Calculations, Right–Left Confusion, Finger Agnosia, Agraphia

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Calculations, Right–Left Confusion, Finger Agnosia, Agraphia

INTRODUCTION
Introduction to the Neurological Exam
MENTAL STATUS
Mental Status Introduction
Level of Alertness, Attention, and Cooperation
Orientation: A Caveat to Those Who Write "A&O×3"
Memory
Language
Calculations, Right–Left Confusion, Finger Agnosia, Agraphia
Apraxia
Neglect and Constructions
Sequencing Tasks and Frontal Release Signs
Logic and Abstraction
Delusions and Hallucinations
Mood
CRANIAL NERVES
Cranial Nerves Introduction
Olfaction (CN I)
Opthalmoscopic Exam (CN II)
Vision (CN II)
Pupillary Responses (CN II, III)
Extraocular Movements (CN III, IV, VI)
Facial Sensation and Muscles of Mastication (CN V)
Muscles of Facial Expression and Taste (CN VII)
Hearing and Vestibular Sense (CN VIII)
Palate Elevation and Gag Reflex (CN IX, X)
Muscles of Articulation (CN V, VII, IX, X, XII)
Sternocleidomastoid and Trapezius Muscles (CN XI)
Tongue Muscles (CN XII)
MOTOR EXAM
Motor Exam Introduction
Observation
Inspection
Palpation
Muscle Tone Testing
Functional Testing
Strength of Individual Muscle Groups
REFLEXES
Reflexes Introduction
Deep Tendon Reflexes
Plantar Response
Finger Flexors
Reflexes Tested in Special Situations
COORDINATION AND GAIT
Coordination and Gait Introduction
Appendicular Coordination
Romberg Test
Gait
SENSORY EXAM
Sensory Exam Introduction
Primary Sensation, Asymmetry, Sensory Level
Cortical Sensation, Including Extinction

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Impairment of all four of these functions in an otherwise intact patient is referred to as Gerstmann's syndrome. Since Gerstmann's syndrome is caused by lesions in the dominant parietal lobe, aphasia is often (but not always) present as well, which can make the diagnosis difficult or impossible. Each of the individual components of Gerstmann's syndrome is poorly localizing on its own, but they are worth documenting as part of the assessment of overall cognitive function:

Calculations. Can the patient do simple addition, subtraction, and so on?

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