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312 Assessment Final > Week 5, Neuro > Flashcards

Week 5, Neuro Flashcards

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
Q

Stupor:

A

Arouses to virorous and continuous stimulation (usually requires pain); won’t usually verbalize or follow commands

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26
Q

Coma:

A

No purposeful response to anything you do to them

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27
Q

What does MMSE stand for and what does it score?

A

Mini Mental Status Exam, emotional and cognitive function; low score–> high score

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28
Q

What does the MMSE look for?

A

Appearance, behavior, cognition, and thought processes

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29
Q

What does deep tendon reflexes measure?

A

Reflex arc

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30
Q

Name the reflex response scores

A 
0= no response
1+ = diminished, low
2+ = average
3+ = brisker than average, possibly normal 
4+ = hyperactive w/ clonus ALWAYS ABNORMAL
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31
Q

When would we do a Deep Tendon Reflex Assessment?

A

with spinal cord injuries

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32
Q

How do we do a DTR assessment: Triceps

A

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

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33
Q

How do we do a DTR assessment: Biceps

A

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

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34
Q

How do we do a DTR assessment: Brachioradialis

A

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

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35
Q

How do we do a DTR assessment: Patellar

A

Pt leg should dangle, place hand on one thigh, strike leg just below kneecap; leg should extend at the knee

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36
Q

How do we do a DTR assessment: Achilles’ tendon reflex

A

pt foot slight dorsiflexion, lightly strike the back of the ankle, just above the heel. food should plantar flex

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37
Q

Babinski sign

A

outward fanning of the toes is ABNORMAL except in kids under 2

38
Q

What do we look for for cerebellar function?

A

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
Q

Romberg test

A

slight sway - normal (negative)
loss of balance- abnormal (positive)
-deficit in proprioception or vestibular sense

40
Q

Spinothalmic tract, SENSORY SYSTEM, exxtremities

A
  • pain
  • temp
  • light touch
41
Q

Stereognosis

A

recognize forms by tough w/ eyes closed

42
Q

Graphesthesia

A

ability to recognize letters or numbers written on palm with eyes closed

43
Q

Glasgow Coma Scale questions

A

“Can you open your eyes? Can you talk? Can you move?”

44
Q

Glasgow Coma Scale

A

RAPID ASSESSMENT, record baseline neurologic status. Tracking neurologic change over time.

45
Q

Glasgow Coma Scale Scale

A 
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
Q

Diabetic foot exam

A

don’t feel pain, don’t heal well. examine feet, check pulses, monofilament

47
Q

Musculoskeletal

A

myalgias (muscle pain, use OLDCARTS)

48
Q

Degenerative diseases:

A

-Degenerative Joint Disease (DJD)- weight bearing damage to joints
-Osteoarthritis- joint inflammation
Rheumatoid arthritis- systemic, chronic inflammation, destroys joints

49
Q

Assessment for Musculoskeletal

A

-Inspect, palpate, move –> ROM–> Strength

50
Q

Passive range of motion

A
  • anchor joint with one hand, use other to move body part

- pain or discomfort? STOP

51
Q

Flexion

A

decrease angle

52
Q

Extension

A

increase angle

53
Q

Hyperextension

A

extension beyond anatomical position

54
Q

Rotation

A

movement around the central axis, like turning screw left or right (shaking head no)

55
Q

Circumduction

A

drawing circle with body part

56
Q

ADDuction

A

ADD toward body

57
Q

Abduction

A

away from body

58
Q

Protraction

A

moving anteriorly; jutting jaw forward

59
Q

Retraction

A

moving posteriorly

60
Q

Inversion

A

ex. rolling ankle IN

61
Q

Eversion

A

ex. rolling ankle OUT

62
Q

Supinate

A

holding soup in your hand (facing up)

63
Q

Pronate

A

facing down

64
Q

Dorsi-flexion

A

pull

65
Q

Plantar flexion

A

point

66
Q

Kyphosis

A

rounding of upper spine (only expected in older adults)

67
Q

Lordosis

A

exaggerated inward curvature of lower spine (pregnant ladies, belly juts out)

68
Q

Scoliosis

A

Lateral curvature of spine

69
Q

Crepitation

A

rice crispy- snap, crackle, pop (if they have this but no pain, could be normal)

70
Q

Ankylosis

A

stiffness or fixation of joint

71
Q

Subluxation

A

partial dislocation

72
Q

Atonic muscle

A

no tone or movement

73
Q

Flaccididty

A

weakness

74
Q

Spasticity

A

sudden muscle contractions-sustained or intermittent

75
Q

Atrophy

A

wasting

76
Q

hypertrophy

A

increased muscle mass

77
Q

contracture

A

shortened muscle

78
Q

Fasciculation

A

muscle twitch

79
Q

Muscle testing:

A 
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
Q

Normal gait

A

smooth, effortless, contralateral- alternating arms and legs

81
Q

Ataxia gait

A

uncoordinated, unsteady

82
Q

Shuffling gait

A

Parkinsons

83
Q

Spastic gait

A

Cerebral palsy

84
Q

Propulsive gait

A

bent forward ex. back injury

85
Q

Scissor gait

A

legs criss cross

86
Q

steppage gait

A

peripheral neuropathy (DM, testing to see where they step because they can’t feel)

87
Q

Waddling

A

Obese, pregnant

88
Q

Foot: Corn

A

cone shaped/circular thickened skin

89
Q

Bunion / hallux valgus

A

bony bump at base of toe from toe pointing towards smaller toes

90
Q

Bursitis

A

inflammation of synovial sack; leads to limitation of mobility (massive elbows)

91
Q

Hammer toe

A

abnormal bend in middle joint of toe

92
Q

swan neck

A

deformity of fingers; rheumatoid arthritis (Lib fingers)

312 Assessment Final (5 decks)

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