Week 4: Mental Status/Neurological Assessment Flashcards

(141 cards)

1
Q

Mental Status Definition: Abstract Reasoning

A

Represents as person’s ability to solve problems, identify patterns, and work with logical systems.

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2
Q

Mental Status Definition: Affect

A

The displaying of emotions

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3
Q

Mental Status Definition: Appearance

A

Overall visual appearance including how they are dressed, their body movements and posture, their facial expressions, and their overall hygiene

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4
Q

Mental Status Definition: Attention

A

Notice take of someone or something, giving focus to something in particular

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5
Q

Mental Status Definition: Behaviour

A

The way one acts or conducts themselves

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6
Q

Mental Status Definition: Cognition

A

Level of thinking and understanding through thought, experience, and senses

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7
Q

Mental Status Definition: Consciousness

A

The state of being awake and aware of one’s surroundings

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8
Q

Mental Status Definition: Judgement

A

The ability to make considered decisions or come to sensible conclusions

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9
Q

Mental Status Definition: Memory

A

The ability to recall events that have occurred/are going to happen or recall information from various time frames (immediate, recent/24 hours, remote)

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10
Q

Mental Status Definition: Mood

A

The displaying of various emotions/feelings often influenced by events or surrounding environment

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11
Q

Mental Status Definition: Orientation

A

Knowing the relative position of something or someone, direction or physical position

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12
Q

Mental Status Definition: Perception

A

The ability to see, hear, or become aware of something through senses

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13
Q

Mental Status Definition: Thinking

A

The process of using one’s mind to consider or reason about something

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14
Q

Mental Status Definition: Thought Process

A

The accepting, processing, and analyzing of information and thoughts

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15
Q

Neurological Assessment Definition: Aphasia

A

A language disorder that affects how you communicate

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16
Q

Mental Status Definition: Ataxia

A

Poor muscle control that causes clumsy movements, balance, walking, hand coordination, speech, and swallowing.

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17
Q

Mental Status Definition: Atrophy

A

The partial or complete shrinking of a body part, organ, cell, or tissue

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18
Q

Mental Status Definition: Dysarthria

A

Difficulty forming words/slurred or slow speech

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19
Q

Mental Status Definition: Dysphagia

A

Difficulty swallowing

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20
Q

Mental Status Definition: Glascow Coma Scale

A

The scale used to describe the extent of impaired consciousness in all types of acute medical and trauma patients, ranging 3 -15, 3 being unconscious, and 15 being fully awake

