Mini-Mental Status Exam

Scoring: 30 points possible (10 – 20 = moderate; <10 = severe).

QUICK MENTAL STATUS: FOGS (Family story, Orientation, General information, Spelling). Count backwards from 100 by 7’s. Ask patient to recall 3 objects after several minutes.


CN1: Smell two scents

CN2: Visual acuity, gross visual fields, opthalmascopic exam.

CN3, 4, 6: Pupillary light response, lateral and vertical gaze.

CN5: Corneal blink reflex.

CN7: Smile, frown, puff cheeks, wrinkle brow.

CN8: Whisper test.

CN9/10: Gag reflex.

CN11: Shoulder elevation

CN12: Stick out tongue

MOTOR: Check for upper extremity grip. Hand grasp, strength, and toe and foot dorsiflexion. Perform muscle strength tests on each muscle group.

SENSORY: Using ten and doe objects test sensory of R vs. L on hands and feet. Proprioception in big toe. Check for dermatomes for pin and light touch.

COORDINATION: Finger to nose, slide heel up shin. Rapid alternating movements of hand and foot Romberg, heel\ toe walk.

REFLEXES: Biceps. Triceps. Patellar. Achilles. Babinsky.


Tract Cross-Over Sense

1. Lateral Cortical Spinal Medulla Motor pathways (UMNs)

2. Vesiculaus Graculus Medulla Sensory lower limbs and trunk

3. Vesicular cunnilatis Medulla Sensory upper limbs and trunk

4. Dorsal Spinal cerebellar Unconscious position sense

5. Laterial Spinal flamatic Cord Pain and temperature

6. Sensory

7. Dorsal Root Motor

8. Ventral Root

Characteristics of upper neuron motor deficit:

  • Spastic weakness
  • No significant muscle atrophy
  • No vascillations or fibberlations
  • Hyperreflexia
  • abinski may be present

Characteristics of lower motor neuron deficits:

  • Placid weakness
  • Significant atrophy
  • Fasciculation and fiibularations
  • Hyporeflexia
  • o Babinski reflex


  • Biceps C5, 6
  • Triceps C6,7
  • Brachioradialus C5, 6
  • Patellar L2, 3, 4
  • alcaneal S1

Glasgow Coma Scale: (GCS less than or equal to 8: intubate)

Infant Child/Adult

Eye Opening:

4 - spontaneously 4 - spontaneously
3 – to speech 3- to command
2 - to pain 2 – to pain
1 – no response 1 – no response

Best Verbal Response:

5 – coos/babbles 5 – orientated
4 – irritable/cries 4 - confused
3 - cries to pain 3 – inappropriate words
2 – moans/grunts 2 – incomprehensible
1 – no response 1 – no response

Best Motor Response:

6 - spontaneous 6 – obeys command
5 – localizes pain 5 – localizes pain
4 – withdraw from pain 4 - withdraws from pain
3 – flexions (decorticate) 3 - flexion (decorticate)
2 – extension (decerebrate) 2 – extension (decerebrate)
1 – no response 1 – no response

Peripheral nerves and their deficits

Radial (C5- C8): Elbow and wrists extensions, finger extension at MCT, triceps reflex

Median (C6-T1): Wrist, thumb, index and middle finger flexion, thumb opposition, forearm pronation, wrists abduction, atrophy of thenar imminence

Ulnar (C8-T1): flexion of writs, ring, and little finger, opposition of little finger, wrist adduction, ad and abduction of fingers, atrophy of hypothenar imminence

Musculocutaneous (C5-C6): elbow flexion (bicep), forearm supination, bicep reflex

Axillary (C5-C6): Upper arm movement (deltoid atrophy)

Long Thoracic (C5-C6): Horizontal arm movement (patient will have scapular winging)

Femeral (L2- L3): Knee extension, hip flexion, knee jerk

Uptoatoer (L2-L4): Hip adduction

Sciatic (L4-S3): Knee flexion plus tibulo and peroneal deficits

Tibula(L4-S3): Foot inversion, ankle planter flexion, ankle jerk

Peroneal (L4-S2): Foot eversion, ankle and toes dorsal flexion (foot drop)

Cranial Nerves: S = sensory and M = motor

CN1: Olfactory nerve S Smell

CN2: Optic nerve S Vision

CN3: Oculomotor nerve M Ocular movement (downward, upward, and

nasal movement) pupil constriction, open eyelid

CN4: Trocilar nerve (SO4) M Ocular movement (down and out)

CN5: Trigeminal nerve MS facial sensation and mastication

CN6: Heppdusons nerve (LR6) M ocular movement (adduction)

CN7: Facial Nerve MS facial motor. Close eye. Taste

anterior 2/3 atone

CN8: Vestibular cochlear S Hearing and position sense

CN9: Colon glossopharyngeal MS palatine rinse/pharynx taste posterior

1/3 of tongue

CN10: Vagus MS motor palate feraanz, feranx, sensory

farranx, larnex, (gag)

CN11: Accessory M External clitomastiode and trapisios

CN12: Hypoglassal M Tongue movement

Comatose Patient Exam:

Vital signs. Hand drop from overhead. PERL. Abnormal eye movements. Grimasin. Withdraw from noxious stimuli. Babinski. Blink reflex to corneal touch, check for dolls eyes. Supplemental: cold colorax (Normal = nystagna with slow components toward water no net eye deviation. Upfoudnation = net eye deviation towards water with or without nystagnus, coma = no movement)

MRI reveals tumors of brain.

MRA (magnetic resonance angiogram) of normal brain showing circulation.

MRI showing brain infarction and degeneration.

Coronal section of brain revealing hydrocephalus.