CNS Examination Template

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Pupils: mm (Rt). mm (Lt). EOM: . VII th Nerve: . IX th , X th Nerves: . XII th Nerve: . Motor system: Bulk: .

Tone: .

Power:

Upper limbs: Shoulder: Rt Lt .

Elbow: Rt Lt .

Wrist: Rt Lt .

Handgrip: Rt Lt .

Small muscles of hand: Rt Lt . Lower Limbs: Hip: Rt Lt .

Knee: Rt Lt .

Ankle : Rt Lt .

DTR: supinator : Rt Lt .

Biceps: Rt Lt .

triceps : Rt Lt .

knee: Rt Lt .

ankle: Rt Lt .

Plantar: Rt Lt .

Sensory system: Fine touch: .

Pain: .

JPS: .

Romberg’s: .

Cerebellar examination: .