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Clinical One > Assessment > Flashcards

Assessment Flashcards

(107 cards)

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1
Q

Purpose of the Neurological Examination

A
  1. Determine whether nervous system dysfunction is present
  2. Diagnose disease of the nervous system
  3. Localize disease within the nervous system
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2
Q

Major components of the Neurological Examination

A
  1. LOC
  2. Mental Status
  3. Cognitive Function
  4. Muscle tone, bulk, strenghth
  5. Senory function
  6. Cordination
  7. Reflexes
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3
Q

Questions for the Neurological Cheif Complaint

A
  1. Change in intellect
  2. Onset of memory defecit
  3. Difficulty of concentration
  4. Personality change
  5. Depression
  6. Loss of drive
  7. Headache
  8. Seizure
  9. Dizziness
  10. Vertigo
  11. Diplopia
  12. Tinnitus
  13. Incordination
  14. Weakness
  15. Pareshtesia
  16. Speech Difficulty
  17. Dysphagia
  18. Bladder, bowel, or sexual dysfunction
  19. Sleep Difficulties
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4
Q

MSE: General impression of awareness and mental function

A
  1. Level of Alertness
  2. General Appearance and Behaivor
  3. Mood and emotional state
  4. General Thinking Process
  5. Content of Thought
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5
Q

MSE: Reception and interpretation of sensory stimuli

A
  1. Orientation
  2. Personal ID
  3. Attention
  4. Comprehension
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6
Q

MSE: Higher-Level cognitive function

A
  1. Memory
  2. Calculations
  3. General fund of information
  4. Abstract thinking, reasoning, and judgement
  5. Language and speech
  6. Constructional ability
  7. Motor intergrative function
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7
Q

Mood and Emotional State

A

Abnormal responses include hostility, evasiveness, anger, tearfulness, and depression

Screen for depression if suspected

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8
Q

General Appearance and Behaivor

A
  1. Attire
  2. Hygiene
  3. Posture/Movement
  4. Facial Expression
  5. Affect and Manner
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9
Q

Thinking Process

A
  1. Thought process
  2. Thought content
  3. Perception
  4. Speech
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10
Q

Abnormal Thought Processes

Name 3

A
  1. Circumstantiality
  2. Derailment
  3. Flight of Ideas
  4. Neologisms
  5. Incoherence
  6. Blocking
  7. Confabulation
  8. Perservation
  9. Echolalia
  10. Clanging
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11
Q

What is dysarthria?

A

Disorder of language articulation

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12
Q

Orientation

A
  1. Time
  2. Place
  3. Person
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13
Q

Reception and Interuption of Sensory Stimuli

A
  • Orientation
  • Personal ID
  • Attention
  • Concentration
  • Comprehension
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14
Q

Personal ID

A

Name
Address
Background information

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15
Q

Attention

A

Ability to focus on a single sensory stimulus

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16
Q

Concentration

A

Sustained focus on a sensory stimulus

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17
Q

Attention and Concentration Assessment

A
  1. Number Series
  2. Spelling Backward
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18
Q

Comprehension

A

The ability to understand the meaning of visual, auditory, and other stimuli

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19
Q

Higher-Level Cognitive Functions

A
  • Memory
  • Calculations
  • General Fund of Information
  • Abstract thinking, reasoning, and judgement
  • Language and Speech
  • Constructional ability
  • Motor intergrative function
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20
Q

Memory

A

Ability to register, store, and retrieve information

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21
Q

How is memory commited?

A

Through registration, storage, and retireval of information

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22
Q

Memory is subdivided intp what groups?

A
  • Immediate
  • Short-Term
  • Long-Term
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23
Q

Immmediate Memory testing

A

Choose 3 unrelated words for the patient to recite immediately

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24
Q

Short-term memory testing

A

Ask the patient to retrieve the same 3 words from immediate memory testing 5 minutes later

