Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content +++ Observation ++ Developmental stage, social interactionGross and fine motor movements, abnormal movements +++ Vital Signs and Anthropometrics ++ Growth charts, including FOC +++ Mental Status ++ LOC, ± GCS, ± Mini Mental Status Exam +++ Cranial Nerves ++Table Graphic Jump Location|Download (.pdf)|PrintCranial NerveNerveExamIOlfactoryTest sense of smellIIOpticPerform funduscopic exam, visual acuity, visual fields, pupillary responseIIIOculomotorAssess medial, superior, and inferior recti muscles, inferior oblique, and levator palpebra superioris muscles; cover/uncover test (Figure 22-1)IVTrochlearAssess superior oblique muscle, cover/uncover test (Figure 22-1)VTrigeminalAssess muscles of mastication, sensation to face and anterior scalp, corneal reflexVIAbducensAssess lateral rectus muscle, cover uncover test (Figure 22-1)VIIFacialAssess facial muscles, taste (anterior 2/3 of tongue), parasympathetics to lacrimal and salivary glandVIIIAuditoryTest hearing to finger rub, vestibular functionIXGlossopharyngealTest gag and palate elevationXVagusTest gag and palate elevationXISpinal accessoryAssess strength of trapezius and sternocleidomastoidXIIHypoglossalAssess tongue bulk and atrophy, symmetry++eFigure 22-1Graphic Jump LocationView Full Size||Download Slide (.ppt)Innervation of the extraocular muscles. Cranial nerves are represented in parentheses next to the muscle of innervations (eg, R4 is right fourth cranial nerve). IO, inferior oblique; IR, inferior rectus; LR, lateral rectus; MR, medial rectus; SO, superior oblique; SR, superior rectus. +++ Deep Tendon Reflexes ++ 4+: Hyperreflexia with clonus3+: Hyperreflexia with spread across joint2+: Normal1+: Hyporeflexia0: No movement +++ Motor ++ Muscle bulk and toneAssess pronator drift for subtle weaknessMuscle strength: 5/5: Full strength4/5: Full ROM against light resistance3/5: Full ROM against gravity only2/5: Full ROM in horizontal plane (gravity eliminated)1/5: Trace (“flicker”) of movement0/5: No movement +++ Coordination ++ Cerebellum and basal ganglia testing Finger to nose, heel to shin, rapid alternating movementsAssess for head tilt or tremor, fluidity of movementAssess for abnormal movementsAssess gait in the forward and backward directions; heel, toe and tandem gaitRomberg test : Assess patient standing with feet together and eyes closed; if patient steps to the side or falls → positive test result (may indicate a disturbance in vestibular apparatus or proprioception) +++ Sensory ++ Test in all extremities (Figure 22-2) Pin prick, temperature sensation (spinothalamic tract in anterior spinal cord)Vibration, proprioception (posterior columns in posterior spinal cord)Assess for sensory level on the trunk if concern for spinal cord lesion +++ Miscellaneous Localizing Signs and Reflexes ++Table Graphic Jump Location|Download (.pdf)|PrintManeuverDescription... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.