellen/Jaegger chart to test for visual acuity
o Pain and temperature testing on the face
• Fundoscopy is omitted because objective assessment of the skill is difficult
• To minimize patient discomfort, the corneal reflex is tested on one eye only, and the student may only attempt
to perform the task twice, at most.

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REB v01. Created April 2017. Based on DeMyer’s The Neurologic Examination, 6 ed.
 ATENEO SCHOOL OF MEDICINE AND PUBLIC HEALTH
NEURO EXAM OSCE CHECKLIST

Name of Student : ___________________________________

Date of Exam : ___________________________________
Preceptor : ___________________________________

STATION THREE:
Examination of Facial, Vestibulocochlear, Glossopharyngeal, Vagus,
Spinal Accessory, and Hypoglossal Nerves

3 points 2 points 1 point No point

MINOR ERROR POOR OR
DONE
OR NEEDED INCORRECT NOT DONE
CORRECTLY
Did the student… PRODDING TECHNIQUE
1. Greet the patient, ask for the patient’s name, and YES NO

introduce himself/herself
2. Test for facial muscle weakness and note any
asymmetry
Ask the patient to wrinkle forehead, close eyelids forcefully,
smile, and whistle/puff out of cheeks.
3. Check taste on the anterior two-thirds of the
tongue
Use salt or sugar solution. Check one side at a time.
4. Assess hearing threshold
Note patient’s ability to hear normal conversational voice, a
tuning fork, a watch tick, or finger rustling on both ears.
5. Perform air-bone conduction test of Rinne
Place a vibrating tuning fork on the mastoid process (bone
conduction), ask the patient to tell the examiner once the
sound has disappeared, and then hold the fork beside the
ear (air conduction). Perform on both ears.
6. Perform vertex lateralizing test of Weber
Place a vibrating tuning fork on the middle of the forehead or
vertex of the skull and ask for lateralization.
7. Inspect for symmetry of palatal elevation
Ask the patient to say “Ahh” and look at the arch, NOT the
uvula.
8. State when testing for gag is warranted, and
identify where the stimulus should be applied on
the illustration provided
9. Listen for phonation
Ask the patient to say “Ka-ka-ka, La-la-la, Mi-mi-mi”
10. Inspect strength of head movement
Place R hand on patient’s L cheek (NOT mandible), ask
patient to turn head to the L, identify the SCM that is being
tested (R). Perform on other side. Place hand on patient’s
forehead and ask patient to flex the neck.
11. Inspect shoulder shrugging
Place hands on both of the patient’s shoulders and press
down, ask the patient to try to touch ears with the tips of the
shoulders.
12. Ask the patient to stick out tongue and move it
from side to side
Inspect for atrophy and fasciculation, and deviation
13. Inspect strength of tongue muscles
Have the patient press the tongue against the inside of the
mouth, and press finger against this from the cheek

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REB v01. Created April 2017. Based on DeMyer’s The Neurologic Examination, 6 ed.
 14. Thank the patient at the end of the examination YES NO

SUBTOTALS

TOTAL SCORE
The maximum score for this station is 38
To pass, a student has to get a total score ≥ 25 (65%)

th
REB v01. Created April 2017. Based on DeMyer’s The Neurologic Examination, 6 ed.
 ATENEO SCHOOL OF MEDICINE AND PUBLIC HEALTH
NEURO EXAM OSCE CHECKLIST

Name of Student : ___________________________________

Date of Exam : ___________________________________
Preceptor : ___________________________________

STATION FOUR:
Examination of Motor System, Cerebellar Function, and Gait

Due to time constraints, the student will only be required to perform examination either on the upper or lower extremities.

3 points 2 points 1 point No point

MINOR ERROR POOR OR
DONE
OR NEEDED INCORRECT NOT DONE
CORRECTLY
Did the student… PRODDING TECHNIQUE
1. Greet the patient, ask for the patient’s name, and YES NO

