[DSA] Neurologic Evaluation with Mental Status [Howell] Flashcards Preview

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Flashcards in [DSA] Neurologic Evaluation with Mental Status [Howell] Deck (18)
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Glascow Coma Scale

Scaling for Eye Opening

1: no response even to supraorbital pressure

2: pain from limb/supraorbital pressure

3: Nonspecific response to speech

4: Spontaneous eye opening


Glascow Coma Scale

Scaling for Motor response

1: To any pain, limbs flaccid

2: Extension/decerebrate rigidity

3: Flexor response/decorticate rigidity

4: Arm withdraws to pain

5: Arm attempts to remove painful localized stimulus (supraorbital pressure)

6: Follows simple commands


Glascow Coma Scale

Scaling for Verbal response

1: No verbalization of any type

2: Moans/groans, no speech, incomprehensible

3: Intelligable, no sustained sentences

4: Converse but confused, disoriented

5: Converses and is oriented


Positive finding + interpretation of:

Nuchal rigidity

Pt unable to touch chin to chest either actively or passively

Dx: meningeal irritation


Positive finding + Interpretation of:

Brudzinski's Test

Pt supine. When head is elevatedknees involuntarily flex

Dx: meningeal irritation


Positive Finding + Interpretation of:

Kernig Test

Pt supine. Hip and knee begin flexed. When knee is extended => pain in the back

Dx: meningeal irritation


Acute, focal unilateral weakness or paralysis in face/UE, LE, and/or difficulty with coordination and gait are highly suggestive of?

Ischemic CVA


HA, vomiting, seizures, decreased LOC with unilateral weakness or paralysis worsening over minutes to hours?

Intracerebral hemorrhage


Sudden onset of severe HA, may be accompanied by loss of consciousness, seizure, NV, and meningismus is highly suggestive of?

Subarachnoid hemorrhage


Present finding + indication of:

Babinski response

Dorsiflexion of the big toe to stimulation of the plantar foot

Dx: CNS lesion in corticospinal tract

Babinski is either present or not present (not a Positive test)


Positive finding + indication of:

Arms extended with palms up, eyes closed 20-30 sec => arm drifts downward

Dx: Mild hemiparesis or CVA, UMN lesion

Pronator drift


Positive finding + indication of:

Finger to nose test

Have pt touch your finger then touch their nose, repeat bilaterally. Ask pt to close both eyes and try again bilaterally => clumsy movements that are unsteady and vary in speed

Dx; Problem with position sense, fxn of labyrinth of inner ear, cerebellum


Positive finding + indication of:

Heel to shin test

Have pt place one heel on the opposite knee, then go up and down the shin. Repeat w/ eyes closed => decreased smoothness and accuracy

Dx: Lesion in motor, basal ganglia, cortical, and cerebellar systems


Positive finding + indication of:

Rapid Alternating movements

Instead of quickly, movements are slow, irregular/clumsy (dysdiadochokinesis)

Dx: cerebellar dz


Positive finding + Indication of:

Romberg test

Pt with feet together, arms extended and palms upward, eyes closed => pt begins to sway or has to move feet to maintain balance

Dx: Cerebellar dz


Positive finding + Indication of:


Pt asked to walk on toes, heels, and tandem => inability to maintain posture, ataxic gait

Dx: Cerebellar dz, loss of position sense, intoxication


______ posturing is ABOVE the red nucleus

Decorticate posturing is ABOVE the red nucleus


____ posturing is BELOW the red nucleus

Decerebrate posturing is BELOW the red nucleus