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21
Q

Mental Status Definition: Muscle Paresis

A

A condition in which muscle movement has become weakened or impaired

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22
Q

Mental Status Definition: Neurological Recheck Canadian Neurological Scale

A

A simple and validated score to assess stroke severity

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23
Q

Mental Status Definition: Nystagmus

A

Back-and-forth oscillation of the eyes

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24
Q

Mental Status Definition: Paraestheia

A

Abnormal sensation such as tingling, burning

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25
Mental Status Definition: Paralysis
Loss of motor function as a result of a lesion
26
Mental Status Definition: Paresis
Partial loss of muscle control or weakness in voluntary movement
27
Mental Status Definition: Ptosis
The drooping of the upper eyelid
28
Mental Status Definition: Romberg Sign
A physical exam that assesses a patient’s balance and proprioception or sense of body position and movement
29
Mental Status Definition: Seizures
A burst of uncontrolled electrical activity between brain cells (neurons/nerve cells) that causes temporary abnormalities in muscle tone/movements (stiffness, twitching, or limpness), behaviours, sensations, or states of awareness
30
Mental Status Definition: Strabismus
A condition in which your eyes don’t line up with one another
31
Mental Status Definition: Syncope
Fainting (lack of cerebral blood flow)
32
Mental Status Definition: Tone
The amount of tension in a muscle at rest or how much a muscle resists stretching; complex system involving the brain, spinal cord, and muscles
33
Mental Status Definition: Tremor
A neurological condition that causes shaking or trembling in the body
34
Mental Status Definition: Vertigo
A type of dizziness that can be caused by issues in the inner ear or brain
35
What are the 2 forms of Vertigo?
Subjective and Objective
36
Mental Status Definition: Subjective Vertigo
Feels as though self is spinning
37
Mental Status Definition: Objective Vertigo
Feels as though the room is spinning
38
What are the 4 domains included in the mental status assessment used to observe and describe a person's current state of mind?
Appearance Behaviour Cognition Thought processes and perception
39
What is Mental Status?
A person's emotional and cognitive functioning
40
What do you ask for during a Mental Health Assessment regarding a health history?
- Biographical information - Reason for seeking care - Past health (ex. “Have you ever experienced or witnessed anything that threatened your life or safety or the life and safety of a loved one?") - Chronic illness (may contribute to mental health) - Family Health History (genetics) - Current Health
41
When do you do a Mental Status Exam?
- General survey, intuition, noticing something is ‘not quite right’. - Subjective assessment (patient shares a change or concern with cognition or mood). - Changes that you or the family notices in mood, behaviour, or speech. Brain lesions (ex. from trauma, seizure or stroke).
42
Which of the following should be tested first in an assessment of mental status? a) Behaviour b) Consciousness c) Judgement d) Language
b) Consciousness
43
What sections are included in a Mental Status Exam?
ABCT Appearance Behaviour Cognition Thought processes and perception
44
What falls under Appearance?
- Posture - Body movements - Dress - Grooming and Hygiene
45
What falls under Behaviour?
- Level of consciousness - Facial expressions - Speech - Mood and Affect
46
What falls under Cognition?
- Orientation (person, place, time) - Gnosis (common objects and uses) - Attention span (completion of thoughts, distractibility) - Immediate recall (recall what you just said) - Recent memory (recall last 24 hours) - Remote memory (recall events/the past) - New learning (4 unrelated words test)
47
What is Immediate Recall?
Repeating what you just said or recalling what just happened
48
What is Recent Memory?
Recalling what just happened in the last 24 hours
49
What is Remote Memory?
Recalling a specific moment or historical event
50
What are the steps of the Glasgow Coma Scale?
Check Observe Stimulate Rate
50
51
What is the 4 new words test?
Telling the patient 4 unrelated words and having them recall and repeat them back to you.
52
What are Thought Processes?
Complete thoughts that are logical, coherent and relevant
53
What are some abnormalities in Thought Processes?
