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Assessment Flashcards

1
Q

Purpose of the Neurological Examination

A
  1. Determine whether nervous system dysfunction is present
  2. Diagnose disease of the nervous system
  3. Localize disease within the nervous system
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2
Q

Major components of the Neurological Examination

A
  1. LOC
  2. Mental Status
  3. Cognitive Function
  4. Muscle tone, bulk, strenghth
  5. Senory function
  6. Cordination
  7. Reflexes
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3
Q

Questions for the Neurological Cheif Complaint

A
  1. Change in intellect
  2. Onset of memory defecit
  3. Difficulty of concentration
  4. Personality change
  5. Depression
  6. Loss of drive
  7. Headache
  8. Seizure
  9. Dizziness
  10. Vertigo
  11. Diplopia
  12. Tinnitus
  13. Incordination
  14. Weakness
  15. Pareshtesia
  16. Speech Difficulty
  17. Dysphagia
  18. Bladder, bowel, or sexual dysfunction
  19. Sleep Difficulties
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4
Q

MSE: General impression of awareness and mental function

A
  1. Level of Alertness
  2. General Appearance and Behaivor
  3. Mood and emotional state
  4. General Thinking Process
  5. Content of Thought
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5
Q

MSE: Reception and interpretation of sensory stimuli

A
  1. Orientation
  2. Personal ID
  3. Attention
  4. Comprehension
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6
Q

MSE: Higher-Level cognitive function

A
  1. Memory
  2. Calculations
  3. General fund of information
  4. Abstract thinking, reasoning, and judgement
  5. Language and speech
  6. Constructional ability
  7. Motor intergrative function
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7
Q

Mood and Emotional State

A

Abnormal responses include hostility, evasiveness, anger, tearfulness, and depression

Screen for depression if suspected

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8
Q

General Appearance and Behaivor

A
  1. Attire
  2. Hygiene
  3. Posture/Movement
  4. Facial Expression
  5. Affect and Manner
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9
Q

Thinking Process

A
  1. Thought process
  2. Thought content
  3. Perception
  4. Speech
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10
Q

Abnormal Thought Processes

Name 3

A
  1. Circumstantiality
  2. Derailment
  3. Flight of Ideas
  4. Neologisms
  5. Incoherence
  6. Blocking
  7. Confabulation
  8. Perservation
  9. Echolalia
  10. Clanging
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11
Q

What is dysarthria?

A

Disorder of language articulation

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12
Q

Orientation

A
  1. Time
  2. Place
  3. Person
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13
Q

Reception and Interuption of Sensory Stimuli

A
  • Orientation
  • Personal ID
  • Attention
  • Concentration
  • Comprehension
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14
Q

Personal ID

A

Name
Address
Background information

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15
Q

Attention

A

Ability to focus on a single sensory stimulus

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16
Q

Concentration

A

Sustained focus on a sensory stimulus

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17
Q

Attention and Concentration Assessment

A
  1. Number Series
  2. Spelling Backward
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18
Q

Comprehension

A

The ability to understand the meaning of visual, auditory, and other stimuli

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19
Q

Higher-Level Cognitive Functions

A
  • Memory
  • Calculations
  • General Fund of Information
  • Abstract thinking, reasoning, and judgement
  • Language and Speech
  • Constructional ability
  • Motor intergrative function
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20
Q

Memory

A

Ability to register, store, and retrieve information

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21
Q

How is memory commited?

A

Through registration, storage, and retireval of information

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22
Q

Memory is subdivided intp what groups?

A
  • Immediate
  • Short-Term
  • Long-Term
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23
Q

Immmediate Memory testing

A

Choose 3 unrelated words for the patient to recite immediately

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24
Q

Short-term memory testing

A

Ask the patient to retrieve the same 3 words from immediate memory testing 5 minutes later

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25
Q

Long-Term Memory testing

A

When is your date of birth?
Where is your place of birth?
Where di you go to school?
Wheen did you attend school?
Where is your school located?
What do you do for work?
Where do you work?
How long have you worked there?
What is your spouses name?
What is your childrens name?
How old are they?
Whats your mothers maiden name?

