2025/2026Graded A+
Assessing DTRs - ✔✔✔Compare both sides, use a grading scale (0-4+).
Assessing vertigo - ✔✔✔Perform the Dix-Hallpike maneuver, Romberg test, vestibular testing, and audiometry.
Assessment of meningitis - ✔✔✔Kernig's sign, Brudzinski's sign, lumbar puncture.
Assessment of pathologic reflexes - ✔✔✔Perform the Babinski test or Hoffmann test.
Ataxia - ✔✔✔Lack of coordination (finger-to-nose test).
Audiometry - ✔✔✔A hearing test that evaluates hearing loss or asymmetrical hearing deficits.
Babinski reflex - ✔✔✔A reflex where the big toe extends upward when the sole of the foot is stroked.
Baroreceptor reflex - ✔✔✔A reflex that helps regulate blood pressure by adjusting heart rate and blood vessel
diameter.
Brudzinski's sign - ✔✔✔With the patient lying supine, gently flex the neck forward. Positive sign: Involuntary
flexion of the hips and knees.
Caloric Testing (Clinical Setting): - ✔✔✔Warm or cold water/air is introduced into the ear canal to stimulate the
vestibular system.
• Eye movements (nystagmus) are observed.
• Abnormal Response: Reduced or absent response indicates vestibular weakness on the affected side.
Cluster Headaches - ✔✔✔Severe, cyclical headaches, often around one eye, recurring at the same time daily.
, Deep tendion reflexes (DTRs) are graded on a 4-point scale what would the following be rated: (average, normal) -
✔✔✔2+
Deep tendion reflexes (DTRs) are graded on a 4-point scale what would the following be rated: (brisker than
average, may indicate disease) - ✔✔✔3+
Deep tendion reflexes (DTRs) are graded on a 4-point scale what would the following be rated: (diminished, low
normal) - ✔✔✔1+
Deep tendion reflexes (DTRs) are graded on a 4-point scale what would the following be rated: (no response) -
✔✔✔0
Deep tendion reflexes (DTRs) are graded on a 4-point scale what would the following be rated: (Very brisk,
hyperactive with clonus, indicative of disease) - ✔✔✔4+
Deep tendon reflexes (DTRs) - ✔✔✔Involuntary muscle contractions in response to a tendon tap.
Diplopia - ✔✔✔Double vision (assess extraocular muscles).
Dix-Hallpike maneuver - ✔✔✔1. Patient Position:
• Seat the patient upright on an examination table.
• Turn their head 45° to one side (e.g., right side for right ear testing).
2. Lay the Patient Down:
• Quickly move the patient from a seated to a supine position, with their head hanging 20-30° below the table
level.
3. Observe for Nystagmus:
Dix-Hallpike Maneuver - ✔✔✔A test for vertigo that involves positioning the patient to observe for nystagmus or
reproduction of vertigo symptoms.
Dysarthria - ✔✔✔Slurred speech (listen to clarity).