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312 Assessment Final > Week 5, Neuro > Flashcards

Week 5, Neuro Flashcards

(92 cards)

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1
Q

Neuro: general assessment categories/major considerations:

A
  • Chief complaint
  • Patient physical condition
  • Pt ability to cooperate with assessment
  • Pt may not be cognitively aware or have ability to communicate condition –> MS assessment can help us here
  • Issues with brain, spinal cord, and nervous system are early signs of changes, disease, and injury
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2
Q

Use ________ method for subjective data/health hx

A

OLDCARTS

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3
Q

What is Dysarthria

A

difficulty speaking

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4
Q

what is dysphagia

A

difficulty swallowing

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5
Q

what is ataxia

A

defective muscular coordination (think alcohol intoxication)

-due to cerebellar dysfunction

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6
Q

Describe Decerebrate Posture:

A

extension posturing, deep tendon reflexes exaggerated.

pronated palms, clenched teeth, more serious than decorticate.

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7
Q

DeCORticate posture

A

Hands come to the CORE. Flexion towards midline

-clenched fists, legs adducted (toes point toward each other)

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8
Q

Memory: Immediate

A

few minutes before

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9
Q

Memory: recent

A

earlier that day

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10
Q

Memory: Remote

A

months or years ago

People lose remote memory LAST.

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11
Q

Paresis

A

partial or complete paralysis= CANNOT MOVE

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12
Q

Paresthesia:

A

Burning or tingling (nerve injury), feels like when your foot falls asleep

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13
Q

Proprioception:

A

Being aware of where we are (proprioceptors)

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14
Q

Clonus:

A

rhythmic, jerky, beat (r/t deep tendon reflex)

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15
Q

Orientation x 4 means

A

Oriented to Person, Place, Time, Situation

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16
Q

Questions for Orientation: Person

A

What’s your name?

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17
Q

Questions for Orientation: Place

A

Where are you?

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18
Q

Questions for Orientation:Time

A

what is the day of the week/month/year/season?

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19
Q

Questions for Orientation: Situation

A

what are you here? What brought you in today?

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20
Q

Speech deficit:

A

adjective that describes level of communication (slurred, delayed)

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21
Q

LOC:

A

Level of consciousness. Includes orientation, but also includes responsiveness

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22
Q

Fully conscious:

A

awake/alert x 4

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23
Q

Lethargy:

A

drowsy but awake, sluggish, needs engagement to stay awake

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24
Q

Obtunded:

A

Difficult to arouse, constantly going back out, needs constant stimulation; confused when awake

