Neurological System

Normal Anatomy & Physiology Neurological System

The nervous system is divided into:

• Central Nervous System (CNS): Brain (cerebrum, cerebellum, brainstem) and spinal cord.

• Peripheral Nervous System (PNS): Cranial nerves (12 pairs) and spinal nerves (31 pairs).

• Autonomic Nervous System (ANS): Sympathetic ("fight or flight") and Parasympathetic ("rest and digest") responses.

Functions of the Neurological System

• Sensory (afferent) pathways: Transmit signals from the body to the CNS.

• Motor (efferent) pathways: Carry signals from the CNS to muscles for movement.

• Cranial nerves: Control vision, smell, taste, hearing, balance, facial movement, swallowing, and speech.

• Reflexes: Involuntary responses that help maintain posture and protect the body.

Physical Examination Techniques

Patient Preparation

• Verify identity, explain the procedure, obtain consent, assess for pain.

• Ensure the patient is in a comfortable position (sitting/lying down).

• Equipment needed: Snellen chart, pen torch, tuning fork, tendon hammer, cotton ball, paperclip, tongue depressor.

Differentiating Normal & Abnormal Findings

Analysis of Findings from Interviews General survey & physical examination

History Taking:

• Headache, dizziness, seizures, numbness, weakness, memory loss.

• Past stroke, head trauma, infections, family history of neurological disorders.

• Lifestyle factors: Smoking, alcohol, medication use, stress.

General Survey:

• Level of Consciousness (LOC): Alert (normal), drowsy/confused (brain injury, stroke).

• Speech & Language: Clear (normal), slurred (dysarthria), difficulty finding words (aphasia).

• Facial Symmetry: Even (normal), drooping (stroke, Bell’s palsy).

• Gait & Balance: Steady (normal), unsteady/shuffling (Parkinson’s, ataxia).

• Body Movements: Smooth (normal), tremors (Parkinson’s), involuntary movements (chorea, dystonia).

• Cognition & Memory: Intact (normal), memory loss/confusion (dementia, head trauma).

Physical Examination Findings:

• Cranial nerve abnormalities → Stroke, multiple sclerosis, brainstem lesion.

• Loss of coordination, tremors → Parkinson’s disease, cerebellar dysfunction.

• Hyperreflexia or Babinski sign → Upper motor neuron lesion.

• Sensory loss → Peripheral neuropathy (diabetes, vitamin deficiencies).