⑧

<except)
*
 except
->

*
*
*
*

BcBurney's point
A

*
0 -

0 =
-

-
-
0O
D 8

D
 Does the child have a neurologic disorder?
ex.
(1) (2) (3)

If
yes, lesion?
site

of the lesson?
Is the illness
Clacking movement) relapsing -

symptoms worsening (over times

acute? subacute? Chronic?Static remitting?

2) gestational, birth, developmental, in familypast medical

history often important andrelevant.

 age of the patient

general physical examination

- *

- *

alert
and

-
Cerebrum

Mental state:

Sensorium

**

*
Clearned from

level chronologic age)

States of decreased consciousness

Lethargy Difficulty aroused state - sleepiness

Obtundation stimulation
Stupor
COMA Unresponsive

Speech

Dysphonia lack
sounds in the larynx
Dysarthria articulating speech sounds

Dysphasla understanding
words as symbols for communication
The Cranial Nerves

Olfactory Nerve (CN II

olfaction
Test for

Anosmia In ability
appreciate odor

Paro smia Alteredsense

smell
Optic Nerve (CN 11)

visual acuity, pupils, visual fields fundi

(1)

"blink reflex"

(2)
-

-
C - -

-
3
(3)

(4)

CN III occulomotor
 /I

Esotropia - Inward turning

R- esO
Exotropia-outward
ward
Aypotropia-down
upward
Hypertropia
-

L-esO

1 -
eXO

-
Inwards turn of one or both eyes

- outward vertical upward

Hypo-downwards

Strabismus

Pt0 siS

Involuntary rhythmic oscillation

Nystagmus
uncontrolled movements

Limitation of

eye
movements
Trigeminal Nerve CNV

facial sensation muscles mastication

th
S 7th
nerves

Sensory loss ipsilateral face

Facial Nerve (CNVII)

Vestibulocochlear Nerve CNVIII
Glossopharyngeal VagusNerves CNIXX

CNIX lesion

IX X lesions

unilateral CNIX X

CN X impairment

Spinal Accessory Nerve CNXI

 function trapezius
sternocleidomastoid muscles

Hypoglossal Nerve CNXII

Motor system.
 scoring system for muscle strength
⑧ NO muscle contraction

I Flicker trace
No movement against gravity

2 with gravity eliminated

3
against gravity

4 against gravity resistance

5 Normal strength

-weakness/inabilityto move one side of

body

Cerebellar function
 Ataxia atonia
control distance, spend, a range of

DysMet right
Intention tremors increasing
clumsiness
Dysnergla
Dysrhythmia Inability repeat rhythmictap

Dysdiadochokinesia
(Impaired)
cnoppy/broken speech

Dysarthria StaccatO

Sensory System

difficult at any age

older children
impossible -

Test for Proprioception

Deep sensation or
 Astereognosis objects

Agraphesthesia letters

Reflexes
 Grading of Reflexes

Increased/ hyperactive

Markedly hyperactive
(spasm) spamodic

superficial reflexes
Primitive Reflexes

Autonomic Nervous System

bowel bladder

resistance pain
NEUROLOGICAL EVALUATION
PERIOD UP TO 2 YEARS OLD

STAGE I GENERALEXAMINATION
STAGE 2 MOTOR AND REFLEX EXAMINATION

(2) Examine muscle tone

 (2)
Developmental Reflexes

(3) Deep Tendon and Pathologic Reflexes

STAGE 3

MANIPULATIVEPROCEDURES/MANEUVERS

STAGE 4 EXTENDED MOTOR EXAMINATION GAIT AND

BALANCE
NEUROLOGICAL EXAMINATION OF THE NEWBORN
 some say marry money but my big brother says Big Brains matter more

One of our top teacher asked for very good vodka andmoney

M N
M

B
 B

S B M

B
(TICLS)
②
common techniques:
I

Umbilicus redness
*

↳
Omphalitis
*
 Girls

Sparse
elevated small
mound

Darker
enlarged NO
contour separation
coarse curly

medial surface

thighs

BOYS

scanty
enlargement pink
texture

altered
Darker Lengthens

scrotum dark

coarse

curly
4

spread to medical
surface of thighs
5 5