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26
Q

Name 3 different types of amnesia

A
  • Retrograde Amnesia
  • Antegrade Amnesia
  • Psychogenic Amnesia
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27
Q

General Fund of Information testing

A

Ask the patient to retireve information related to their location and area of expertise

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28
Q

Abstract Thinking testing

A

Ask the patient to interpret a sentence like “People who live in glass houses should not throw stones”

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29
Q

Similarities testing

A

Ask the patient to find similarities between two words

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30
Q

Reasoning testing

A

Define differences between combinations “mistake” vs “lie” and “sadness” vs “hopelessness”

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31
Q

Judgement

A

Opinion or evaluation of something

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32
Q

Insight

A

Ability to see the inner nature of things

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33
Q

Judgement and Insight testing

A

“What brings you in today?”

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34
Q

Aphasia

A

Disorder of processing language

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35
Q

Apraxia

A

Disorder of motor programming of language symbols

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36
Q

Classifications of Aphasia

A

Brocas Aphasia
Wernickes Aphasia
Global Aphasia
Conduction Aphasia
Anomic Aphasia

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37
Q

Brocas Aphasia

A

Unable to convert thoughts into meaningful language

Normal reception of language is intact

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38
Q

Wernickes Aphasia

A

Fluent unintelligble speech due to impaired pronounciation

Impaired comprehension of language

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39
Q

Constructional Ability testing

A

Ask the patient to draw a figure on command

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40
Q

CN 1 Assessment

Stimuli?

A

Olfactory Nerve

Have the patient smell a common odor

Sensory

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41
Q

Components of the Ophthalmoscope Exam

A
  • Optic Disc
  • Macula Lutea
  • Fovea
  • Diameter of arteries and veins
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41
Q

CN II Assessment

Stimuli?

A

Optic Nerve

Visual Acuity, Visual Fields, Ophthalmoscopic Exam

Senosory

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42
Q

Common abnormal Optic Disc findings

A

Papilledema
Papillitis
Optic Atrophy
Retotubular Neuritis
Optic Neuritis
Cotton wool patches

43
Q

Cranial Nerve III, IV, VI Assessment

Stimuli?

A

Oculomotor, Trochlear, Abducens
1. Position of the eyes
2. EOM
3. Examine the pupils
4. Direct Light reflex
5. Near-Point Reaction

Motor

44
Q

Diplopia

A

Double vision or seeing two seperate images

45
Q

Gaze Palsy

A

Eyes move conjugately but have limited movement in one direction

45
Q

CN V Assessment

Stimuli?

A

Trigeminal Nerve

Light Touch
Pain Perception

Sensory, Motor

46
Q

CN VII

Stimuli?

A

Facial Nerve

  1. Protrude the tounge
  2. Sweet on tip
  3. Sour on sides
  4. Bitter in the back
  5. Smile

Sensory, Motor

47
Q

CN VIII

Stimuli?

A

Acoustic

  1. Whisper
  2. Shout
  3. Weber
  4. Rinne

Sensory

48
Q

CN IX/X

Stimuli?

A

Glossopharyngeal/Vagus

  1. Say “ah”
  2. Assess voice quality

Sensory, Motor

49
Q

CN XI

Stimuli?

A

Spinal Accessory Nerve

  1. Palpate the trazpezius muscle
  2. Turn their head

Motor

50
Q

CN XII

A

Hypoglossal

  1. Open the mouth
  2. Protrude the tounge
  3. Swing tounge from side to wide
51
Q

Upper Extremity Assessment

A
  1. Shoulder Movement
  2. Adduction of Shoulder
  3. Flexion of elbow
  4. Extension of elbow
  5. Pronator Drift
  6. Extension of wrist
  7. Flexion of wrist
  8. Extension of fingers
  9. Flexion of Fingers
  10. Abduction of Fingers
  11. Adduction of fingers
  12. Opposition of thumb
52
Q

Shoulder Movement

Muscle, Spinal Level?