introduce himself/herself
2. Inspect for atrophy, hypertrophy, fasciculations,
and tremors
3. Check muscle tone
Ask patient to relax and gently manipulate the joints (passive
movement throughout range of motion) to test for spasticity,
clonus, rigidity, or hypotonia
4. Check for subtle signs of weakness
Ask the patient to close eyes, raise both arms with palms up,
and observe for downward drift and/or pronation of weaker
arm
5. Check motor strength in a sequential,
rostrocaudal manner and exert the appropriate
amount of force during the examination
Compare proximal with distal muscles, and right with left
muscles. This evaluates manner of examination.
6. Examine all key muscle groups All tested Most tested Few tested Not done
This evaluates completeness of examination.
UE: arm abduction (C5), elbow flexion (C5), wrist extension
(C6), elbow extension (C7), finger flexion/grip (C8), finger
abduction (T1)
LE: hip flexion (L2), knee extension (L3), ankle dorsiflexion
(L4), toe extension (L5), ankle plantarflexion (S1)
7. Elicit deep tendon reflexes
UE: biceps (C5-C6), brachioradialis (C6-C7), triceps (C7-C8)
LE: quadriceps (L2-L4), triceps surae (L5-S1)
Relax the muscle first. Swing the hammer, don’t peck. Hit the
tendon, not muscle belly.
8. Try to elicit the extensor toe sign using any
method
9. Perform test for dysmetria
UE: Finger-to-nose movement (From tip of nose to tip of
examiner’s finger, exactly)
LE: Heel-to-knee movement (Patient’s heel on opposite
knee, hold for a few seconds, then run the heel in a straight
line precisely down the shin)
10. Perform test for dysdiadochokinesia
UE: Thigh patting (Patient pronates and supinates hands on
the thighs with a slapping action and audible sound, as
rapidly and rhythmically as possible)
LE: Heel tapping (Patient’s heel over opposite shin, tap the
shin as rapidly as possible on one spot)

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REB v01. Created April 2017. Based on DeMyer’s The Neurologic Examination, 6 ed.
 11. Inspect the patient’s gait
Ask the patient to walk freely across the room.
12. Perform additional tests for gait
Heel walking, toe walking, or tandem walking (from heel to
toe along a straight line)
13. Thank the patient at the end of the examination YES NO

SUBTOTALS

TOTAL SCORE
The maximum score for this station is 35
To pass, a student has to get a total score ≥ 23 (65%)

Note:
• Key muscle groups based on ASIA score for spinal cord injury assessment. Students may test additional
muscle groups, but these are the minimum requirements.

th
REB v01. Created April 2017. Based on DeMyer’s The Neurologic Examination, 6 ed.
 ATENEO SCHOOL OF MEDICINE AND PUBLIC HEALTH
NEURO EXAM OSCE CHECKLIST

Name of Student : ___________________________________

Date of Exam : ___________________________________
Preceptor : ___________________________________

STATION FIVE:
Examination of Sensory System and for Signs of Meningeal Irritation

Due to time constraints, the student will only be required to perform examination of the sensory system either on the upper or lower
extremities. Patient’s eyes must be closed for all sensory exams.

3 points 2 points 1 point No point

MINOR ERROR POOR OR
DONE
OR NEEDED INCORRECT NOT DONE
CORRECTLY
Did the student… PRODDING TECHNIQUE
1. Greet the patient, ask for the patient’s name, and YES NO

introduce himself/herself
2. Ask a screening question before proceeding with YES NO

the detailed sensory examination

3. Give clear instructions (including eye closure),
proceed in a logical and sequential manner, and
ask the patient to compare proximal and distal
regions, right and left sides
4. Test light touch
Use a piece of cotton.
5. Test pain perception
Use a pointed object.
6. Test temperature discrimination
Use the shaft of a tuning fork for cold stimulus and the little
finger for warm stimulus.
7. Test vibratory sense
UE: Vibrating tuning fork on ulnar styloid process or distal
radius
LE: Vibrating tuning fork on internal malleolus or shin
8. Test position sense
Grasp the digit by its side and wiggle it up and down,
stopping randomly in one direction or the other, and ask the
patient if the digit is up or down. Separate the digit being
tested from the other digits. Don’t apply different pressures
or use a different tone of voice on the up and down
movement.
9. Perform the Romberg test
Ask the patient to stand with the feet together. Note whether
the patient sways. Then ask the patient to close eyes, and
note whether the swaying increases. Stand behind the
patient with arms held up ready to catch the patient, but do
not touch the patient.
10. Try to elicit Kernig sign
With the patient supine, keep the knee flexed and flex the
limb at the hip. When the thigh reaches the vertical position,
gently straighten the knee. The patient will wince with pain.
11. Try to elicit Brudzinski sign
Flex the neck and observe for adduction and flexion of the
legs

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REB v01. Created April 2017. Based on DeMyer’s The Neurologic Examination, 6 ed.
 12. Thank the patient at the end of the examination YES NO

SUBTOTALS

TOTAL SCORE
The maximum score for this station is 30
To pass, a student has to get a total score ≥ 20 (65%)

th
REB v01. Created April 2017. Based on DeMyer’s The Neurologic Examination, 6 ed.