Larsen Peds Neuro Exam

PedNIHSS

Glasgow Coma Score

Pestronk Neuromuscle

Neurological exam

• Mental Status
  • Awake, alert
  • A&O to person, place, date, purpose
  • Language – fluency, delays, naming objects
    • Receptive, Expressive, Responds to commands
  • Repeat sentence
  • Attention – months backwards, numbers backwards, spell WORLD backwards
  • Memory
  • Mood/affect
  • Describe scene in picture
  • Reading, writing
  • Mood/affect

• CNs
  • Pupillary exam
  • Fundoscopic exam
  • Examine palate raise
  • Visual fields
  • EOMs
  • CNV
  • CNVII
  • Hearing in both ears
  • Tongue
  • Shoulder raise
• Motor

  • Tone

  • Strength grading

    • Upper extremities (Deltoid, Wrist, Biceps/Triceps, Fingers)
    • Lower extremities (Hip flexors, Leg flexion/extension, Foot flexion/extension)

    0 - no activation 1 - activation of muscle is felt 2 - moves in plane of bed 3 - antigravity but is overcome on confrontation 4 - can move against resistance but not full strength 5 - normal

  • Clonus

• Reflexes
• Sensory
  • Light touch
  • Vibratory
  • Temperature
• Coordination
  • FNF/reaching in younger kids
  • Hand flipping
  • Romberg, Gait

Fundoscopic exam

Neuroimaging

LP Procedure

Sterile materials (upper left): (a) Local anesthetic (b) Syringe for application of local anesthetic (c) and (d) Syringe and needles for superficial and deep application of local anesthetic (e) Gauze (f) CSF collection tubes (4) (g) Forceps (h) Sterile gloves (i) Antiseptic (j) Spinal needle

Nonsterile materials (lower left): (k) Surgical mask