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NPTE NM > Examination > Flashcards

Examination Flashcards

(55 cards)

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1
Q

LOC - obtundation =

A

can open eyes, look at examiner
but responds slowly and is confused
demonstrates dec alertness and interest in environment

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2
Q

LOC - stupor =

A

can be aroused from sleep only with painful stimuli
verbal responses are slow or absent
pt returns to unresponsive state when stimuli are removed
demonstrates minimal awareness of self and environment

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3
Q

LOC - unresponsive vigilance (vegetative) state =

A

characterized by return of sleep/wake cycles, normalization of vegetative functions (resp, HR, BP, digestion) and lack of cog responsiveness (can be aroused but is unaware)

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4
Q

LOC - persistent vegetative state =

A

a state lasting over 1 year for TBI and over 3 months for anoxic brain injury

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5
Q

LOC - minimally conscious state =

A

a state characterized by severely altered consciousness with minimal but definite evidence of self or environmental awareness `

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6
Q

GCS - relates

A

consciousness to three elements of response
Eye opening, motor response, and verbal response
Scored from 3 to 15

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7
Q

GCS - severe brain injury, mod and min

A 
severe = 1 to 8
mod = 9 to 12
minor = 13 to 15
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8
Q

Memory - immediate recall

A

name three items previously presented after a brief interval of about 5 min

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9
Q

Memory - recent memory (short term)

A

recall recent events - what did you have for breakfast

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10
Q

Memory - remote memory (long term)

A

recall past events - where were you born

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11
Q

Mini mental state exam (MMSE) - screening test for

A

cog dysfunction

includes screening items for orientation, registration, attn, calculation, recall and language

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12
Q

MMSE - scoring

A

max is 30
mild impairment = 21-24
mod = 16-20
severe = 15 or less

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13
Q

LOCF - rancho los amigos levels of cog function - assesses

A

cognitive recovery from TBI

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14
Q

LOCF - scoring

A 
8 levels of bx 
1 = no response
2 and 3 = decreased response
4, 5, 6 = confused 
7, 8 = appropriate automatic, purposeful
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15
Q

vital signs - resp - cheyne stokes respiration is what

A

a period of apnea lasting 10-60 sec followed by gradual inc depth and freq of respirations
Accompanies depression of frontal lobe and diencephalic dysfunction

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16
Q

vital signs - resp - hyperventilation

A

inc rate and depth of resp

Accompanies dysfunction of lower midbrain and pons

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17
Q

vital signs - resp - apneustic breathing

A

abnormal resp marked by prolonged inspiration

Accompanies damage to upper pons

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18
Q

Exam for CNS infection or meningeal irritation - neck mobility test

A

supine, flex neck to chest
pos - neck pain with limitation and guarding of head flexion due to spasm of post neck mm
can result from meningeal inflammation, arthritis, or neck injury

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19
Q

Exam for CNS infection or meningeal irritation - Kernig’s sign

A

Supine, flex hip and knee fully to chest and then extend knee
Pos - causes pain and inc resistence to extending knee due to spasm of hamstring
when bilateral - suggests meningeal irritation

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20
Q

Exam for CNS infection or meningeal irritation - Brudzinski’s sign

A

Supine, flex knee to chest
Pos - causes flexion of hips and knees (drawing up)
Suggests meningeal irritation

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21
Q

Perceptual function - test for homonomous hemianopsia

A

loss of half of visual field in each eye - contralateral to side of lesion
Slowly bring two fingers from behind head and have them tell you when and where fingers first appear

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22
Q

Perceptual function - body scheme/body image disorders - body scheme disorder =

A

somatognosia

have pt identify body parts or their relationship to each other

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23
Q

Perceptual function - body scheme/body image disorders - visual spatial neglect =

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A

unilateral neglect

determine whether pt ignores one side of body and stimuli coming from that side

24
Q

Perceptual function - body scheme/body image disorders - right/left discrimination disorder =

