[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Clinical exam](https://durgical.com/en/clinical-exam/) › Nervous system

# Nervous system

Mental status, cranial nerves, motor, reflexes, sensation, cerebellum, meningeal signs and neurological syndromes.

30 pages

## Sign

- [**Abnormal gaits: hemiparetic, parkinsonian, ataxic, steppage, waddling** The way a person walks reveals where the problem is: brain, basal ganglia, cerebellum, nerves or…](https://durgical.com/en/clinical-exam/abnormal-gaits-hemiparetic-parkinsonian-ataxic-steppage-waddling/)
- [**Babinski sign** When the sole is stroked, the big toe goes up instead of down; in adults it means damage to the…](https://durgical.com/en/clinical-exam/babinski-sign/)
- [**Hoffmann sign and clonus** Two signs of brisk reflexes: the thumb flexes when the middle fingernail is flicked, and the…](https://durgical.com/en/clinical-exam/hoffmann-sign-and-clonus/)
- [**Meningeal signs: neck stiffness, Kernig and Brudzinski** Manoeuvres that look for pain or resistance when inflamed meninges are stretched, as in…](https://durgical.com/en/clinical-exam/meningeal-signs-neck-stiffness-kernig-and-brudzinski/)
- [**Pupils: light reflex and abnormal pupils (Marcus Gunn, Horner, Argyll Robertson)** A check of pupil size and response to light, which localises lesions of the eye, the nerves and…](https://durgical.com/en/clinical-exam/pupils-light-reflex-and-abnormal-pupils/)

## Syndrome

- [**Cerebellar syndrome** Clumsy coordination: staggering gait, tremor when aiming, broken-up speech and abnormal eye…](https://durgical.com/en/clinical-exam/cerebellar-syndrome/)
- [**Cortical syndromes: aphasia, apraxia, agnosia, neglect, frontal signs** The signs that show which lobe of the brain is damaged: problems with language, skilled…](https://durgical.com/en/clinical-exam/cortical-syndromes-aphasia-apraxia-agnosia-neglect-frontal-signs/)
- [**Intracranial hypertension syndrome** Raised pressure inside the skull: headache, vomiting, blurred vision and drowsiness; it can be…](https://durgical.com/en/clinical-exam/intracranial-hypertension-syndrome/)
- [**Involuntary movements: tremor, chorea, dystonia, myoclonus and tics** How to name the movements a patient cannot control, because the name points to the cause](https://durgical.com/en/clinical-exam/involuntary-movements-tremor-chorea-dystonia-myoclonus-and-tics/)
- [**Meningeal syndrome** Severe headache, stiff neck, discomfort with light and vomiting, with or without fever, from…](https://durgical.com/en/clinical-exam/meningeal-syndrome/)
- [**Parkinsonian syndrome** Slowness of movement with a resting tremor, stiffness and problems with gait and balance](https://durgical.com/en/clinical-exam/parkinsonian-syndrome/)
- [**Sensory syndromes: where the lesion is from the pattern of numbness** The shape of the area where a patient feels numbness or tingling tells you whether the problem…](https://durgical.com/en/clinical-exam/sensory-syndromes-where-the-lesion-is-from-the-pattern-of-numbness/)
- [**Spinal cord syndromes: complete, Brown-Séquard, central, anterior** Patterns of weakness and sensory loss that show which part of the spinal cord is damaged](https://durgical.com/en/clinical-exam/spinal-cord-syndromes-complete-brown-sequard-central-anterior/)
- [**Upper vs lower motor neuron syndrome** Two patterns of weakness: one with stiffness and brisk reflexes (brain or cord) and one with…](https://durgical.com/en/clinical-exam/upper-vs-lower-motor-neuron-syndrome/)

## Maneuver

- [**Cerebellar tests: finger–nose, heel–shin and rapid alternating movements** Simple aiming and rhythm tasks that show whether the cerebellum is coordinating movement well](https://durgical.com/en/clinical-exam/cerebellar-tests-finger-nose-heel-shin-and-rapid-alternating-movements/)
- [**Pronator drift** With the arms outstretched and the eyes closed, an arm that turns in and sinks shows subtle…](https://durgical.com/en/clinical-exam/pronator-drift/)
- [**Romberg test** The patient stands with the feet together and closes the eyes; losing balance means position…](https://durgical.com/en/clinical-exam/romberg-test/)

