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Start Neurological Exam
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VITALS
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Deep Tendon Reflexes
• • •
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Comments
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Babinski
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Clonus
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Cranial Nerve I
• • •
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Deviated Septum/ Previous Injury
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CN 2/3 RIGHT
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CN2/3 Right Eye
• • •
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CN 2/3 LEFT
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CN 2/3 LEFT
• • •
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V:A Ratio RIGHT
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V:A Ratio LEFT
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Oculomotor Exam CN 3, 4, 6 WNL
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Hypertropia
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Lateral Skew
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Gaze Stability intact
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Gaze Stability
• • •
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LEFT PURSUITS
• • •
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Quality of Left Pursuits
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RIGHT PURSUITS
• • •
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Quality of Right Pursuits
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Leftward Saccades WNL
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Quality of Leftward Saccades
• • •
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Rightward Saccades WNL
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Quality of Rightward Saccades
• • •
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Cranial Nerve 5 WNL
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CN 5 Senory/Motor
• • •
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Cranial Nerve 7 WNL
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CN 7 Grading
• • •
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Cranial Nerve 8 WNL
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CN 8 Grading
• • •
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Cranial Nerve 9 WNL
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CN 9 Grading
• • •
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Cranial Nerve 10 WNL
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CN 10 Grading
• • •
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Cranial Nerve 11
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CN 11 Grading
• • •
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Cranial Nerve 12 WNL
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CN 12 Tongue Deviation
• • •
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