Lecture 2: BSF Exam- Cognition, ACOM, Sensation

Question 1

What are important questions to ask during subjective history?

Answer 1

prior level of function, living environment, work?, resources available, current limitations, client goals

Question 2

What are main components of neuro systems review?

Answer 2

gross movement, motor function

Question 3

What are areas of gross movement?

Answer 3

balance, transfer, gait/ wc mobility

Question 4

What are areas of motor function?

Answer 4

motor control/ muscle tone

Question 5

What are two different approaches that can be taken for a neuro exam?

Answer 5

1. impairment or body structure based/ function oriented

2. activity oriented

Question 6

What factors influence what method you choose?

Answer 6

setting, pt status, level of expertise

Question 7

What are components of BSF oriented exam?

Answer 7

ROM, MMT, muscle tone, consciousness, sensation, cognition, motor control/ACOM, reflexes, cranial nerve integrity

Question 8

What do you do during an activity based exam?

Answer 8

examine and analyze activities then formulate list of hypothesized contributing factors (HCF)

then perform tests specific to HCF to refute or confirm

Question 9

What are components of activity based exam?

Answer 9

balance, trunk control, reaching, bed mobility, transfers, ambulation, stairs, sit to stand

Question 10

What is consciousness and level of arousal?

Answer 10

determines level of readiness for activity

Question 11

What is alert?

Answer 11

awake, attentive, interactive

Question 12

What is lethargic?

Answer 12

drowsy, brief response to stimuli, poor attention

Question 13

What is obtunded?

Answer 13

difficult to arouse, confused when alert

Question 14

What is stupor/ semicoma?

Answer 14

not self alerting, responds to vigorous or noxious stimuli

Question 15

What is a coma?

Answer 15

can’t be aroused, unconscious, no sleep wake cycle

Question 16

What is a vegetative state?

Answer 16

irregular sleep wake cycle, can be aroused but no awareness of environment

Question 17

What is persistent vegetative state?

Answer 17

remain in vegetative state for greater than 3 months(anoxia) or 1 year (TBI)

Question 18

What is locked in syndrome?

Answer 18

alert and unable to respond to environment, no speech or active movements

Question 19

What are two standardized tests for consciousness?

Answer 19

glasgow come scale

rancho los amigos scale

Question 20

What are different areas of cognition?

Answer 20

orientation - AO x 3

attention, memory, executive functions

Question 21

What are components of attention?

Answer 21

ability to screen and process sensory info

ability to concentrate and dual task

document: speed of response, duration

Question 22

What are components of memory?

Answer 22

register, retain and recall

short vs long term, ability to follow multi step commands

Question 23

What is retrograde amnesia?

Answer 23

can’t recall past info

Question 24

What is anterograde amnesia?

Answer 24

can’t learn new info

Question 25

What are executive functions?

Answer 25

awareness, reasoning, planning, judgement, intuition, decision making

Question 26

What are two standardized test and measures for cognition and what scores are needed to "pass"?

Answer 26

mini mental state exam- 24/30 Montreal cognitive assessment 26/30

Question 27

What is Wernicke's aphasia?

Answer 27

receptive or unable to understand language

Question 28

What is Broca's aphasia?

Answer 28

expressive, trouble with speaking

Question 29

What is dysarthria?

Answer 29

poor articulation

Question 30

Why is somatosensation so important?

Answer 30

critical to motor learning and motor performance, guides selection of movement pattern required in a given sensory environment, used by CNS to modify or adapt ongoing movements

Question 31

What is so important about sensory integration?

Answer 31

vital to planning and allowing interaction with environment people can have intact somatosensation but impaired integration

Question 32

What does light touch, pain and temperature assess?

Answer 32

anterolateral column in spinal cord, fibers slow and small

Question 33

What does vibration, two point discrimination and proprioception test?

Answer 33

dorsal column of spinal cord large and fast fibers

Question 34

What will be affected in nerve root lesion?

Answer 34

dermatomal distribution or abnormal sensation

Question 35

What will be affected in peripheral nerve involvement?

Answer 35

distribution of that specific nerve

Question 36

What is will neuropathy affect?

Answer 36

stocking glove distribution

Question 37

What do you test for superficial sensation?

Answer 37

pain- sharp/dull temp- hot/ cold light touch- cotton balls/ swab, monofilaments pressure- finger tip start distal to proximal and usually done first

Question 38

How to test deep sensation?

Answer 38

kinesthesia- movement sense proprioception- joint position vibration perception

Question 39

What are combined cortical sensations?

Answer 39

cortical sensory areas that involve both superficial and deep sensation

Question 40

What is agnosia?

Answer 40

not knowing

Question 41

What is neglect?

Answer 41

lack of awareness or attention

Question 42

What is stereognosis?

Answer 42

object recognition

Question 43

What is 2 point discrimination?

Answer 43

distinguish between one or two stimuli

Question 44

What is double simultaneous stimulation?

Answer 44

apply stimuli to one or both sides or the same body location simultaneously, identify between one or two stimuli

Question 45

What is graphesthesia?

Answer 45

identify figures drawn on skin

Question 46

What is barognosis?

Answer 46

identify which object is heavier or lighter

Question 47

What is active control of movement?

Answer 47

ACOM, assessment of motor control ability to execute a motor plan and isolate muscle of muscle groups

Question 48

What are two different types of movement seen in neuro patients?

Answer 48

1. selective or isolated | 2. abnormal synergistic patterns, occurs with attempt to actively move limb

Question 49

What are you looking for during ACOM?

Answer 49

is motion absent? initiated? complete range of motion? AG or GM? isolated? abnormal patterns?

Question 50

When do you use MMT for neuro pts?

Answer 50

if movement is isolated even just a little

Question 51

What is a classic UE flexion synergy pattern?

Answer 51

``` scap retraction and elevation shoulder ABD and ER Elbow flexion forearm supination wrist finger flexion ```

Question 52

What is classic LE flexion synergy pattern?

Answer 52

Hip flex. ABD, ER knee flexion ankle DF, inversion

Question 53

What is classic UE extension pattern?

Answer 53

``` scap protraction shoulder ADD/IR elbow extension forearm pronation wrist finger flexion ```

Question 54

What is classic LE extension pattern?

Answer 54

hip ext, ADD, IR knee extension ankle PF/ INV