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25
Long-Term Memory testing
When is your date of birth? Where is your place of birth? Where di you go to school? Wheen did you attend school? Where is your school located? What do you do for work? Where do you work? How long have you worked there? What is your spouses name? What is your childrens name? How old are they? Whats your mothers maiden name?
26
Name 3 different types of amnesia
* Retrograde Amnesia * Antegrade Amnesia * Psychogenic Amnesia
27
General Fund of Information testing
Ask the patient to retireve information related to their location and area of expertise
28
Abstract Thinking testing
Ask the patient to interpret a sentence like "People who live in glass houses should not throw stones"
29
Similarities testing
Ask the patient to find similarities between two words
30
Reasoning testing
Define differences between combinations "mistake" vs "lie" and "sadness" vs "hopelessness"
31
Judgement
Opinion or evaluation of something
32
Insight
Ability to see the inner nature of things
33
Judgement and Insight testing
"What brings you in today?"
34
Aphasia
Disorder of processing language
35
Apraxia
Disorder of motor programming of language symbols
36
Classifications of Aphasia
Brocas Aphasia Wernickes Aphasia Global Aphasia Conduction Aphasia Anomic Aphasia
37
Brocas Aphasia
Unable to convert thoughts into meaningful language Normal reception of language is intact
38
Wernickes Aphasia
Fluent unintelligble speech due to impaired pronounciation Impaired comprehension of language
39
Constructional Ability testing
Ask the patient to draw a figure on command
40
CN 1 Assessment | Stimuli?
Olfactory Nerve Have the patient smell a common odor | Sensory
41
Components of the Ophthalmoscope Exam
* Optic Disc * Macula Lutea * Fovea * Diameter of arteries and veins
41
CN II Assessment | Stimuli?
Optic Nerve Visual Acuity, Visual Fields, Ophthalmoscopic Exam | Senosory
42
Common abnormal Optic Disc findings
Papilledema Papillitis Optic Atrophy Retotubular Neuritis Optic Neuritis Cotton wool patches
43
Cranial Nerve III, IV, VI Assessment | Stimuli?
Oculomotor, Trochlear, Abducens 1. Position of the eyes 2. EOM 3. Examine the pupils 4. Direct Light reflex 5. Near-Point Reaction | Motor
44
Diplopia
Double vision or seeing two seperate images
45
Gaze Palsy
Eyes move conjugately but have limited movement in one direction
45
CN V Assessment | Stimuli?
Trigeminal Nerve Light Touch Pain Perception | Sensory, Motor
46
CN VII | Stimuli?
Facial Nerve 1. Protrude the tounge 2. Sweet on tip 3. Sour on sides 4. Bitter in the back 5. Smile | Sensory, Motor
47
CN VIII | Stimuli?
Acoustic 1. Whisper 2. Shout 3. Weber 4. Rinne | Sensory
48
CN IX/X | Stimuli?
Glossopharyngeal/Vagus 1. Say "ah" 2. Assess voice quality | Sensory, Motor
49
CN XI | Stimuli?
Spinal Accessory Nerve 1. Palpate the trazpezius muscle 2. Turn their head | Motor
50
CN XII
Hypoglossal 1. Open the mouth 2. Protrude the tounge 3. Swing tounge from side to wide
51
Upper Extremity Assessment
1. Shoulder Movement 2. Adduction of Shoulder 3. Flexion of elbow 4. Extension of elbow 5. Pronator Drift 6. Extension of wrist 7. Flexion of wrist 8. Extension of fingers 9. Flexion of Fingers 10. Abduction of Fingers 11. Adduction of fingers 12. Opposition of thumb
52
Shoulder Movement | Muscle, Spinal Level?
Extend your arms and push agaisnt the wall | Seratus anterior; C5, C6, C7
53
Adduction of Shoulder | Muscle, Spinal Level?
Flex your elbow and move your upper arm away from your body | Deltoid and Supraspinatus; C5, C6
54
Flexion of Elbow 1 | Muscle, Spinal Level?
Flex your elbow and make a fist parallel to the ground | Biceps Crachii, C5
55
Flexion of Elbow 2 | Muscle, Spinal Level?
Flex your elbow and make first parallel to the midline | Brachioradialis, C6
56
Extension of Elbow | Muscle, Spinal Level
Push me away with your arm | Triceps brachii, C7, C8
57
Pronator Drift
Raise arms and keep them elevated for "x" amount of time
58
Extension of Wrist | Muscle, Spinal Level?
Extend your wrist and dont let me straighten it | Extensor carpi readialis longus and ulnaris; C6, C7
59
Flexion of Wrist | Muscle, Spinal Level?
Flex your wrist and dont let me straighten it | Flexor carpi radialis and ulnaris; C7, C8
60
Extension of Fingers | Muscle, Spinal Level?
Put your fingers straight and dont let me push down | Extensor digitorium communis, extensor indicis proprius, digit minmi. C7
60
Flexion of Fingers | Muscle, Spinal Level?
Flex your fingers and dont let me straighten them | Flexor digitorum superficialis, profunder, and lumbricals. C8, T1
61
Abduction of fingers | Muscle, Spinal Level?
Put your hand on the table and resist me trying to put them together | Dorsal interossei, Abductor digiti quinti. T1.
62
