Purpose:  To test for irritation to the meninges by placing a stretch through them. Test procedure: • The patient lies supine. • The examiner stands next to the patient’s head. • The examiner gradually flexes the patients head and neck towards the patient’s chest. • Observe the patient’s knees and their face for evidence of pain.   Test […]

Purpose:  Test for the presence of cervical nerve root irritation. Test procedure: • The patient is seated. • The examiner stands beside the patient supporting them (if necessary). • The examiner asks the patient to abduct their shoulder and place their hand on their head. • The patient may report relief of radicular pain or symptoms. […]

Purpose:  Test for lesions to weight-bearing structures, the facets or for nerve root pathology. Test procedure: • The patient is seated. • The examiner stands behind patient. • The examiner places both hands with fingers locked over the patient’s head and exerts a gradual compressive force direct through the cervical spine. • Observe the patient […]

Purpose:  Test for the presence of nerve root pathology, injury to cervical weight bearing structures or ligaments. Test procedure: • The patient is seated. • The examiner stands behind patient. • The examiner cradles the patients head at the occiput and mandible. A careful, progressive traction of the patient’s cervical spine is performed. • Observe […]

Purpose:  To test for presence of nerve root pathology. Test procedure: • The patient is seated. • The examiner stands behind patient. • The examiner sequentially compresses, extends and then rotates the patients head to the side of the suspected lesion. • Observe the patient for pain, or radicular symptoms. Test findings: Positive if radicular symptoms […]

Definition: The use and interpretation of physical examination techniques to determine the integrity and adequate function of the olfactory nerve (first cranial nerve). This nerve provides the innervation for one of the special senses: smell. Test procedure: Physical examination should involve rhinoscopy which may reveal polyps, membranous inflammation, foreign bodies, and septal deviations. A neurological […]

Definition: The use and interpretation of medical examinations to determine the integrity and adequate function the Optic nerve (second cranial nerve). This nerve provides the innervation for one of the special senses: vision. Test procedure and findings: The eyes should be examined for any signs of ptosis, nystagmus and any abnormalities in pupil size and […]

Definition: The visual fields test is usually performed when assessing the integrity and adequate function of the Optic nerve and as part of a routine eye examination. Test procedure: Visual fields may be assessed by asking the patient to cover one of their eyes while the examiner assesses the opposite eye; this method is called […]

Definition: Ocular movements are controlled synergistically by a group of muscles, supplied by three cranial nerves: Oculomotor, Trochlear and Abducens. The visual pursuit test aims to assess the proper function and integrity of these nerves and associated musculature. Test procedure: The visual pursuit test is performed by asking the patient to follow the practitioner’s finger […]

Definition:  The use and interpretation of medical examinations to determine the integrity and adequate function of the Oculomotor nerve (third cranial nerve). Test procedure and findings: The Oculomotor nerve supplies the levator palpebrae superioris muscle, the sphincter pupillae and three eye muscles: the medial and inferior rectus muscles, and the inferior oblique muscle. Damage to […]

Definition: The use and interpretation of medical examinations to determine the integrity and adequate function the Trochlear nerve (fourth cranial nerve). Test procedure: The visual pursuit test is performed by asking the patient to follow the practitioner’s finger or the tip of a pen with their eyes whilst the patient’s head remains still. The examiner […]

Definition: The trigeminal nerve, fifth cranial nerve, can be tested clinically to assess its integrity and adequate functioning. Its primary role is to supply the face and cornea with sensory perception, as well as motor function to the muscles of mastication. Test procedure: The trigeminal nerve can be subdivided into three branches: Vi) ophthalmic, Vii) […]

Definition: The use and interpretation of medical examinations to determine the integrity and adequate function the motor portion of the trigeminal nerve (fifth cranial nerve). Test procedure: The trigeminal nerve can be subdivided into three branches: Vi) ophthalmic, Vii) mandibular and Viii) maxillary, with only the later having both motor and sensory functions. The muscles […]

Definition: The use and interpretation of medical examinations to determine the integrity and adequate function the abducens nerve (sixth cranial nerve). Test procedure: The visual pursuit test is performed by asking the patient to follow the practitioner’s finger or the tip of a pen with their eyes whilst the patient’s head remains still. The examiner […]

Definition: The use and interpretation of medical examinations to determine the integrity and adequate function of the facial nerve (seventh cranial nerve). This nerve provides the innervation for one of the special senses: taste. The facial nerve’s motor component innervates the muscles of facial expression as well as the digastric, styloid and stapedius muscles. Its […]

Definition: The use and interpretation of medical examinations to determine the integrity and adequate function of the vestibulococlear nerve (eighth cranial nerve). The cochlear portion of this nerve provides the innervation for one of the special senses: hearing. Test procedure: The vestibulococlear nerve is composed of two parts: 1) the vestibular portion which preoccupies itself […]

Definition: The Rinne test is often performed after the Webber test to determine whether a patient’s hearing is reduced because of a sensory-neural pathology or a conductive obstruction by discriminating between air and bony conduction. Test procedure: Using a vibrating 512 Hz tuning fork, place it on the patient’s mastoid process on the side where […]

Definition: The Webber test is performed, often before the Rinne test to determine whether a hearing loss is of a sensory neural or conductive origin. Test procedure: Using a vibrating 256 Hz or 512 Hz tuning fork, place it with both forks facing forwards at the midline of the apex of the patient’s skull. Test […]

Definition: The use and interpretation of medical examinations to determine the integrity and adequate function of the glossopharyngeal nerve (ninth cranial nerve). This nerve provides the innervation for one of the special senses: taste. Test procedure: This cranial nerve can be tested by assessing the gag reflex, which is performed by gently stroking the patient’s […]

Definition: The use and interpretation of medical examinations to determine the integrity and adequate function of the Vagus nerve (tenth cranial nerve). The role of Vagal afferent nerves:  in initiating the cough reflex is undisputed. Test procedure: The Vagus nerve is usually tested together with the glossopharyngeal and hypoglossal nerves. Instruct the patient to say […]

Definition: The use and interpretation of medical examinations to determine the integrity and adequate function of the accessory nerve (eleventh cranial nerve). Test procedure: The accessory nerve supplies motor innervation to the sternocleidomastoid and trapezius muscles. To assess these muscles, firstly observe the patient for any sings of atrophy, asymmetry and palpate for hyper/hypotonicty and […]

Definition: The use and interpretation of medical examinations to determine the integrity and adequate function of the hypoglossal nerve (twelfth cranial nerve).   Test procedure: Commonly tested with the glossopharyngeal and vagus nerves, lesions to the hypoglossal nerve are appreciated by having the patient open their mouth and examining the tongue.   Test findings (inc […]

Definition: Opthalmoscopy, also known as fundoscopy is a method used to examine the retina. Test procedure: A fundoscopic examination is performed in a darkened room. Firstly determine the location of the retina by directing the opthalmoscope at fifteen degrees from the center of the eye and following the red light reflex, until you come across […]

Definition: Facial hemiparesis as a result of a lesion of the facial cranial nerve VII (seven). Causes: Although the true aetiology of Bell’s Palsy is not fully understood a number of well postulated theories may be considered. These are; a viral infection such as HSV-I (Herpes Simplex Type-) being reactivated, a demyelinating polyneuropathy, diabetes mellitus, […]