Lying or sitting

1. General inspection

• Obvious cranial nerve or limb lesions
• Ask patient about right- or left-handedness, level of education
• Shake hands

2. Orientation

• Time
• Place
• Person

3. Speech

• Orientation
  • Full name?
  • Date?
• Name objects (nominal dysphasia)
• Free speech
  • Describe my tie?
• Phonation
  • “Big cough for me”
  • “say eeeee”
• Articulation
  • “say peter piper refers Perth”
  • “say la-la-la-la”

4. Parietal lobes

• Dominant (Gerstmann’s syndrome)
  • Acalculia (mental arithmetic)
  • Agraphia (write)
  • Leftright disorientation
  • Finger agnosia (name fingers)
• Non-dominant
  • Dressing apraxia
• Both
  • Sensory inattention
  • Visual inattention
  • Cortical sensory loss (loss of graphaesthesia, two-point discrimination, joint position sense and stereognosis)
  • Constructional apraxia

5.Memory (temporal lobe)

• Short term (e.g. names of flowers)
• Long term

6. Frontal lobe

• Reflexes—grasp—pout—palmar mental
• Proverb interpretation
• Smell
• Fundi
• Gait

7. Other

• Visual fields
• Bruits