NeuroLogic Examination Videos and Descriptions: An Anatomical Approach
NeuroLogic Examination Videos and Descriptions...
an Anatomical Approach
Go to the Home Page for the NeuroLogic Exam (Adult)Home (Adult NeuroLogic Exam)
Go to the Cases for the NeuroLogic ExamNeuroLogic Cases
Go to the Pediatric NeuroLogic ExamPediatric NeuroLogic Exam

ADDITIONAL RESOURCES:
Neuroanatomy Video Lab: Brain Dissections
Neuroanatomy Online Tutorial: HyperBrain
Lumbar Puncture Tutorial: The Procedure and CSF Analysis
Site Index ...
Go to Site Index by Exam ... by Exam
Go to Site Index by Topic ... by Topic

Go to IntroductionINTRODUCTION TO THE NEUROLOGIC EXAM VIDEOS AND DESCRIPTIONS

MENTAL STATUS EXAM
Go to Mental Status Exam > Anatomy sectionAnatomy
Go to Mental Status Exam > Normal ExamNormal Exam
Go to Mental Status Exam > Abornormal ExamplesAbnormal Examples
Go to Mental Status Exam > QuizQuiz
Go to Mental Status Exam > Media ResourcesMedia Resources

CRANIAL NERVE EXAM

Go to Cranial Nerve Exam > Anatomy sectionAnatomy
Go to Cranial Nerve Exam > Normal ExamNormal Exam
Go to Cranial Nerve Exam > Abnormal ExamplesAbnormal Examples
Go to Cranial Nerve Exam > QuizQuiz
Go to Cranial Nerve Exam > Media ResourcesMedia Resources

COORDINATION EXAM
Goto Coordination Exam > Anatomy sectionAnatomy
Go to Coordination Exam > Normal ExamNormal Exam
Go to Coordination Exam > Abnormal ExamplesAbnormal Examples
Goto Coordination Exam > QuizQuiz
Go to Coordination Exam > Media ResourcesMedia Resources

SENSORY EXAM
Go to Sensory Exam > Anatomy sectionAnatomy
Goto Sensory Exam > Normal ExamNormal Exam
Go to Sensory Exam > Abnormal ExamplesAbnormal Examples
Go to Sensory Exam > QuizQuiz
Go to Sensory Exam > Media ResourcesMedia Resources

MOTOR EXAM
Go to Motor Exam > Anatomy sectionAnatomy
Go to Motor Exam > Normal ExamNormal Exam
Go to Motor Exam > Abnormal ExamplesAbnormal Examples
Go to Motor Exam > QuizQuiz
Go to Motor Exam > Media ResourcesMedia Resources

GAIT EXAM
Go to Gait Exam > Anatomy sectionAnatomy
Go to Gait Exam > Normal ExamNormal Exam
Go to Gait Exam > Abnormal ExamplesAbnormal Examples
Go to Gait Exam > QuizQuiz
Go to Gait Exam > Media ResourcesMedia Resources


Go to the Neurological CasesNEUROLOGIC CASES

SITE INDEX
Go to the Site Index by Exam ...by Exam
Go to the Site Index by Topic ...by Topic



Go to the CreditsCredits
Go to the Copyright StatementCopyright
Contact UsContacts & Feedback
Info on How to Use this SiteHow to Use This Site
Go to the Page for Downloading MoviesDownload Movies Page
Go to Instructions for Downloading MoviesMovie Download Instructions
Info on getting the Password to Unlock Zipped MoviesPassword to Unlock Zipped Movies
Go to our Creative Commons LicenseCreative Commons License: Movie Use
Instructions on How to Fix Messy FontsHow to Fix Messy Fonts
Instructions on How to Show Closed CaptionsHow to Show Closed Captions Closed Captions icon
How to add QuickTime Movies to PowerPointHow to add QuickTime to PowerPoint
To the the University of Utah Health Content DisclaimerHealth Content Disclaimer
Go to this website's Production NotesSite Production Notes
Return to the Home Page for the Adult Neurologic ExamHome



ADDITIONAL RESOURCES
Go to the Pediatric Neurologic Exam websitePediatric Neurologic Exam Website
Go to the Brain Dissection Video LabVideo Lab: Brain Dissections
Go to HyperBrain TutorialOnline Tutorial: HyperBrain
Go to Lumbar Puncture TutorialLumbar Puncture Tutorial:
The Procedure and CSF Analysis

University of Utah Logo

Copyright
The University of Utah 2001
Updated February 2007
Updated September 2007
Updated September 2008
Updated September 2009
Updated September 2010
Updated November 2012
Updated September 2013
Updated December 2014




Get QuickTime
This site requires
QuickTime

QuickTime and the QuickTime Logo are trademarks of Apple Computer, Inc., registered in the U.S. and other countries. The Get QuickTime Badge is a trademark of Apple Computer Inc., used with permission.