A

Extend your arms and push agaisnt the wall

Seratus anterior; C5, C6, C7

53
Q

Adduction of Shoulder

Muscle, Spinal Level?

A

Flex your elbow and move your upper arm away from your body

Deltoid and Supraspinatus; C5, C6

54
Q

Flexion of Elbow 1

Muscle, Spinal Level?

A

Flex your elbow and make a fist parallel to the ground

Biceps Crachii, C5

55
Q

Flexion of Elbow 2

Muscle, Spinal Level?

A

Flex your elbow and make first parallel to the midline

Brachioradialis, C6

56
Q

Extension of Elbow

Muscle, Spinal Level

A

Push me away with your arm

Triceps brachii, C7, C8

57
Q

Pronator Drift

A

Raise arms and keep them elevated for “x” amount of time

58
Q

Extension of Wrist

Muscle, Spinal Level?

A

Extend your wrist and dont let me straighten it

Extensor carpi readialis longus and ulnaris; C6, C7

59
Q

Flexion of Wrist

Muscle, Spinal Level?

A

Flex your wrist and dont let me straighten it

Flexor carpi radialis and ulnaris; C7, C8

60
Q

Extension of Fingers

Muscle, Spinal Level?

A

Put your fingers straight and dont let me push down

Extensor digitorium communis, extensor indicis proprius, digit minmi. C7

60
Q

Flexion of Fingers

Muscle, Spinal Level?

A

Flex your fingers and dont let me straighten them

Flexor digitorum superficialis, profunder, and lumbricals. C8, T1

61
Q

Abduction of fingers

Muscle, Spinal Level?

A

Put your hand on the table and resist me trying to put them together

Dorsal interossei, Abductor digiti quinti. T1.

62
Q

Adduction of Fingers

Muscle, Spinal Level?

A

Put your hand on the table with the fingers slightly spread. Resist me trying to put them together

Palmar interossi. C8, T1

63
Q

Opposition of thumb

Muscle, Spinal Level?

A

Touch the tip of your little finger with your thumb

Opponen pollicis. C8, T1

64
Q

Lower Extremity Assessment

A
  1. Hip Flexion
  2. Hip Adductors
  3. Hip ABductors, gluteus medius and minimus
  4. Hip extension
  5. Knee extension
  6. Knee flexion
  7. Dorsiflexion of ankle
  8. Plantar flexion of ankle
65
Q

Lower Extremity muscles

A
  1. Iliopsoas
  2. Adductor brevis
  3. Adductor longus
  4. Adductor magnus
  5. Gluteus maximus
  6. Quadriceps
  7. Hamstrings
  8. Tibialis anterior
  9. Peroneus tertius
  10. Extensor digitorum longus
  11. Extensor hallucis longus
  12. Gastrocnemius and soleus
  13. Tibialis posterior
  14. Peroneus longus and brevis
66
Q

Hip Flexion

Muscle, Spinal Level?

A

Flex your thigh agaisnt the resistance provided

Iliopsoas. T12, L1, L2, L3

67
Q

Hip ADductors

Muscle, Spinal Level?

A

Lie on your back, seperate them, and spread them open

A. Brevis, A. Longus, A. Magnus. L2, L3, L4.

68
Q

Hip ABductors, gluteus medius and minimus

Muscle, Spinal Level?

A

Spread both legs against my hands

Gluteus Medius. L4, L5, S1

69
Q

Hip Extension

Muscle, Spinal Level?

A

(Place hands on anterior and posterior thigh)
Push leg down against the bed

Gluteus maximus. L5, S1, S2.

70
Q

Knee Extension

Muscle, Spinal Level?

A

(Place patient in prone position, Examiner places hand on top of lower leg)

Straighten your leg

Quadriceps. L2, L3, L4.

71
Q

Knee Flexion

Muscle, Spinal Level?

