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General Inspection
During the general inspection of the cranial nerves, we should look for whether the patient has any ptosis, abnormal eye movements and facial asymmetry. We should also inspect for whether there are any neuro-cutaneous features (for example in patients with tuberous sclerosis and neuro-fibromatosis), syndromal features etc.
Cranial Nerve I (Olfactory Nerve)
Cranial Nerve II (Optic Nerve)
Visual Acuity
Visual Fields
Inspection of the Pupils
Direct and Consensual Light Reflexes
The Swinging Torch Test
Accommodation Reflex
Cranial Nerves III (Oculomotor Nerve), IV (Trochlear Nerve) and VI (Abducens Nerve)
Cranial Nerve V (Trigeminal Nerve)
Cranial Nerve VII (Facial Nerve)
Cranial Nerve VIII (Vestibulocochlear Nerve)
Cranial Nerves IX (Glossopharyngeal Nerve) and X (Vagus Nerve)
The set of cranial MRI (coronal cuts) shown here are from a patient presenting with fever and confusion. Multiple, ring-enhancing nodular lesions are noted in the FLAIR sequence (Figures 1 and 2) as well as in the T1W imaging with contrast (Figures 3 and 4). Serology was positive for toxoplasma and the patient was tested…
A lumbar puncture (LP, also known as a spinal tap) is a diagnostic and at times, therapeutic medical procedure. Diagnostic indications The main diagnostic indications of performing a LP is for collection and evaluation of cerebrospinal fluid (CSF) for diagnosis and exclusion of infectious, inflammatory and neoplastic diseases affecting the central nervous system. For example,…
By palpating onto the iliac crest and spinal processes of the back, the site of needle puncture for lumbar puncture (LP) is identified. As the spinal cord ends at the level of L2 in adults, the spinal needle can be inserted safely between the L3/4 or L4/5 levels. The highest point of the iliac crest…
Subtitles in English for this video can be displayed by clicking on (first button on the bottom right hand corner of the video). Direct ophthalmoscopy is a troublesome skill for medical students and practitioners, but when practiced frequently, this is a technique that can be very useful in clinical practice. It is advisable that each medical…
In this video, the patient exhibits a positive heel-shin test on the right side. Compared to the left (normal) side, the right lower limb is seen to be rather clumsy. The heel-shin test is a test to screen for ipsilateral cerebellar function. Once again, clear instructions are required for this test, and you could see…
Before touching the patient, it is important and good practice to stand back and spend some time in performing a thorough general examination of the patient. Unfortunately, students often rush into touching the patient, hence often neglecting crucial signs which may lead to the diagnosis. An approach to the general examination of a patient presenting…
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