Rapid neuro exam assessment can be used When faced with a head trauma or other rapidly deteriorating clinical situation. Experienced clinicians remember the following to perform a rapid neurological exam to assess traumatic brain injury and possible damage to the brainstem:
The brainstem is made of three parts from most cephalad to most caudal – the midbrain, pons and medulla.
Cranial nerves 1-4 are in proximity and the integrity of the midbrain can be estimated by checking for the reactivity and symmetry of the pupils (CN 2 and 3).
Cranial nerves 5-8 are in proximity to the pons and corneal reflexes will estimate function and damage
Cranial nerves 9-11 are associated with the medulla and this can be assessed by checking for gag reflex.