The eyes are tested in the cardinal fields by turning the head with the eyes still looking at the eye chart. On alternate cover testing one eye is always occluded and any latent deviation of the eye is noted, deviation from inward to outward would be an example of an esophoria. The corneal reflex may be tested by applying a wisp of cotton on the cornea or by gently blowing on each eye separately. The sternutatory reflex is tested by sticking a small object up the nose and looking for a blink or cough. Gait testing combines cerebellar, motor, and sensory function.
Normal gait is tested by having the patient walk up and down the hallway, and doing rapid turns.
Stress gait is tested by having the patient walk on the outsides and insides of the feet, then duck walking. Finally test in the sharpened Romberg position with the one foot in front of the other, head tilted back toward the ceiling, eyes opened then closed. The motor examination begins proximally and goes distally starting with neck flexion, extension, and rotation then abduction, Adduction, internal and external rotation then shrugging of the shoulders. The elbow is tested in flexion, extension, pronation, and supination. Flexion and extension of the wrist is followed by finger flexion and extension then spreading of the fingers.