Guidelines for Exam and Eval of People w/ Neuro Deficits Flashcards

1
Q

informal observation

A

level of awareness

posture in seated

gait

wheelchair propulsion

devices

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2
Q

level of awareness

A

interaction w/ environment

eyes open

looking around

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3
Q

posture in seated

A

slouch

tilt

where is UE?

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4
Q

gait will be observed

A

if appropriate

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5
Q

gait

A

assistive device

stability

pattern

assistance

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6
Q

w/c propulsion checked

A

if appropriate

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7
Q

w/c propulsion

A

pattern

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8
Q

if in the w/c, then

A

any devices are noted

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9
Q

any devices

A

lap board

communication board

IV pole

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10
Q

what does the subjective exam establish

A

level of communication with patient

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11
Q

what should we get from the subjective exam

A

communication level

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12
Q

common questions

A

what happened to you? when?

what was your tx before you came here?

what activities do you do on your own?

what activities do you need help with?

do you have any pain?

where are you?

what date is it?

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13
Q

subjective exam includes

A

pt interview/family interview/ chart review

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14
Q

pt interview/family interview/ chart review

A

PMH

PSH

social history

vocation

recreation

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15
Q

what shouldnt we do with our cues –> subjective

A

lead patient w/ verbal and non-verbal cues

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16
Q

some questions should –> subjective

A

challenge short and long term memory

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17
Q

what does the subjective exam help with

A

better understand the pt’s mentation, cognition and emotional state

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18
Q

objective exam includes

A

formal observation

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19
Q

formal observation includes

A

systems review

sensation

communication

CN screening

vision

balance

gait

cerebellar tests

w/c eval

fxnal tests

berg balance

special tests

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20
Q

formal observation

A

posturing of extremities and trunk in sitting

posturing of extremities and trunk in standing (if appropriate)

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21
Q

systems review

A

cardiopulmonary

integument

MSK

NM

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22
Q

cardiopulmonary

A

heart sounds

vital signs

breathing patterns

sitting posture

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23
Q

integument

A

decubiti present

potential decubiti

areas of redness

prevention via communication w/ family/caregiver(s), nursing staff

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24
Q

MSK

A

posture

AROM of extremities and trunk

PROM of extremities

pain

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25
Q

NM

A

motor patterns of movement

tone

26
Q

motor patterns of movement –> NM

A

synergy patterns

ataxic

athetoid

27
Q

tone –> NM

A

normal

abnormal

28
Q

abnormal tone –> NM

A

spasticity

rigidity (leadpipe, cogwheel)

29
Q

modified ashworth scale

A

0-5

30
Q

0 –> modified ashworth scale

A

no increase in muscle tone

31
Q

1 -> modified ashworth scale

A

slight increase in muscle tone

manifested by catch and release or by minimal resistance at the end of the ROM when affected part(s) is moved in flexion or extension

32
Q

2 -> modified ashworth scale

A

slight increase in muscle tone

manifested by a catch, followed by minimal resistance throughout the remainder (less than half) of the ROM

33
Q

3 -> modified ashworth scale

A

more marked increase in muscle tone through most of ROM

but affects part(s) easily moved

34
Q

4 -> modified ashworth scale

A

considerable increase in muscle tone

passive movement difficult

35
Q

5 -> modified ashworth scale

A

affected part(s) rigid in flexion and extension

36
Q

sensation

A

cutaneous

deep

combined cortical

37
Q

cutaneous sensation

A

pain (sharp/dull)

temp

light tough

deep pressure

38
Q

deep sensation

A

proprioceptive

kinesthesia

vibration

39
Q

combined cortical sensation

A

stereognosis

graphesthesia

barognosis

two point discrimmination

40
Q

communication

A

aphasia

41
Q

aphasia

A

expressive - broca

receptive - wernikie

global

42
Q

vision

A

field losses

43
Q

most common vision field loss

A

homonymous hemianopia

44
Q

left homonymous hemianopia

A

loss of left temporal and right nasal fields

d/t right brain insult

45
Q

balance

A

sitting and standing

standing if appropriate

static and dynamic

46
Q

gait will be checked

A

if appropriate

47
Q

gait –> objective

A

ADs and gait deviations

swing phase

stance phase

48
Q

cerebellar tests are checked

A

if appropriate

49
Q

cerebellar tests

A

dysarthria

dysdiadochokinesia

dysmetria

dyssynergia

nystagmus

rebound phenomena

tremor - intention

50
Q

w/c is checked

A

if appropriate

51
Q

w/c eval

A

type

accessories

fit

52
Q

type of w/c

A

manual

power

recliner

tilt in space

hemi

53
Q

accessories of w/c

A

swing away removable leg rests

elevating leg rests

removable arm rests

desk arms

54
Q

fit of w/c

A

adult regular

adult narrow

hemiplegic height

pediatric

55
Q

ADL’s

A

basic ADLs (BADLs)

bed activities

transfers

self-care

56
Q

instrumental ADLs

A

shopping

cooking

doing laundry

57
Q

standardized fxnal tests and measures

A

fxnal independence measure

barthels index

fugl-meyer

TUG

fxnal reach

58
Q

standardized tests for specific dx

A

hemiplegia

parkinsons

MS

ALS

HD

59
Q

what should we correlate

A

subjective and objective findings

60
Q

formulate

A

short and long term goals

plan of interventions

61
Q

what should we be thinking of from day 1

A

d/c

62
Q

we then

A

treat and asses

change if appropriate