Neurologic Examination Cheek oarrnal.

ctrate I deaselhe abnormal

Patient date: .
CC & sign ificant history: !murmur
t Dabs of birth: MP
—A n
Key considerations: ❑ heasIaces., ❑ head rrunr, e cloaruErs-sheregu, ❑ seizures. ❑ tremors- weaknees. ❑ tricomIrkabark, ❑ nurrArrusningilno,
❑ &limey awallowng. ❑ dricuity speuhing. ❑ :vacant pot haeurf, ❑ environmental hazards, ❑ other.
o Refer for secondary consultation!
Refer for d lag nos& Imaging: _

Mental Status: WNL Cranial Nerves: JIN L

Sipa•" Solider
Le le 1.A.
De ve loprn ant good, u lair, u pant LYAMI
11111111i. aI
Behavior bihargiC, speech) ..t .: ., : .i
Facial apprerssons
Orientation {rime. person, aisce & slealion} Inwiw

Me MO ry.tonceniration
Swint N.2 Facial eopres; on P.,: RSIGLIE
❑ tiamE sessiderdrenem neweworlhy events. 11- Cote: I riorml eve mo shire

❑ 3 wino or place madl at 0 and 5 minutes ❑ gaud =Mei III1- Ye ailbulozachlear

1140) - lip to flva Wee (03, 86, Visual leak ithomberg'a Iasi
❑ Spel ward backwards Furgliscoplc exam Autlibr eclair
❑ Draw admit !make the 4 1e 12:3e) ❑
-. QI - Ocutuenotalc Itochlpr. weber
Drew orenaprig pawns
aluseria
I' me
'H' pattern.
IX. X - GlassoptiarympAal W
Curnrergence
NVS1J3g117119 G G ag reflex

Consensual ligh! • • Elex!atian of palate

Reflexes: a WM.
lErir
Lateral Jaw ...,
xi - Spinal ac:eessll

Trapeilua made test

SC IA muscle test
Manger cordrat! :
Face sansakpn lb - Hypogiossel

Cornealinucri reflex S:cit out amps

Cerebellar: ❑ WNL Sensory: a WNL

R L
Rapid Anger moment Light W116
P aiholog It R L Rape' 'Hallucinate:el VIhratem

Babineki Finger-lo-rrsanInger Stereagnasis

Andmnnel Hee:lawn BM Gra phestresia

Hafirnam's Holmes rebel/xi sign. 2-polni. &sure

Gsubbeel-tae walk FIos4tion sense

-We presence of sinus
Fri:Oa:80nm

Motor Function: 17 WM_ Romberg

Sharpkiull
Motor (0.5)
i-hitgao
Dettaid ICS, CS) (mill:hrs.)
Nerve Tension: miL
Brachloradlale M . CS) (radial!
Biceps {CS, C6I rnusuulacuLi
TrIcepatCS.C?, CS, Ti) (radgall Strap)! Leg Rome
Virlitilmows (CD. C7 frnsaiulnar) Maximal. SLR
Wrist ekes:name (CS. C7. CS) (rad) Draprea
Weems' (C7. C-B, Ti) (,llaar) Femoral nerve bacton
Tb.lulteriar .I.LI, LS) (deep per) Matllan ne:Ne1racion
Extensor hisialcue lingua OA LS, S1)
Racial nerve trodden
(deep percales)
'. !or nor* irachan
Fibulartsiperoneu0 krngus R.5, St)
isuperricial proneab ;rrela

km atarpuhmsre chaddal .31 mararark.r. prmadaar.. Earl ham amid 63 dizo as a d...wask spin bard./ ar 73 palms prt-.6.11ra
h!s
&maims and 7¢ crag CESVGIM ce 111 eurnm Ear, pic.ord.o3 rcr. have La be parivra: L-mry palgri S.Drit ra, Signature! Date:
taiMpricalo iicsatio skularLPalaar..rivriar..n v..rd.dmd skit* Rayackexms wnrxc is
rm.:furor-43 araOrsitko. ordakrdatiathsyl.can .17M5 Preloldraolii*.ith Spann Ir..3,11righo mtrv4d. -dxdicalad a) ankal EICAME17.-