AIN SHAMS UNIVERSITY – NEUROLOGY DEPARTMENT

M.S. SHORT CASE EXAMINATION – CLINICAL MARKSHEET

Candidate name Candidate number

Examine muscle power

Item Examiner score Full score

Examiner introduce himself/herself to patient 1
Examiner assess power of the upper limbs 5
□ Hand grip (1 marks)
□ Flexion and extension at wrist (1 marks)
□ Flexion and extension at elbow (1 marks)
□ Flexion, extension, abduction and
adduction at shoulder (2 marks)
Examiner assess power of the lower limbs 5
□ Flexion and extension of all toes (1 marks)
□ Flexion and extension of ankle (1 marks)
□ Flexion and extension of knee (1 marks)
Flexion and extension of hip (2 marks)
Examiner comments of findings 1
Total 12
Comments Examiner

Please print name and sign below

AIN SHAMS UNIVERSITY – NEUROLOGY DEPARTMENT

M.S. SHORT CASE EXAMINATION – CLINICAL MARKSHEET

Candidate name Candidate number

Examine deep tendon reflexes

Item Examiner score Full score

Examiner introduce himself/herself to patient 1
Brachioradialis reflex: Examiner asks the patient 2
to rest the forearm then taps the radius about 1-
2 inches above the wrist with the reflex hammer

Biceps reflex: Examiner places finger firmly on 2

biceps tendon then taps the finger with the
reflex hammer
Triceps reflex: Examiner supports the upper arm 2
and let the forearm hangs free then taps the
triceps tendon above the elbow with the reflex
hammer
Ankle reflex: Examiner places the ankle over the 2
leg with slight ankle dorsiflexion and eversion
then taps the Achilles tendon with the reflex
hammer
Knee reflex: Examiner supports the half bent 2
knee on arm while the patient is supine then
taps the quadriceps tendon just below the
patella with the reflex hammer
Examiner comments of findings 1
Total 12
Comments Examiner

Please print name and sign below

 AIN SHAMS UNIVERSITY – NEUROLOGY DEPARTMENT

M.S. SHORT CASE EXAMINATION – CLINICAL MARKSHEET

Candidate name Candidate number

Examine superficial sensations

Item Examiner score Full score

Examiner introduce himself/herself to patient 1
Superficial sensation in upper limbs: 5
□ Examiner sets a reference point on forehead and
compare it with areas over upper limbs within the same
side (2 marks)
□ Examiner compares symmetrical areas on both upper
limbs (2 marks)
□ Examiner compares distal and proximal areas of upper
limbs to test for peripheral sensory loss (1 marks)

Superficial sensation: 5
□ Examiner sets a reference point on forehead and
compare it with areas over lower limbs within the same
side (2 marks)
□ Examiner compares symmetrical areas on both lower
limbs (2 marks)
□ Examiner compares distal and proximal areas of lower
limbs to test for peripheral sensory loss (1marks)

Examiner comments of findings 1

Total 12
Comments Examiner

Please print name and sign below

 AIN SHAMS UNIVERSITY – NEUROLOGY DEPARTMENT

M.S. SHORT CASE EXAMINATION – CLINICAL MARKSHEET

Candidate name Candidate number

Examination for deep and cortical sensations

List of items Score mark

Approach

Display respect to the patient, confidence and fluency in 1

examination

Formal test

a- Assesses vibration sense using tuning fork: 1

- Set a reference point on clavicle
1
 - Check side to side difference in both upper and lower 2

limbs on bony prominences

2
- Check for peripheral deep sensory loss

- Check for deep sensory level

b- assesses sense of position in both hands and feet 1

c- Assesses sense of movement in both hands and feet 1

d- Tests for stereogenosis and graphasthesia 2

Examiner comments of findings 1

Total 12

Comments Examiner

Please print name and sign below

Examination for state and tone

List of items Score Mark

Approach
Displays respect to the patient, confidence and fluency in examination 1
Formal test for state
a- Assesses muscles of both upper and lower limbs for atrophy 1
or hypertrophy and compares to other side by inspection, palpation
and measurement
b- Inspects for spontaneous fasciculations and taps on proximal limb 1
muscles to elicit them
c- Assess Passive movement and shaking test of the wrist 2
d- Assess passive flexion and extension of elbow 2
e- Assess circumduction of shoulder 1
f- Assess Passive movement and shaking test of feet 1
g- Assess passive flexion and extension of the knee 1
h- Assess circumduction and/or rolling test 1
Examiner comments of findings 1

Total 12

Comments Examiner
Please print name and sign below

AIN SHAMS UNIVERSITY – NEUROLOGY DEPARTMENT

M.S. SHORT CASE EXAMINATION – CLINICAL MARKSHEET

Candidate name Candidate number

Examine facial and trigeminal nerves

 Item Examiner score Full score
Examiner introduce himself/herself to patient 1
Examiner assesses muscles supplied by facial nerve 5
□ Examiner inspects the face for symmetry (1 mark)
□ Examiner asks patient to raise eyebrows (1marks), close eyes
tightly against resistance (1 marks), smile showing teeth (1
marks) and blow cheeks (1 mark)
Examiner assesses glabellar reflex: Examiner taps the region between 1
the eyebrows while the patient is looking to you finger placed about
25 cm away from patient’s head
Tests superficial sensation by pin prick on the 3 divisions of the 1
trigeminal nerve and compare side to side

Assesses muscle bulk of masseter and temporalis muscles and 2

examines power of pterygoids

Performs the jaw reflex 1

Examiner comments of findings 1

Total 12

Comments Examiner
Please print name and sign below