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Neurological Examination


Cranial Nerve Exam


Muscle Strength Testing
C5 - Elbow flexors (biceps, brachialis)
C6 - Wrist extensors (extensor carpi radialis longus and brevis)
C7 - Elbow extensors (triceps)
C8 - Finger flexors (flexor digitorum profundus) to the middle finger
T1 - Small finger abductors (abductor digiti minimi)
L2 - Hip flexors (iliopsoas)
L3 - Knee extensors (quadriceps)
L4 - Ankle dorsiflexors (tibialis anterior)
L5 - Long toe extensors (extensors hallucis longus)
S1 - Ankle plantar flexors (gastrocnemius, soleus)

Muscle strength Grading ( Medical Research Council (MRC) scale )
5 - Normal power
4+ - Submaximal movement against resistance
4 - Moderate movement against resistance
4- - Slight movement against resistance
3 - Movement against gravity but not against resistance
2 - Movement with gravity eliminated
1 - Flicker of movement
0 - No movement

Sensory Testing
C2 - Occipital protuberance
C3 - Supraclavicular fossa
C4 - Top of the acromioclavicular joint
C5 - Lateral side of antecubital fossa
C6 - Thumb
C7 - Middle finger
C8 - Little finger
T1 - Medial side of antecubital fossa
T2 - Apex of axilla
T3 - Third intercostal space (IS)
T4 - 4th IS at nipple line
T5 - 5th IS (midway between T4 and T6)
T6 - 6th IS at the level of the xiphisternum
T7 - 7th IS (midway between T6 and T8)
T8 - 8th IS (midway between T6 and T10)
T9 - 9th IS (midway between T8 and T10)
T10 - 10th IS or umbilicus
T11 - 11th IS (midway between T10 and T12)
T12 - Midpoint of inguinal ligament
L1 - Half the distance between T12 and L2
L2 - Mid-anterior thigh
L3 - Medial femoral condyle
L4 - Medial malleolus
L5 - Dorsum of the foot at third metatarsophalangeal joint
S1 - Lateral heel
S2 - Popliteal fossa in the midline
S3 - Ischial tuberosity

S4-5 - Perianal area (taken as one level) 




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