1. Subjective
2. Objective
3. Assessment
   1. Tumors
   2. Compression of cervical spinal cord
   3. Drugs
   4. Diagnosis
      1. Chiari I malformation
         1. Embryology
            1. 1- The neural tube is formed from the neural plate
            2. 2- The neural groove develops
            3. 3- The raised edges are called Neural folds (neural crest)
            4. 4- The neural fold fuse to form The neural tube.
            5. 5- The skin become closed dorsally
            6. if deficit
            7. Chiari Malformation
         2. Types
            1. I
            2. the lower part of the cerebellum extends into the foramen magnum
            3. II
            4. the cerebellum and the brain stem extend into the foramen magnum
            5. III
            6. protrusion or herniation of the cerebellum and brain stem through the foramen magnum and into the spinal cord
            7. IV
            8. that involves an incomplete or undeveloped cerebellum.
         3. Diagnosis
            1. PE
            2. X-ray, CT scan, MRI
         4. Treatment
            1. analgesics, muscle relaxants, and the occasional use of a soft collar
            2. Surgery
      2. Syringomyelia
         1. Definition
            1. The development of a fluid-filled cyst (syrinx) within your spinal cord
         2. Causes
            1. Chiari malformation
            2. Meningitis
            3. Spinal cord tumors
            4. Spinal cord injuries and damage
         3. Diagnostic methods
            1. History Taking & Physical Examination
            2. MRI
            3. CT scan
         4. Treatment
            1. Treating Chiari malformation
            2. Draining the syrinx
            3. Removing the obstruction
            4. Correcting the spinal abnormality
4. Plan
   1. Imaging
      1. X-ray
      2. MRI
      3. CT scan
      4. EMG
   2. Treatment
      1. Surgery
      2. Shunt
      3. Decompression
      4. Cyst Aspiration
5. Symptoms
   1. Motor
      1. dragging feet
         1. Differential diagnosis
            1. sports injuries
            2. diabetes
            3. spending long hours sitting cross-legged or squatting
            4. childbirth
            5. Injury to the nerve roots in the spine may also cause foot drop.
            6. Brain or spinal disorders. Neurological conditions can contribute to foot drop. These include:
            7. stroke
            8. multiple sclerosis (MS)
            9. muscular dystrophy
            10. polio
      2. dropping things
   2. Sensory
      1. Numbness
         1. Differential diagnosis
            1. Brachial plexus injury
            2. Cerebrovascular accident
            3. Diabetes
            4. Fracture
            5. Peripheral nerve compression
            6. Peripheral nerve trauma
      2. Neck pain
         1. Differential diagnosis
            1. Tension Headaches. 
            2. Vascular Headaches.
            3. Migraine. 
            4. Sinus Headaches. 
            5. Parkinson's Disease. 
            6. Strain or Sprain. 
            7. Poor Posture. 
            8. Arthritis. 
            9. Tumors
      3. Loss of Temp. sensation
6. Signs
   1. Physical Examination
      1. Tonsilar herniation
         1. Definition
            1. Displacment of the cerebral tonsils through the foramen magnum
         2. causes
            1. Decreased or malformed posterior fossa
            2.  Abnormal CSF volume
            3. Connective tissue disorders
      2. Upper Limb
         1. wasting of hands muscles
         2. weak grip
         3. loss of temperature and pinprick sensation
         4. power grade V
            1. Muscle Weakness DD
            2. Myasthenia gravis
            3. Hypothyroidism
            4. Dermatomyositis-polymyositis
            5. Drug-induced myopathy
            6. Cushing syndrome
         5. diminished reflexes
      3. Lower Limb
         1. Normal sensations
         2. increased muscle tone
         3. brisk ankle reflex
         4. ankle clonus
         5. spastic gait
         6. planter reflex equivocal
7. Demographics
   1. Male
   2. 19 years old
   3. student
   4. No childhood significant illness/history