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

PCM4 Exam1 > [DSA] Neurologic Evaluation with Mental Status [Howell] > Flashcards

Flashcards in [DSA] Neurologic Evaluation with Mental Status [Howell] Deck (18)
Loading flashcards...
1

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

2

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

3

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

4

Positive finding + interpretation of:

Nuchal rigidity

Pt unable to touch chin to chest either actively or passively

Dx: meningeal irritation

5

Positive finding + Interpretation of:

Brudzinski's Test

Pt supine. When head is elevatedknees involuntarily flex

Dx: meningeal irritation

6

Positive Finding + Interpretation of:

Kernig Test

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

Dx: meningeal irritation

7

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

Ischemic CVA

8

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

Intracerebral hemorrhage

9

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

Subarachnoid hemorrhage

10

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)

11

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

12

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

13

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

14

Positive finding + indication of:

Rapid Alternating movements

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

Dx: cerebellar dz

15

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

16

Positive finding + Indication of:

Gait

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

Dx: Cerebellar dz, loss of position sense, intoxication

17

______ posturing is ABOVE the red nucleus

Decorticate posturing is ABOVE the red nucleus

18

____ posturing is BELOW the red nucleus

Decerebrate posturing is BELOW the red nucleus