neurological assessment is an evaluation of a person's nervous system, which includes the brain, spinal

cord, and the nerves that connect these areas to other parts of the body
Purpose:
1. To survey the functioning of nerves delivering sensory information to the brain and carrying motor
commands (peripheral nervous system) and impulses back to the brain for processing and coordinating
(central nervous system).
2. To assess for any abnormalities in the nervous system that can cause problems with daily functioning.
3. To determine the cause of impairment and help to localize the problem.

PROCEDURE NORMAL FINDINGS

TEST CN I (OLFACTORY) - Client correctly identifies scent presented each nostril.
Have the client sit in a comfortable position at your eye
level.
Ask also the client to clear the nose to remove any
mucus and close eyes, occlude one nostril and idenitfy a
scented object that you are holding such as soap, coffee.
(repeat procedure for other nostril)
TEST CN II (OPTIC) -
Use a snellen chart to assess the client’s vision Client has 20/20 vision in both eyes

Ask the client to read a newspaper to assess near vision Client reads print at 14 inches without difficulty.

Assess visual fields of each eye by confrontation

Full visual fields
Use an ophthalmoscope to view retina and optic disc of
each eye Round red reflex is present. Optic disc is 1.5mm.
Retina is Pink
ASSESS CN III (OCULOMOTOR) AND IV
(TROCHLEAR) Eyelid covers about 2mm of the iris
Inspect margins of the eyelids of each eye and assess
extraocular movements
Eyes move in a smooth, coordinate motion in all
directions
ASSESS CN V (TRIGEMINAL)
Test motor function
Ask the client to clench the teeth while you palpate the Temporal and masseter muscles contract bilaterally
temporal and masseter muscles for contraction

Test sensory function The client correctly identifies sharp and dull stimuli
“I am going to touch your forehead, cheeks and chin with and light touch to the forehead, cheeks and chin.
sharp and dull side of this safety paper clip. Close your
eyes and tell me if you feel any sharp or dullness
sensation and also tell me where you feel it.”

Eyelids blink bilaterally

Test corneal reflex
Ask the client to look away and up while you lightly touch
the cornea with a fine wisp of cotton. Repeat on the other
side
ASSESS VI (ABDUCENS)
Assess pupillary response to light pupils constrict simultaneously

TEST CN VII (FACIAL)

Test motor function
Ask the client to The movements are symmetrical
Smile, frown and wrinke forehead, show teeth, puff out
cheeks, purse lips, raise eyebrows, close eyestightly
against a resistance

Test sensory function

Sensory function is not routinely tested. If it is, touch the Client identifies correct flavor
anterior two-thirds of the tounge with a moistened
applicator dipped in salt, sugar or lemon juice and ask
the client to identify the flavor

TEST CN VIII (ACOUSTIC / VESTIBULOCOCHLEAR)
Test the client’s hearing ability
In each ear and perform Weber and Rinne tests to
assess cochlear (auditory) component of CN VIII
TEST CN IX (GLOSSOPHARYNGEAL) AND X (VAGUS)
Test motor function
Ask the client to open mouthwide and say “ah” while you
use a tongue depressor on the client’s tongue
Client hears whispered words from 1-2 feet
Weber test: Vibration heard equally well in both ears.
Rinne test: air conduction is twice as logn as bone
conduction
Uvula and soft palate rise bilaterally and
symmetrically on phonation

Test the gag reflex

By touching the posterior pharynx with the tongue Gag reflex intact. Some normal clients may have
depressor. reduced or absent gag reflax

Check the client’s ability to swallow

By giving the client a drink of water. Note the client’s Client swallows without difficuly. No hoarseness
voice quality noted.
TEST CN XI (SPINAL ACCESSORY)
Ask the client to shrug the shoulders against resistance Symmetric, strong contraction of trapezius muscle.
to assess trapezius muscle.

Ask the client to turn the head against resistance, first to Strong conctraction of sternocleidomastoid muscle on
right then to the left, to assess the sternocleidomastoid side opposite the turned face.
muscle
TEST CN XII (HYPOGLOSSAL) Tongue movement is symmetric
Ask the client to protrude tongue and move tongue each
side against resistance of tongue depressor and put it
back in the mouth