Instruments and Objects Required for complete CNS examination

One of the major preparation before any medical examination is that you have all the necessary instruments ready to perform the clinical examination. It takes a lot of effort, time and money to gather all the necessary instruments. But it is not feasible that we have all the necessary instruments to perform complete examination. 

The following table includes all the instruments needed to perform complete CNS examination. They are classified as MUST HAVE, SHOULD HAVE and GOOD TO HAVE based upon their need, availabililty and cost needed to buy them. 

 No medical student both undergraduate and post graduate should take all the MUST HAVE items in their examination along with other basic examination tools such as Stethescope, BP cuff, Measauring Scale, Notebook, Pen, Pencil and Cardboard. No CNS examination can be completed without major instruments like Pen Torch, Reflex Hammer, Tuning Fork and measuring tape which  have to be bought. Other object like cotton, pin, pen, paper, spatula, disposable gloves, thumb pins, and Key can be obtained from our own household object and stationary items.

Know about plantar reflex and its variants before you go for exams.

Certain things like solution containing various solutions used for tasting, smelling has to be prepared and labelled so that it can be identified by examiner but not by the one taking  physical examination.

The objects like Snellens chart, Jaegers chart, Ischihara chart, Ophthalmoscope can not be assesscible to all and may cost more than regular instruments to buy. If we can manage from some source that is acceptable otherwise alternative methods of gross examination can be used to perform those test. Similarly MMSE chart can be printed however that may not be acceptable to some examiner to have such material in exam hall.

So, make a set of instruments that contains all the items in MUST HAVE section. TRY to make sure you have all the objects in SHOULD HAVE. But GOOD TO  HAVE are really good to have items. If some one gives you, take it with a big smile but dont worry if you dont have it .


Cranial nerve examination techniques: Step by Step and with video

	SN	Instrument	Purpose
MUST HAVE	1	Pen	HMF, CN II, III, IV, VI,
	2	Pen Torch (White light)	CN II
	3	Cotton	Fine touch sensory, corneal, Conjuctival reflexes
	4	Pin / Tooth pick	CN V, Sensory examination, Two point discrimation
	5	Reflex hammer	CN V jaw jerk,
	6	Measuring tape	Muscle Bulk, BMI
	7	Spatula	Gag reflex
	8	Tuning Fork	CN VIII, Vibration sensation
	9	Paper/Note book	HMF, To note the findings
	10	Key	Babinski Sign , HMF , stereognosis
SHOULD HAVE	1	4 vessels with Tasting material (Sugar/ Salt/ Vinegar/ Metronidazole) in solution form	CN  VII Taste sensation
	2	Cards with various tastes (Sweet/ Salty/ Sour/Bitter )	CN VII taste Sensation
	3	Soap/ clove/ coffee powder in various sachets	CN I Smell sensation
	4	Thumb Pins with various color heads	Color vision and Confrontation test
	5	Pair of Gloves	To Hold tongue
	6	Guaze piece	To hold tongue
	7	Two test tubes with warm and cold water	Temperature sensation
	8	Ear Buds	Sensory fine touch, Application of solution in tongue
	9	Objects of various shapes (Ring, cup, cables)	HMF, Stereognosis
NICE TO HAVE	1	Snellens Chart	Visual Acquity
	2	Ischihara Chart	Color vision
	3	Drinking Water	To rinse mouth in between various taste sensation
	4	Blunted Divider	Two point discrimination
	5	Mini Mental Score Chart	HMF

Download a checklist.