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25
Stupor:
Arouses to virorous and continuous stimulation (usually requires pain); won't usually verbalize or follow commands
26
Coma:
No purposeful response to anything you do to them
27
What does MMSE stand for and what does it score?
Mini Mental Status Exam, emotional and cognitive function; low score--> high score
28
What does the MMSE look for?
Appearance, behavior, cognition, and thought processes
29
What does deep tendon reflexes measure?
Reflex arc
30
Name the reflex response scores
``` 0= no response 1+ = diminished, low 2+ = average 3+ = brisker than average, possibly normal 4+ = hyperactive w/ clonus ALWAYS ABNORMAL ```
31
When would we do a Deep Tendon Reflex Assessment?
with spinal cord injuries
32
How do we do a DTR assessment: Triceps
patient's arm should be flexed 90 degrees. Support the arm and strike it just above the elbow, between the epicondyles; the arm should extend at the elbow
33
How do we do a DTR assessment: Biceps
patient's arm should be flexed slightly with the palm facing up. Hold arm with your thumb in the anticubital space over the biceps tendon. Strike your thumb with the hammer; the arm should flex slightly
34
How do we do a DTR assessment: Brachioradialis
patient's arm should be flexed slightly resting on lap with palm facing up. Strike the outer forearm about two inches above the wrist; palm should turn upward as the forearm rotates laterally
35
How do we do a DTR assessment: Patellar
Pt leg should dangle, place hand on one thigh, strike leg just below kneecap; leg should extend at the knee
36
How do we do a DTR assessment: Achilles' tendon reflex
pt foot slight dorsiflexion, lightly strike the back of the ankle, just above the heel. food should plantar flex
37
Babinski sign
outward fanning of the toes is ABNORMAL except in kids under 2
38
What do we look for for cerebellar function?
balance and coordination (gross vs fine movement) - balance test (romberg) - gait? - Coordination and skilled movements (rapid movements, finger to nose, heel to shin test)
39
Romberg test
slight sway - normal (negative) loss of balance- abnormal (positive) -deficit in proprioception or vestibular sense
40
Spinothalmic tract, SENSORY SYSTEM, exxtremities
- pain - temp - light touch
41
Stereognosis
recognize forms by tough w/ eyes closed
42
Graphesthesia
ability to recognize letters or numbers written on palm with eyes closed
43
Glasgow Coma Scale questions
"Can you open your eyes? Can you talk? Can you move?"
44
Glasgow Coma Scale
RAPID ASSESSMENT, record baseline neurologic status. Tracking neurologic change over time.
45
Glasgow Coma Scale Scale
``` Eye opening (4 points) Verbal response (5 points) Best motor response (6 points) higher number, the better score is 3-15 (less than 8 - coma) ```
46
Diabetic foot exam
don't feel pain, don't heal well. examine feet, check pulses, monofilament
47
Musculoskeletal
myalgias (muscle pain, use OLDCARTS)
48
Degenerative diseases:
-Degenerative Joint Disease (DJD)- weight bearing damage to joints -Osteoarthritis- joint inflammation Rheumatoid arthritis- systemic, chronic inflammation, destroys joints
49
Assessment for Musculoskeletal
-Inspect, palpate, move --> ROM--> Strength
50
Passive range of motion
- anchor joint with one hand, use other to move body part | - pain or discomfort? STOP
51
Flexion
decrease angle
52
Extension
increase angle
53
Hyperextension
extension beyond anatomical position
54
Rotation
movement around the central axis, like turning screw left or right (shaking head no)
55
Circumduction
drawing circle with body part
56
ADDuction
ADD toward body
57
Abduction
away from body
58
Protraction
moving anteriorly; jutting jaw forward
59
Retraction
moving posteriorly
60
Inversion
ex. rolling ankle IN
61
Eversion
ex. rolling ankle OUT
62
Supinate
holding soup in your hand (facing up)
63
Pronate
facing down
64
Dorsi-flexion
pull
65
Plantar flexion
point
66
Kyphosis
rounding of upper spine (only expected in older adults)
67
Lordosis
exaggerated inward curvature of lower spine (pregnant ladies, belly juts out)
68
Scoliosis
Lateral curvature of spine
69
Crepitation
rice crispy- snap, crackle, pop (if they have this but no pain, could be normal)
70
Ankylosis
stiffness or fixation of joint
71
Subluxation
partial dislocation
72
Atonic muscle
no tone or movement
73
Flaccididty
weakness
74
Spasticity
sudden muscle contractions-sustained or intermittent
75
Atrophy
wasting
76
hypertrophy
increased muscle mass
77
contracture
shortened muscle
78
Fasciculation
muscle twitch
79
Muscle testing:
``` 0= no contraction 1- can squeeze muscle 2- can move joint with assistance 3- can move joint against GRAVITY (ROM) 4- can move joint against SOME resistance 5- move joint against FULL resistance ```
80
Normal gait
smooth, effortless, contralateral- alternating arms and legs
81
Ataxia gait
uncoordinated, unsteady
82
Shuffling gait
Parkinsons
83
Spastic gait
Cerebral palsy
84
Propulsive gait
bent forward ex. back injury
85
Scissor gait
legs criss cross
86
steppage gait
peripheral neuropathy (DM, testing to see where they step because they can't feel)
87
Waddling
Obese, pregnant
88
Foot: Corn
cone shaped/circular thickened skin
89
Bunion / hallux valgus
bony bump at base of toe from toe pointing towards smaller toes
90
Bursitis
inflammation of synovial sack; leads to limitation of mobility (massive elbows)
91
Hammer toe
abnormal bend in middle joint of toe
92
swan neck
deformity of fingers; rheumatoid arthritis (Lib fingers)

312 Assessment Final (5 decks)

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