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A

have pt identify r and l sides of his or her own body and PT body

25
Perceptual function - body scheme/body image disorders - anosognosia =
severe denial, neglect, or lack of awareness of severity of condition determine whether pt shows severe impairments in neglect and body scheme
26
Perceptual function - spatial relations syndromes - figure ground discrimination
have pt pick out an object from an array of objects (brake from rest of wheelchair)
27
Perceptual function - spatial relations syndromes - form constancy
have pt pick out an a object from an array of similarly shaped, but different sized objects (large block from group of blocks)
28
Perceptual function - spatial relations syndromes - spatial relations
have pt duplicate a pattern of two or three blocks
29
Perceptual function - spatial relations syndromes - position in space
have pt demonstrate difference limb positions (put your arm OH, put your foot underneath chair)
30
Perceptual function - spatial relations syndromes - topographical disorientation
determine whether pt can navigate a familiar route on his or her own (travel from room to PT clinic)
31
Perceptual function - spatial relations syndromes - depth and distance imperceptions
determine whether pt can judge depth and distance (navigate stairs, and sit down in chair)
32
Perceptual function - spatial relations syndromes - vertical disorientation
determine whether pt can accurately identify when something is upright (hold cane, ask pt when it is vertical)
33
Perceptual function - Examine for agnosia
inability to recognize objects with one sensory modality while retaining ability to recognize same object with other sensory modality Not clock but sight, but able to with sound of tick
34
Perceptual function - Examine for apraxia
inability to perform voluntary, learned movementa in absence of loss of sensation, strength, coordination, attn, or comprehension represents a breakdown in conceptual system or motor production system or both
35
Perceptual function - ideomotor apraxia
pt cant perform task on command, but can do it when left alone
36
Perceptual function - ideational apraxia
pt cant perform task at all, either on command or on own
37
Examine motor function - spasticity
inc resistance to PROM - determine whether inc speed, inc the resistance Spasticity is velocity dependent!
38
Examine motor function - Additional signs of spastic hypertonia = clasp knife response
marked resistance to PROM suddenly gives way
39
Examine motor function - Additional signs of spastic hypertonia = clonus
maintained stretch stimulus produces a cyclical, spasmodic contaction common in PFs, wrist flexors, jaw
40
Examine motor function - Additional signs of spastic hypertonia = hyperactive cutaneous reflexes, pos babinski
DF of great toe with fanning or other toes in response to stroking up lateral side of sole of foot - indicative of corticospinal tract disruption
41
Examine motor function - Additional signs of spastic hypertonia = hyperreflexia
increased DTRs
42
Examine motor function - Spasticity - Modified ashworth scale
6 grades 0 = no inc in mm tone 1 = slight inc in mm tone, minimal resistance at end ROM 1+ = slight inc in mm tone, minimal resistance through less than half of ROM 2 = more marked inc in mm tone through most of ROM, affected part easily moved 3 = considerable inc in mm tone, passive mvmnt difficult 4 = affected part rigid in flex or ext
43
Examine motor function - Rigidity
inc resistance to PROM that is independent of velocity of movement
44
Examine motor function - Rigidity - can be ___ or ___
``` leadpipe = uniform throughout range cogwheel = interrupted by series of jerks ```
45
Examine motor function - Decerebrate rigidity/posturing
seen in comatose pts with brainstem lesions btw sup colliculus and vestibular nucleus results in inc tone and sustained posturing in rigid extension of all four limbs and trunk/neck
46
Examine motor function - Decorticate rigidity/posturing
seen in comatose pts with lesions above superior colliculus | results in inc tone and sustained posturing of upper limbs in flexion and lower limbs in extension
47
Examine motor function - Opisthotonos
prolonged, severe spasms of mm causing head, back and heels to arch backward; arms and hands are rigidly flexed Seen in severe meningitis, tetanus, epilepsy, and strychnine poisoning
48
Examining reflexes - scoring scale
``` 0 = absent 1+ = tone change, no visible mvmnt in extremities 2+ = visible mvmnt in extremities 3+ = exaggerated, full mvmnt in extrem 4+ = obligatory and sustained mvmnt, lasting over 30 sec ```
49
Examine for involuntary movements - tics =
spasmodic contractions of specific muscles, commonly involving face, head, neck or shoulder mm
50
Examine for involuntary movements - chorea =
relatively quick twitches or dancing movements
51
Examine for involuntary movements - athetosis =
slow, irregular, twisting, sinous movements, occurring esp. in UE
52
Examine for involuntary movements - tremor =
continuous quivering movements, rhythmic, oscillatory movement observed at rest (resting tremor)
53
Examine for involuntary movements - myoclonus
single, quick jerk
54
Examine balance - sensory organization test
``` 6 conditions 1 = EO, stable surface 2 = EC SS 3 = visual conflict (sway referenced vision using a moving surrounding screen) SS 4 = EO, moving surface 5 = EC, MS 6 = visual conflict, moving surface ```
55
Examining balance - modified clinical test for sensory interaction in balance (mCTSIB)
``` 4 conditions EO SS EC SS EO FS (foam) EC FS Three 30 sec trials are used ```

NPTE NM (16 decks)

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