## Exam technique

- [**Cranial nerve examination** Simple tests that check the twelve nerves that leave the brain and brainstem](https://durgical.com/en/clinical-exam/cranial-nerve-examination/)
- [**Deep tendon reflexes and their grading** A tap of the hammer on a tendon that triggers an automatic contraction; it checks nerves, roots…](https://durgical.com/en/clinical-exam/deep-tendon-reflexes-and-their-grading/)
- [**Examining the autonomic nervous system and the autonomic syndromes** Bedside tests of the nerves that control blood pressure, heart rate, pupils, sweating, bladder…](https://durgical.com/en/clinical-exam/examining-the-autonomic-nervous-system-and-the-autonomic-syndromes/)
- [**Lumbar puncture and reading the cerebrospinal fluid** A needle placed in the lower back below the end of the spinal cord to measure pressure and take…](https://durgical.com/en/clinical-exam/lumbar-puncture-and-reading-the-cerebrospinal-fluid/)
- [**Mental status: orientation, attention and screening tests** An assessment of the patient's consciousness, attention, orientation, memory and language](https://durgical.com/en/clinical-exam/mental-status-orientation-attention-and-screening-tests/)
- [**Motor examination: bulk, tone and strength grading** A check of muscle bulk, stiffness or floppiness of the muscles, and strength graded from 0 to 5](https://durgical.com/en/clinical-exam/motor-examination-bulk-tone-and-strength-grading/)
- [**Psychiatric mental status exam: mood, thought, perception, insight** A structured description of how a person looks, feels, thinks and perceives during the…](https://durgical.com/en/clinical-exam/psychiatric-mental-status-exam-mood-thought-perception-insight/)
- [**Sensory examination: modalities and dermatomes** A check of touch, pain, temperature, vibration and position sense to find where sensation fails](https://durgical.com/en/clinical-exam/sensory-examination-modalities-and-dermatomes/)
- [**The neurological examination: order and screening exam** An ordered check of the mind, cranial nerves, strength, reflexes, sensation, coordination and…](https://durgical.com/en/clinical-exam/the-neurological-examination-order-and-screening-exam/)

## Topic

- [**Headache: primary or secondary, and the red flags (SNOOP)** Most headaches are migraine or tension-type, but a few hide a bleed, an infection or raised…](https://durgical.com/en/clinical-exam/headache-primary-or-secondary-and-the-red-flags/)
- [**Neurological studies: EEG, EMG and nerve conduction, evoked potentials** Tests that record the electrical activity of the brain, nerves and muscles to locate a problem…](https://durgical.com/en/clinical-exam/neurological-studies-eeg-emg-and-nerve-conduction-evoked-potentials/)
- [**Recognising a stroke: BE-FAST and the NIH Stroke Scale** Sudden signs of a brain attack: balance, eyes, face, arm and speech; every minute counts](https://durgical.com/en/clinical-exam/recognising-a-stroke-be-fast-and-the-nih-stroke-scale/)
- [**The patient with weakness: brain, cord, nerve, junction or muscle** How to tell where weakness comes from: the brain or spinal cord, a nerve, the nerve–muscle…](https://durgical.com/en/clinical-exam/the-patient-with-weakness-brain-cord-nerve-junction-or-muscle/)

## A to Z

- [A](https://durgical.com/en/clinical-exam/a-z/a/)
- [B](https://durgical.com/en/clinical-exam/a-z/b/)
- [C](https://durgical.com/en/clinical-exam/a-z/c/)
- [D](https://durgical.com/en/clinical-exam/a-z/d/)
- [E](https://durgical.com/en/clinical-exam/a-z/e/)
- [F](https://durgical.com/en/clinical-exam/a-z/f/)
- [G](https://durgical.com/en/clinical-exam/a-z/g/)
- [H](https://durgical.com/en/clinical-exam/a-z/h/)
- [I](https://durgical.com/en/clinical-exam/a-z/i/)
- [J](https://durgical.com/en/clinical-exam/a-z/j/)
- [K](https://durgical.com/en/clinical-exam/a-z/k/)
- [L](https://durgical.com/en/clinical-exam/a-z/l/)
- [M](https://durgical.com/en/clinical-exam/a-z/m/)
- [N](https://durgical.com/en/clinical-exam/a-z/n/)
- [O](https://durgical.com/en/clinical-exam/a-z/o/)
- [P](https://durgical.com/en/clinical-exam/a-z/p/)
- [R](https://durgical.com/en/clinical-exam/a-z/r/)
- [S](https://durgical.com/en/clinical-exam/a-z/s/)
- [T](https://durgical.com/en/clinical-exam/a-z/t/)
- [U](https://durgical.com/en/clinical-exam/a-z/u/)
- [V](https://durgical.com/en/clinical-exam/a-z/v/)
- [W](https://durgical.com/en/clinical-exam/a-z/w/)

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Educational content on the clinical exam; it is learned and practised under supervision. It does not replace assessment by a health professional and is not for self-diagnosis.

Representative model, for educational purposes only.

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License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/clinical-exam/areas/neuro/