We assume that you know basic neuroanatomy and neurophysiology (but we review them anyway). The text teaches the necessary mental and manual skills for the neurologic examination (NE). Your teachers, then freed from teaching these skills by lecturing, can use precious class hours solely to examine patients (Pts). Then, if you can go directly after classes to the clinics and wards, you have the ideal situation for learning the NE.
At the outset, we find that students want to know just what constitutes an NE? Thus we start this text by outlining and demonstrating a full NE. Of course, you can’t do the examination now, but you can use the outline in two ways: (1) refer back to it at the end of each chapter, to fit what you have learned into the total examination; (2) take it to the wards and clinics as a guide until you can wean yourself from it.
You must have on hand basic examining equipment (listed shortly) and some learning aids: colored pencils, a hand mirror, and for Chapter 4 a 2- to 3-in. foam rubber ball. Get all the items before starting.
Do the text in order. Skipping around invites confusion because each new step presumes mastery of the previous steps. Allow approximately one hour for each nine pages you want to study.
Because the text requires inspection of one’s self and others, study in your own living quarters, preferably with a partner. Do all tests and make all observations called for. The doing results in active, permanent learning by developing your own powers of observation and manual skills. Most of your education to this point has consisted of memorizing lists or concepts compiled by someone else. Now you have to learn how to learn directly from the Pt through your own eyes, ears, and touch. That’s what requires all of the doing and makes this text unique.
TABLE NE-1 • Abbreviations
AP |
Anteroposterior |
ARAS |
Ascending reticular activating system |
BE |
Branchial efferent |
BP |
Blood pressure |
C |
Cervical |
CAT |
Computerized axial tomography |
Cm |
Centimeter |
CNS |
Central nervous system |
Cps |
Cycles per second |
CrN |
Cranial nerve |
CrNs |
Cranial nerves |
CSF |
Cerebrospinal fluid |
EEG |
Electroencephalogram |
EMG |
Electromyography |
Ex |
Examiner |
F |
False |
GSA |
General somatic afferent |
GSE |
General somatic efferent |
GVA |
General visceral afferent |
GVE |
General visceral efferent |
ICA |
Internal carotid artery |
L |
Lateral, left, or lumbar |
LMN |
Lower motor neuron |
LP |
Lumbar puncture |
MLF |
Medial longitudinal fasciculus |
Mm |
Millimeters |
MRA |
Magnetic resonance angiography |
MRI |
Magnetic resonance imaging |
MSR |
Muscle stretch reflex |
NE |
Neurologic examination |
O2 |
Oxygen |
OFC |
Occipitofrontal circumference |
Pt |
Patient |
R |
Right |
RBC |
Red blood cells |
RF |
Reticular formation |
S |
Sacral |
SA |
Somatic afferent |
SCA |
Superior cerebellar artery |
SCM |
Sternocleidomastoid muscle |
SSSS |
Solely special sensory set (cranial nerves I, II, and VIII) |
SVA |
Special visceral afferent |
T |
True or thoracic |
TNR |
Tonic neck reflex |
UMN |
Upper motor neuron |
V |
Vertical |
WBC |
White blood cells |