Central nervous system

examination
Pr. Sawsan Sati ABBAS
 .Mental status
• assess your child’s level of awareness and how she interacts with the
environment.
• For older children, we ask them to follow directions or answer
questions.
• For younger children, we watch how they interact with their parents.
 Cranial nerves
identify different smells smell olfactory nerve (I)
with her eyes closed
identify letters, shapes or pictures vision optic nerve (II)
on a chart
perhaps identify different colors
 

Visual acuity Visual field colors

 use her eyes to follow a moving moving the eyes oculomotor (III)
light or a moving finger while her ”,keeping them “connected trochlear nerve (IV)
doctor examines her eyes with a controlling the size of the pupil abducens nerve (VI)
different light
bite down while doctor touches touch trigeminal nerve (V)
different areas of her face movement of jaw muscles
chew  
close her jaw against slight
resistance
 
identify different tastes (sweet, taste facial nerve (VII)
sour, bitter) movement of facial muscles
smile
move her cheeks
show her teeth
Rt sided facial palsy
identify when she hears certain hearing acoustic nerve (VIII)
sounds balance
 

Rhine’s test Weber’s test

identify different tastes placed on taste glossopharyngeal nerve (IX)
the back of her tongue swallowing
swallow while her doctor watches
her palate move
 swallow taste vagus nerve (X)
her doctor may use a tongue blade movement
to elicit the gag response
turn her head from side to side movement accessory nerve (XI)
against mild resistance
shrug her shoulders
stick out her tongue movement of tongue hypoglossal nerve (XII)
speak
 
 Motor function and balance 
• push and pull against the doctors hands with her arms and legs
• hop, skip or jump
• walk on tip-toes, walk on heels, walk on outsides of feet or walk on
insides of feet
• squeeze fingers
• stand with her eyes closed while being gently pushed to one side
  .Sensory perception
• We may touch your child's legs, arms or other parts of her body and
have her identify the sensation (hot/cold, sharp/dull).
 Reflexes
• If your child is older, we examine her reflexes by gently tapping a
small, soft reflex hammer on different points on her body.
• Biceps
• Triceps
• Supinator
• Knee
• Ankle
• Babinski
Biceps reflex
Triceps reflex
Supinator reflex
Knee reflex
Ankle jerk
Babinski reflex
Abdominal reflex