2.22 Neuro Exam 3

Question 1

AAOx3 or x4

Answer 1

alert and oriented x

• person
• place
• time and/or
• situation

Question 2

levels of alertness

Answer 2

• alert
• lethargic
• obtunded
• stupor
• coma

Question 3

alert

Answer 3

attentive and awake

Question 4

lethargic

Answer 4

• drowsy
• may fall asleep
• difficulty in focusing on task

Question 5

obtunded

Answer 5

• difficult to arouse
• frequently confused when awake
• interactions largely unproductive
• may be under some sedation

Question 6

stupor

Answer 6

• semi-coma
• responds only to noxious stimuli (nail bed pressure, pinch web space, sternal rub, nipple twist » don’t just go into the room and do this)

Question 7

What does a response to noxious stimuli mean in someone in stupor?

Answer 7

If there’s a response, means a signal is going to the brain and doing something

Question 8

coma

Answer 8

• nothing elicits any form of response

- may or may not be medically induced

Question 9

AAOx0

Answer 9

• just because they’re attentive, doesn’t mean it’s an attention that leads toward progress
• may not know who or where they are, but are alert and/or attentive

Question 10

attention

Answer 10

• ability to focus on one stimulus without being distracted by other stimuli
• typically should be picked up on early

Question 11

testing attention

Answer 11

• repeat short lists

- normal realm should be able to be given 6 things and repeat back

Question 12

MME: mini mental exam

Answer 12

• typically done by ST or OT

- an eval by one of these may help guide your treatment strategy

Question 13

orientation

Answer 13

• person
• place
• time
• situation

Question 14

language function: communication

Answer 14

• communication back and forth shows high cortical function

- sounds, visual, writing back and forth, pictoral, sign language, etc.

Question 15

How does communication back and forth shows high cortical function?

Answer 15

has to receive, process, plan a function/mvt, and carry it out

Question 16

2 categories of aphasia

Answer 16

• Broca’s

- Wernicke’s

Question 17

Which type of aphasia is easier for us to treat?

Answer 17

Broca’s

Question 18

Broca’s aphasia

Answer 18

expressive

• they try and struggle, but can’t express themselves
• doesn’t come out
• often nonverbal

Question 19

Wernicke’s aphasia

Answer 19

receptive

• words go in, get jumbled up, can’t comprehend or figure out what to do
• may have normal speech

Question 20

global aphasia

Answer 20

• can’t receive or express

- no ability to do anything communication-wise

Question 21

What are we looking for with speech?

Answer 21

looking for fluid sentences with regular rate and rhythm

Question 22

stutter

Answer 22

• typically the first portion of the word

- getting it going is the hard part for them

Question 23

stammer

Answer 23

can be throughout speech

Question 24

Why do stutters and stammers need to be addressed as early as possible?

Answer 24

• may delay communication development for children

- avoidance of speech

Question 25

comprehension

Answer 25

- ability to make appropriate/correct responses to commands and questions - typically done by ST

Question 26

most basic level of comprehension

Answer 26

- yes/no, (nodding, blinking) | - how often are they accurate?

Question 27

testing comprehension: methods

Answer 27

- yes, no - repetition - word finding - reading and writing

Question 28

testing comprehension: repetition

Answer 28

- giving a list have them repeat back | - short term/long term recall

Question 29

testing comprehension: word finding

Answer 29

- lost a lot with stroke patients and TBI (anomia) | - hold an object, may be able to describe it, but won't know what it's called

Question 30

testing comprehension: reading and writing

Answer 30

- must know if they can do both | - important for HEP delivery, finding their room number in a hospital, finding the bathroom in their home, etc.

Question 31

testing memory

Answer 31

- immediate recall - short term recall - long term recall (from distant past)

Question 32

types of amnesia

Answer 32

- retrograde | - anterograde

Question 33

retrograde amnesia

Answer 33

- can't remember anything before the event | - "Burger King Doe"

Question 34

anterograde amnesia

Answer 34

- can't make new memories - some can never make new memories, some regain - no carryover from treatment to treatment, very difficult to work with

Question 35

cognitive function: consider these

Answer 35

- fund of knowledge - gnosia/agnosia - praxia/apraxia

Question 36

fund of knowledge

Answer 36

- The bigger the fund of knowledge, the longer it takes for a neuro disorder to take them away because of the sheer volume - pts have different amounts of knowledge

Question 37

gnosia

Answer 37

ability to detect stimuli

Question 38

agnosia

Answer 38

- inability to detect stimuli | - can't visualize what a stimulus is without looking at it

Question 39

apraxia

Answer 39

inability to carry out a task

Question 40

mood

Answer 40

feelings and emotions evoked by situations, events, etc.

Question 41

affect

Answer 41

- somatic and autonomic behavior that are used to convey a mood - affect is something of a reflection of mood

Question 42

flat affect

Answer 42

- nothing changes the way they look at you | - some diagnoses may cause a flat affect (Parkinson's)

Question 43

labile

Answer 43

- may have the wrong type of emotional response to a situation - i.e. laughing at something that's really sad, crying for no reason

Question 44

Dr Schaefer's response to labile pt (crying)

Answer 44

"you got 2 minutes, then we have to start therapy"

Question 45

thought content

Answer 45

fullness or organization of a patient's thinking as reflected by conversation and behavior