Mental Status

Ask routine questions (see Chapters 1, The Interviewer's Questions;21, The Nervous System; and 25, The Geriatric Patient).

Face (Chapter 21, The Nervous System)

1. Test motor function of trigeminal nerve, both sides.

2. Test sensory function of trigeminal nerve, both sides.

3. Test corneal reflex, both eyes.

4. Test facial nerve, both sides.

5. Test spinal accessory nerve, both sides.

6. Test double simultaneous stimulation, both sides.

7. Perform finger-to-nose test.

Neck

Test range of motion (see Chapter 20, The Musculoskeletal System).

Hands and Wrists (Chapters 20, The Musculoskeletal System, and 21, The Nervous System)

1. Inspect hand and wrist, both sides.

2. Inspect nails, both sides (see Chapter 8, The Skin).

3. Palpate shoulder joint, both sides.

4. Palpate interphalangeal joints, both sides.

5. Palpate metacarpophalangeal joints, both sides.

6. Test light touch sensation, both sides.

7. Test vibration sense, both sides.

8. Test position sense, both sides.

9. Test object identification, both sides.

10. Test graphesthesia, both sides.

11. Test two-point discrimination, both sides.

12. Assess rapid alternating movements, both sides.

Elbows (Chapter 20, The Musculoskeletal System)

1. Inspect elbow, both sides.

2. Test range of motion, both sides.

3. Palpate elbow, both sides.

4. Test upper extremity strength, both sides.

5. Test biceps tendon reflex, both sides (see Chapter 21, The Nervous System).

6. Test triceps tendon reflex, both sides (see Chapter 21, The Nervous System).

Shoulders (Chapter 20, The Musculoskeletal System)

1. Inspect shoulder, both sides.

2. Test range of motion, both sides.

3. Palpate shoulder joint, both sides.

Shins

1. Inspect skin, both sides.

2. Test for edema, both sides (see Chapter 14, The Heart).

Feet and Ankles (Chapters 20, The Musculoskeletal System, and 21, The Nervous System)

Inspect feet and ankles.

Test range of motion, both sides.

Palpate Achilles tendon, both sides.

Palpate metatarsophalangeal joints, both sides.

Palpate metatarsal heads, both sides.

Palpate ankle and foot joints, both sides.

Test light touch sensation, both sides.

Test vibration sense, both sides.

Test position sense, both sides.

Test lower extremity strength, both sides.

Test ankle reflex, both sides.

Test plantar response, both sides.

Knees (Chapters 20, The Musculoskeletal System, and 21, The Nervous System)

1. Inspect knee, both sides.

2. Test range of motion, both sides.

3. Palpate patella, both sides.

4. Perform ballottement of patella if effusion is suspected.

5. Test patellar reflex, both sides.

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