Extraocular Movements (CN III, IV, VI)

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Extraocular Movements (CN III, IV, VI)

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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Check extraocular movements (eye movements) by having the patient look in all directions without moving their head. While doing this, ask them if they experience any double vision. Test smooth pursuit by having the patient follow an object moved across their full range of horizontal and vertical eye movements.

Test convergence movements by having the patient fixate on an object as it is moved slowly toward a point right between the patient's eyes.

Also, observe the eyes at rest to see if there are any abnormalities such as spontaneous nystagmus (which we discuss shortly) or dysconjugate gaze (eyes not both fixated on the same point), resulting in diplopia (double vision).

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