A

(Examiner partially flexes knee above the ankle and stabilizes the hip with the other hand)

Flex your knee

Hamstrings. L5, S1, S2

72
Q

Dorsiflexion of Ankle

Muscle, Spinal Level

A

(Place hand on top of foot)
Pull your toes toward your nose

T. Anterior, Peroneus ertius, Extensor digitorum longus, E. hallucis

L4, L5

73
Q

Plantar flexion of ankle

Muscle, Spinal Level

A

(Place hand on ball of foot)
Press down like on the gas pedal

Gastrocnemius, Soleus. S1, S2.

74
Q

Foot Inversion

A

(Place hand on lateral side of foot)
Try to move your foot outward and down

75
Q

Foot Eversion

A

(Place hand on lateral side of foot)
Turn your foot outward

76
Q

Peripheral Nerves

(Name 6)

A

Obturator
Superior gluteal
Inferior gluteal
Femoral
Sciatic
Deep peroneal
Tibial
Superficial peroneal
Long Thoracic
Axillary
Musculocutaneous
Radial
Medial
Ulnar

77
Q

Superficial Sensation Assessment

A
  1. Light Touch
  2. Pain
  3. Temperature
78
Q

Light Touch

A

Use a wisp of cotton to lightly touch around the skin

79
Q

Pain

A

Use a “sharp” object to lightly touch around the skin

79
Q

Temperature

A

Ask the patient to identify hot or cold with a tube of water

80
Q

Deep Sensation Assessment

A

Vibration
Deep pressure pain
Proprioception

81
Q

Vibration

A

128-hz tunig fork is placed on big toe and thumb

82
Q

Deep Pressure pain

A

Achilles tendon and forearm muscles are squeezed

83
Q

Proprioception

A

The thumb and then the large toe is moved up or down

84
Q

Discrimitive Sensation Assessment

A

Two-Point
Point
Recognition of shape and form
Texture
Graphesthesia
Extension Phenomenon

85
Q

Two-point Discrimination

A

Part of the body is pricked with sharp objects to see if two sensations are felt

86
Q

Point Discrimination

A

Patient is asked where the patient was touched

87
Q

Recognition of shape and form

A

Identify objects in their pocket

88
Q

Texture discrimination

A

Diffrentiatate among textures

89
Q

Graphesthesia

A

A letter or number is written on the palm and then the patient is asked to identify the symbol

90
Q

Extension phenomenon

A

Touch the patient on each side simultaneously. Determine if the patient can tell the difference

91
Q

Upper Extremity Cerebellar Assessment

A
  1. Touch your finger to my finger
  2. Pronate and Supinate one hand and then the other
  3. Rapid tap fingers
92
Q

Lower Extremity Cerebellar Assessment

A
  1. Slide heel down the other legs shin while sitting
  2. Draw the number 8 with your foot in the air
93
Q

Balance

A

Rombergs Sign

94
Q

Muscle Stretch Reflexes

A

Biceps
Triceps
Brachioradialis
Patellar
Achilles
Plantar

95
Q

Superficial Reflexes

A

Corneal
Gag
Swallowing
Upper Abdominal
Lower Abdominal
Cremasteric
Bulbocavernosus
Perianal

96
Q

Corneal Reflex

A

Touch cornea lightly with a wisp of cotton

97
Q

Gag Reflex

A

Stimulate the back of the pharynx

98
Q

Swallowing Reflex

A

Stimulate one side of the uvula

99
Q

Upper Abdominals Reflex

A

Stroke the outer abdomen toward the umbilicus

100
Q

Lower Abdominals Reflex

A

Stroke the lower abdomen toward the umbilicus

101
Q

Cremasteric Reflex

A

Lightly stroke the inner aspect of the thigh or lower abdomen

102
Q

Bulbocavernosus Reflex

A

Apply direct pressure over the bulbocavernosus muscle behind the scrotum

103
Q

Perianal Reflex

A

Scratch the tissue at the side of the anus

Clinical One (8 decks)

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