Adduction of Fingers | Muscle, Spinal Level?
Put your hand on the table with the fingers slightly spread. Resist me trying to put them together | Palmar interossi. C8, T1
63
Opposition of thumb | Muscle, Spinal Level?
Touch the tip of your little finger with your thumb | Opponen pollicis. C8, T1
64
Lower Extremity Assessment
1. Hip Flexion 2. Hip Adductors 3. Hip ABductors, gluteus medius and minimus 4. Hip extension 5. Knee extension 6. Knee flexion 7. Dorsiflexion of ankle 8. Plantar flexion of ankle
65
Lower Extremity muscles
1. Iliopsoas 2. Adductor brevis 3. Adductor longus 4. Adductor magnus 5. Gluteus maximus 6. Quadriceps 7. Hamstrings 8. Tibialis anterior 9. Peroneus tertius 10. Extensor digitorum longus 11. Extensor hallucis longus 12. Gastrocnemius and soleus 13. Tibialis posterior 14. Peroneus longus and brevis
66
Hip Flexion | Muscle, Spinal Level?
Flex your thigh agaisnt the resistance provided | Iliopsoas. T12, L1, L2, L3
67
Hip ADductors | Muscle, Spinal Level?
Lie on your back, seperate them, and spread them open | A. Brevis, A. Longus, A. Magnus. L2, L3, L4.
68
Hip ABductors, gluteus medius and minimus | Muscle, Spinal Level?
Spread both legs against my hands | Gluteus Medius. L4, L5, S1
69
Hip Extension | Muscle, Spinal Level?
(Place hands on anterior and posterior thigh) Push leg down against the bed | Gluteus maximus. L5, S1, S2.
70
Knee Extension | Muscle, Spinal Level?
(Place patient in prone position, Examiner places hand on top of lower leg) Straighten your leg | Quadriceps. L2, L3, L4.
71
Knee Flexion | Muscle, Spinal Level?
(Examiner partially flexes knee above the ankle and stabilizes the hip with the other hand) Flex your knee | Hamstrings. L5, S1, S2
72
Dorsiflexion of Ankle | Muscle, Spinal Level
(Place hand on top of foot) Pull your toes toward your nose | T. Anterior, Peroneus ertius, Extensor digitorum longus, E. hallucis ## Footnote L4, L5
73
Plantar flexion of ankle | Muscle, Spinal Level
(Place hand on ball of foot) Press down like on the gas pedal | Gastrocnemius, Soleus. S1, S2.
74
Foot Inversion
(Place hand on lateral side of foot) Try to move your foot outward and down
75
Foot Eversion
(Place hand on lateral side of foot) Turn your foot outward
76
Peripheral Nerves | (Name 6)
Obturator Superior gluteal Inferior gluteal Femoral Sciatic Deep peroneal Tibial Superficial peroneal Long Thoracic Axillary Musculocutaneous Radial Medial Ulnar
77
Superficial Sensation Assessment
1. Light Touch 2. Pain 3. Temperature
78
Light Touch
Use a wisp of cotton to lightly touch around the skin
79
Pain
Use a "sharp" object to lightly touch around the skin
79
Temperature
Ask the patient to identify hot or cold with a tube of water
80
Deep Sensation Assessment
Vibration Deep pressure pain Proprioception
81
Vibration
128-hz tunig fork is placed on big toe and thumb
82
Deep Pressure pain
Achilles tendon and forearm muscles are squeezed
83
Proprioception
The thumb and then the large toe is moved up or down
84
Discrimitive Sensation Assessment
Two-Point Point Recognition of shape and form Texture Graphesthesia Extension Phenomenon
85
Two-point Discrimination
Part of the body is pricked with sharp objects to see if two sensations are felt
86
Point Discrimination
Patient is asked where the patient was touched
87
Recognition of shape and form
Identify objects in their pocket
88
Texture discrimination
Diffrentiatate among textures
89
Graphesthesia
A letter or number is written on the palm and then the patient is asked to identify the symbol
90
Extension phenomenon
Touch the patient on each side simultaneously. Determine if the patient can tell the difference
91
Upper Extremity Cerebellar Assessment
1. Touch your finger to my finger 2. Pronate and Supinate one hand and then the other 3. Rapid tap fingers
92
Lower Extremity Cerebellar Assessment
1. Slide heel down the other legs shin while sitting 2. Draw the number 8 with your foot in the air
93
Balance
Rombergs Sign
94
Muscle Stretch Reflexes
Biceps Triceps Brachioradialis Patellar Achilles Plantar
95
Superficial Reflexes
Corneal Gag Swallowing Upper Abdominal Lower Abdominal Cremasteric Bulbocavernosus Perianal
96
Corneal Reflex
Touch cornea lightly with a wisp of cotton
97
Gag Reflex
Stimulate the back of the pharynx
98
Swallowing Reflex
Stimulate one side of the uvula
99
Upper Abdominals Reflex
Stroke the outer abdomen toward the umbilicus
100
Lower Abdominals Reflex
Stroke the lower abdomen toward the umbilicus
101
Cremasteric Reflex
Lightly stroke the inner aspect of the thigh or lower abdomen
102
Bulbocavernosus Reflex
Apply direct pressure over the bulbocavernosus muscle behind the scrotum
103
Perianal Reflex
Scratch the tissue at the side of the anus

Clinical One (8 decks)

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