Go to Top of Page
 
 
Introduction to the NeuroLogic Exam Videos and Descriptions

SECTIONS
"Window" to the Brain video
"x", "y" Graph video
"y" Values video
"x" Values video
Longitudinal Systems video
Corticospinal Tracts video
Somatosensory Tracts video
Mental Status Exam video
Cranial Nerve Exam video
Coordination Exam video
Sensory Exam video
Motor Exam video
Gait Exam video
Overview video


MOVIES CAN BE VIEWED ONLINE, OR DOWNLOADED FOR LATER VIEWING.
see "How to use this Site"
see "Movie Download Instructions"

 


"Window" to the Brain
Anatomy and pathology of the nervous system is understood by directly visualizing it. This is best accomplished by handling the brain (or model of the brain as the case may be) and dissecting or taking it apart for direct examination. The purpose (for the clinician) of understanding neuroanatomy and neurophysiology is to be able to use that knowledge to solve clinical problems. The first step in solving a clinical problem is anatomical localization. So, if one cannot directly inspect the patient's brain, how is this localization accomplished? The "window" to the patient's brain is the neurological examination. The neuro exam is a series of tests and observations that reflects the function of various parts of the brain. If the exam is approached in a systematic and logical fashion that is organized in terms of anatomical levels and systems then the clinician is lead to the anatomical location of the patient's problem.


"x", "y" Graph
To understand how this is done, let's first of all think of the mathematical model of an x,y graph.

We know we can locate a point on the graph if we have an "x" and a "y" coordinant. For example, if we had a y=4 and x=2, then we know where that point is located on the graph.


"y" Values
Now let's take the brain and spinal cord and superimpose it over the graph. We can see that the brain can be subdivided into parts along its vertical or "y" axis.

The neurological exam is designed to inspect the brain and spinal cord at these basic vertical levels thus giving us a "y" value


"x" Values
So far we have a handle on the vertical localization within the neuroaxis but we have a very flat, one-dimensional structure. We need to have a way to come up with "x" values. Let's rotate the neuroaxis by 90 degrees so we can see it in the coronal plane.

Now we can appreciate that most structures in the neuroaxis have a right, left or midline orientation on our "x" axis.


Longitudinal Systems
To further help us obtain "x" information, we need to add 3 basic systems that are longitudinal in nature but which also cross the midline during their descending or ascending course and thereby give us valuable localizing information.

The first system we will consider is a descending motor system, the corticospinal tract.


Corticospinal Tracts
Axons from the motor cortex descend on the same side of the brain until the level of the spinomedullary junction at which time most of the fibers cross to the opposite side and continue to descend through the spinal cord until they reach the lower motor neuron on that side.


Somatosensory Tracts
Now let's add the 2 ascending sensory systems that give us important clinical information for localizing lesions in the neuroaxis.

The first system is the spinothalamic tract (pain and temperature) diagramed in light blue and the second is the Dorsal Column- Medial Lemniscus system (discrimatory touch and position sense) outlined in dark blue.

Two important anatomical (and hence clinical) points about these two systems:

  1. The spinothalamic tracts cross almost immediately upon entering the cord but the Dorsal Column tracts don't cross until they reach the level of the medulla.
  2. The course of these two sensory systems have a different "x" location until they reach the rostal pons where they are then in close proximity to each other for the remainder of their climb to the thalamus and on to the sensory cortex.

The clinical importance of these two anatomical facts will be become apparent as we discuss the sensory exam.


Mental Status Exam
Let's review how the neuro exam dissects or views the brain and the spinal cord.

Mental Status Exam- this lets us "see" the supratentorial structures of the cerebral hemispheres.


Cranial Nerve Exam
This gives an excellent way to look at the brainstem and the posterior fossa structures.


Coordination Exam
Essentially an examination of the cerebellum, which is another posterior fossa structure.


Sensory Exam
Examination of the two ascending sensory systems which gives "y" as well as "x' values.


Motor Exam
Examinations of the corticospinal tract as well as the lower motor neuron nerve and muscle which again gives "y" and "x" values.


Gait Exam
Gait is the last component of the neuro exam and it too can have localizing value. All of the above systems make a contribution to gait. There are 7 basic pathological gaits that should be looked for and readily recognized on examination.


Overview
Each of the following modules will focus on one of the 6 components of the neuro exam. The format of each will be as follow:

  1. Anatomical review of the level or system being examined.
  2. Demonstration of that part of the neuro exam.
  3. Patient demonstration of pathological findings of that particular system or level.
  4. Self-evaluation quiz for that module.

At the end of the tutorial there will be patient cases which will give you an opportunity to put the neuro exam all together and test yourself in actually using the exam to solve patient problems.

 

 


 

Go to Top of this Page
Home | Contacts & Feedback | Copyright | Credits | Disclaimer | Privacy