- Blocking related to emotion (e.g. “I forgot what I was going to say). - Confabulation (fabricating events to fill memory gaps). - Loose associations or flight of ideas (switching from one topic to another). - Circumstantiality (excessive detail).
54
What is Thought Content?
“Is what they say consistent and logical?”
55
What are some abnormalities in Thought Content?
- Phobias - Hyperchondria - Obsession (e.g. violence or contamination) - Compulsion (e.g. counting, handwashing, checking and rechecking)
56
What are Perceptions?
Is the patient aware of reality? Is the patient’s perceptions consistent with yours? Does the patient have any hallucinations?
57
What is the Neurological System made up of?
Central Nervous System (CNS) and the Peripheral Nervous System (PNS)
58
What makes up the CNS?
The brain and spinal cord
59
What makes up the PNS?
12 pairs of cranial nerves 31 pairs of spinal nerves and their branches
60
What does the PNS do?
Carries sensory (afferent) messages to the central nervous system (CNS).
61
What are Afferent messages?
Messages being carried to the brain
62
What does the CNS do?
Send messages out to the muscles and glands, and autonomic messages that direct the internal organs and blood vessels
63
What are Efferent messages?
Messages being carried from the brain to the muscles/body
64
What protects the CNS?
The 3 meninges (dura mater, arachnoid mater, pia mater) and cerebral spinal fluid (CSF)
65
What are the 3 meninges?
Dura mater Arachnoid mater Pia mater
66
hat lobe is responsible for personality, behaviour, emotion and intellectual functions?
Frontal lobe
67
What lobe is responsible for hearing, taste, and smell?
Temporal lobe
68
What lobe is responsible for visual reception?
Occipital lobe
69
What lobe is responsible primarily for sensation?
Parietal lobe
70
If someone has RECEPTIVE aphasia, what does it mean?
They can hear sound but it has no meaning, like a foreign language
71
With RECEPTIVE aphasia there is a problem with what area?
Wernicke's Area
72
If someone has EXPRESSIVE aphasia, what does it mean?
Person can understand, hear, and knows what they want to say but can’t speak (only garbled response)
73
With EXPRESSIVE aphasia, there is a problem with what area?
Broca's Area
74
What 3 vital signs are the Hypothalamus responsible for?
Heart Rate (HR) Temperature (T) Blood Pressure (BP)
75
What is responsible for motor coordination, equilibrium and muscle tone?
Cerebellum
76
What are the 3 areas of the brainstem (nerve fibres)?
Midbrain Pons Medulla
77
Which cranial nerve is responsible for talking and swallowing?
Vagus nerve (X)
78
Which cranial nerve is responsible for hearing and equilibrium?
Acoustic (VIII)
79
In a Neurological Assessment, what do we want to include in a screening assessment?
1. Subjective assessment 2. LOC/orientation (cognition) 3. Cranial nerves 4. Brief motor inspection 5. Cerebellum: balance, coordination, skilled movement 6. Canadian Neurological Assessment (specific to stroke)
80
What is Syncope?
Fainting (lack of cerebral blood flow)
81
What is Dysphagia?
Difficulty swallowing
82
What is Paraesthesia?
Abnormal sensation such as tingling, burning
83
What is Paralysis?
Loss of motor function as a result of a lesion
84
What is Subjective Vertigo?
Feels as though self is spinning
85
What is Nystagmus?
Back-and-forth oscillation of the eyes.
86
What is Objective Vertigo?
Feels as though the room is spinning
87
What is Paresis?
Partial loss of muscle control or weakness in voluntary movement
88
What is Dysarthria?
Difficulty forming words/slurred or slow speech
89
What is Postictal State?
Period following a seizure
90
What is Dysphasia?
Difficulty with language comprehension and/or expression
91
What is Aura?
Sensation that comes before a seizure
92
What is Neurogenic Anosmia?
Neurologically cause loss of smell
93
What is Dysmetria?
Lack of coordination of movements
94
What is the acronym for the 12 cranial nerves?
OOOTTAFVGVAH On Occasion Our Trusty Truck Acts Funny Very Good Vehicle Any How
95
What is the acronym for the FUNCTION of the 12 cranial nerves?
S = Sensory M = Motor B = Both OOOTTAFVGVAH SSMBMBSBBMM Some Say Marry Money But My Brother Says Big Brains Matter More
96
What is Cranial Nerve (I)?
Olfactory
97
What is Cranial Nerve (II)?
Optic
98
What is Cranial Nerve (III, IV, & VI)?
Oclulomotor Trochlear Abducens
99
What is Cranial Nerve (V)?
Trigeminal
100
What is Cranial Nerve (VII)?
Facial
101
What is Cranial Nerve (VIII)?
Acoustic (vestibulocochlear)
102
What is Cranial Nerve (IX & X)?
Glossopharyngeal Vagus
103
What is Cranial Nerve (XI)?
Spinal accessory
104
What is Cranial Nerve (XII)?
Hypoglossal
105
How do you test Cranial Nerve: Olfactory (I)?
- Use familiar smells on both sides of nose
106
How do you test Cranial Nerve: Optic (II)?
