Assessment of Mental Status and Sensation Flashcards
expressive aphasia
difficulty expressing thoughts through words spoken or written, Broca’s area, motor aphasia (anterior)
receptive aphasia
difficulty receiving/understanding language, spoken or written, wernickes area, sensory aphasia (posterior)
global aphasia
both expressive and receptive
signs of touch sense deprivation
kids: inability to perform developmental tasks related to grasping objects or drawing
Adults: clumsiness, overreaction, or underreaction to painful stimulus, pins and needles
signs of smell sensory deprivation
kids: difficulty indiscriminating noxious odors
adults: failure to react to strong odor
signs of taste sense deprivation
kids: inability to tell whether food is salty or sweet
adults: change in appetite and excessive use of seasoning, weight change
stereognosis
the sense that allows a person to recognize the shape, size, and texture of an object
stereognosis testing
ask the patient to close their eyes, place the object in hand, and have them identify; altered function may indicate parietal lobe or sensory nerve tract disfunction
graphesthia
ability to discriminate outlines, number words, or symbols traced on skin, failure may mean parietal lobe lesion
discrimination assessment
testing the ability of the cerebral cortex to interpret and integrate information. (stereognosis and graphesthesia)
GCS
Glasgow coma scale, tests awareness, 8 or below means you are in a coma, measures eye opening, verbal response, and motor response
dermatomes
areas of skin innervated by dorsal root nerves, spinal cord injury would alter function of these areas, uses to assess skin sensation and spinal cord
AOX3
alert and oriented times 3 (can identify person, time and place)
AOX4
alert and oriented times 4 (can identify person, time, place, and situation)
LOC
level of conciousness
LOC- alert
awake and readily aroused
LOC-lethargic
not fully alert, drifts off when not stimulated
LOC-obtunded
sleeps most of the time, difficult to arouse
LOC-stuptor/semi coma
sleepy, limited/minimal response
LOC-coma
completely unconscious
MMSE
mini-mental state exam, pen and paper test if cognitive function, good to detect dementia and delirium; scale of 1-30, 20-30 is normal
Mini-cog
3 word registration, clock drawing, 3 word recall, screen for cognitive impairment in healthy adults
4 types of reflexes
deep tendon reflex (patellar), superficial (corneal), visceral (pupillary response to light), pathological (Babinskis)
deep tendon reflexes
test with reflex hammer and compare bilaterally, there is 5 and we will test patella, graded from 0-5
plantar reflex (babinski)
stroke the lateral aspect of the sole from the heel to the ball of the foot, toes should clench down (Babinski is abnormal and would make toes go up)
factors effecting sensory function
age, meaningful stimuli, amount of stimuli, social interaction, environmental factors, cultural factors
kinesthetic
enables a person to be aware of the position and movement of body parts without seeing them
components of a full neuro assessment
mental and emotional status, intellectual function, cranial nerve function, sensory function, motor function, reflexes
when is a comprehensive mental status exam necessary?
initial screening shows anxiety or depression, behavior changes (memory loss, bad social interaction), brain lesions, aphasia, signs of psychiatric mental illness
delirium
acute confusion, fluctuating, hours-weeks, altered consciousness, increased or decreased psychomotor changes, may accompany acute illness like pneumonia
dementia
insidious onset, progressive, usually clear consciousness, normal attentions until very advanced stage, normal psychomotor changes
depression
acute or insidious onset, chronic course, clear consciousness, decreased attention, slowed psychomotor changed if severe