- Test visual acuity and test visual fields - Can use Snellen Eye Chart - Recognition of objects - Confrontation Test- to test peripheral visual fields
107
How do you test Cranial Nerves: Oculomotor (III), Trochlear (IV), & Abducens (VI)?
- Check pupils for size, equality, consensual light reaction and accommodation - Assess extra ocular movements (changing positions of gaze) ex. Follow my finger - 6 Cardinal positions of gaze – client holds head still and follows an object such as finger or pen through several directions (ie. H pattern)
108
How do you test Cranial Nerve: Trigeminal Nerve (V)?
- Palpate muscles of mastication (temporal and mastoid muscles) - Lightly touch patients face (sensation in face to light touch in three branches- forehead, cheeks and jaw). “Say Now” - Push down on chin, try to separate jaws
109
How do you test Cranial Nerve: Facial Nerve (VII)?
- Ask them to smile, frown, note symmetry - Ask to show teeth, puff cheeks - Ask to clench teeth
110
How do you test Cranial Nerve: Acoustic Nerve (VIII)?
Whispered voice or quiet noise (whisper 2-syllable words behind the patient)
111
How do you test Cranial Nerves: Glossopharyngeal (IX) & Vagus Nerves (X)?
- Use tongue depressor and note pharyngeal movement as patient says "ahh“ - Observes talking and swallowing
112
How do you test Cranial Nerve: Spinal Accessory Nerve (XI)?
- Examine sternomastoid and trapezius muscles, apply resistance when rotating head - Ask patient to shrug shoulders against resistance
113
How do you test Cranial Nerve: Hypoglossal Nerve (XII)?
- Inspect the tongue - Ask the patient to say "light, tight, dynamite"
114
How do you test the Cerebellar Function?
- Balance tests such as gait, Tandem walking, Romberg test, and Shallow Knee bend. - Coordination and skilled movements such as rapid alternating movements, finger-finger, finger-nose, heel-shin tests.
114
How do you test the Motor System?
Inspect and palpate muscles for size, strength, tone, and involuntary movements
115
How do you test Gait?
Observe as patient walks 3 to 6m and turns and returns to starting point
116
What is Tandem walking?
Walk a straight line in a heel-to-toe manner
117
What would be abnormal findings in Gait?
Stiffness, ataxia (unsteadiness), lack of arm swing, unequal rhythm, wide base of support
118
What is the Romberg Test?
Ask patient to stand up with feet together and arms at sides and ask pt to close eyes and hold the position (20-30 sec)
119
Canadian Neurological Scale: What is included in Mentation?
LOC Orientation Speech
120
Canadian Neurological Scale: What is included in Motor Functions for Weakness?
*Weakness Face Arms (proximal and distal) Legs (proximal and distal)
121
Canadian Neurological Scale: What is included in Motor Function for Response?
*Response Face Arms Legs
122
What are the three neurological functions assessed by the Glasgow coma scale?
Eye response Best motor response Best verbal response
123
What is the scaling of the Glasgow Coma Scale?
3 (severe brain injury) to 15 (normal brain activity)
124
At what score on the Glasgow Coma Scale do you intubate?
Score of 8 "If its 8, intubate"
125
The Glasgow Coma Scale (GCS) measures the level of consciousness in clients who are at high risk for rapid deterioration of the nervous system. A score of 13 indicates: a) Deep coma b) Severe impairment c) No verbal response d) Mild impairment
d) Mild impairment
126
What does PERRLA stand for?
Pupils Equal Round Reactive Light Accommodation
127
What does Pupils mean in PERRLA?
Control how much light enters the eye by shrinking and widening.
128
What does Equal mean in PERRLA?
Same size, shape
129
What does Round mean in PERRLA?
Look for unusual shape or borders
130
What does Reactive mean in PERRLA?
Direct and consensual
131
What does Light Accommodation mean in PERRLA?
Eyes adjust according to distance of object
132
True or False: Increased Intracranial Pressure (IICP) presents with symptoms opposite to shock.
True
133
What are signs of IICP?
Increased BP Decreased HR Decreased RR ** Also known as the Cushings Triad
134
What are the signs of Shock?
Decreased BP Increased HR Increased RR
135
What is the Trigeminal Nerve (V) responsible for in infants?
Rooting, sucking reflex
136
What is the Facial Nerve (VII) responsible for in infants?
Wrinkling forehead when crying
137
What is the Acoustic Nerve (VIII) responsible for in infants?
Eyes follow direction of sound
138
What is the Glossopharyngeal & Vagus Nerves (IV & X) responsible for in infants?
Infant's nose pinched, mouth opens, tongue rises in midline
139
What is the Hypoglossal Nerve (XII) responsible for in infants?
Gag reflex