Chapter 7 neurological system tables/charts Flashcards
CVA Hemispheric specialization: Left hemisphere (7 bullet points)
CVA Hemispheric specialization: Left hemisphere -Right side of body: movement, sensory processing, visual reception -visual-verbal processing -bilateral motor praxis -verbal memory -bilateral auditory reception -speech -processing of verbal auditory information
CVA Hemispheric specialization: Right hemisphere (9 bullet points)
CVA Hemispheric specialization: Right hemisphere -Left side of body: movement, sensory processing, visual reception -visual-spatial processing -left motor praxis -nonverbal memory -attention to incoming stimuli -emotional lability -processing of nonverbal auditory information -interpretation of abstract information -interpretation of tonal inflection
Glasgow Coma Scale:
- rates
- scale ranges from
Glasgow Coma Scale:
- rates eye movement, verbal response, and motor response.
- scale ranges from 3 (deep coma/death) to 15 (fully awake).
Glasgow Coma scale: Best eye response 4. 3. 2. 1.
Glasgow Coma scale: Best eye response 4. eyes open spontaneously 3. eyes open to speech 2. eyes open in response to pain 1. no eye opening
Glasgow Coma Scale: Best verbal response 5. 4. 3. 2. 1.
Glasgow Coma Scale:
Best verbal response
5. Oriented (responds coherently and appropriately to questions like name, age, where they are and why, year, month etc)
4. Confused (responds to questions coherently but some disorientation/confusion)
3. Inappropriate words (random or exclamatory, speech but no conversational exchange)
2. Incomprehensible sounds (moaning, no words)
1. None
Glasgow Coma Scale: Best motor response 6. 5. 4. 3. 2. 1.
Glasgow Coma Scale:
Best motor response
6. obeys commands (does simple things when asked)
5. Localizes to pain (purposeful movements towards changing painful stimuli)
4. Withdraws from pain (pulls part of body away when pinched)
3. Flexion in response to pain (decorticate response)
2. Extension in response to pain (Decerebrate response)
1. No motor response
Ranchos Los Amigos Levels of Cognitive Functioning Scale:
Level 1
Ranchos Los Amigos Levels of Cognitive Functioning Scale:
Level 1- No response : total assist
*complete absence of behavior changes when presented with stimulus
Ranchos Los Amigos Levels of Cognitive Functioning Scale:
Level 2
Ranchos Los Amigos Levels of Cognitive Functioning Scale:
Level 2- generalized response: Total assist
*generalized reflex response to pain
*responds to repeated auditory stimulus with increased/decreased activity
*responds to external stimuli with physiologic changes, gross body movements and/ or non purposeful vocalization.
*responses may be same regardless of stimulus and may be delayed.
Ranchos Los Amigos Levels of Cognitive Functioning Scale:
Level 3
Ranchos Los Amigos Levels of Cognitive Functioning Scale:
Level 3- localized response: total assist
*withdraw or vocalization response to pain
*turn towards/away auditory stimuli
*blinks when looking at strong light
*follows moving objects in visual field
*responds to discomfort by pulling tubes/restraints
*inconsistent response to simple commands
*responses relate to type of stimuli
* may respond to some people but not others
Ranchos Los Amigos Levels of Cognitive Functioning Scale:
Level 4
Ranchos Los Amigos Levels of Cognitive Functioning Scale:
Level 4- Confused/Agitated: max assist
*alert and heightened state of activity
*attempts to remove restraints/tubes, get out of bed
*non purposeful movement like sitting/ reaching/ walking, but not when asked by someone else.
*brief and non-purposeful moments of sustained alternatives and divided attention
*absent Short term memory
* may cry out or scream out of porportion to stimulus even after removed
*may have aggressive or flight behavior
*mood swings from euphoric to hostile for no apparent reason
*unable to cooperate with treatment efforts
*verbalizations are frequently incoherent and/or inappropriate to activity/environment
Ranchos Los Amigos Levels of Cognitive Functioning Scale: Level 5 *level of alertness/orientation *agitation *behaviors *attention *memory *performance/ *Conversation
Ranchos Los Amigos Levels of Cognitive Functioning Scale:
Level 5- confused, inappropriate, non agitated: max assist
*alert, not oriented to person/place/time
*non agitated. may become agitated in response to external stimulation or lack of environmental structure.
*May wander with vague intention of going home. absent goal directed, problem solving, self-monitoring behavior.
*frequent, brief, non-purposeful sustained attention
*severely impaired recent memory, confusion of past/present when reacting to ongoing activity
*inappropriate use of objects without external directions. may be able to perform previously learned tasks when structured and cues provided. unable to learn new information. able to respond appropriately to simple commands fairly consistently with structure and cues. without structure responses are random and non purposeful.
*able to converse on social, automatic level for brief periods of time when provided external structure and cues. verbalizations about present events are inappropriate and confabulatory when external structure and cues are not provided
Ranchos Los Amigos Levels of Cognitive Functioning Scale: Level 6 *Orientation *awareness *Attention *memory *problem solving *learning *following directions *verbal/social skills
Ranchos Los Amigos Levels of Cognitive Functioning Scale:
Level 6- Confused appropriate: Moderate assistance
*Inconsistently oriented to person/time/place. *emerging awareness of appropriate response to self, family and basic needs. Unaware of impairments, disabilities, and safety needs.
*able to attend to highly familiar tasks in non distracting environment for 30 minutes with moderate redirection.
*remote memory has more depth/detail than recent memory. Vaguely recognize some staff. Uses assistive memory aide with max assist
*mod assist to problem solve barriers to task completion.
*supervised for old learning and carryover for relearned familiar tasks (selfcare). Max assist for new learning with little to no carryover.
*consistently follows simple directions
*verbal expressions are appropriate in highly familiar and structured situations.
Ranchos Los Amigos Levels of Cognitive Functioning Scale: Level 7 Orientation: Awareness: Attention: Learning: Routines: Memory: psychosocial:
Ranchos Los Amigos Levels of Cognitive Functioning Scale: Level 7 Automatic, appropriate: min assist for ADLs
*Orientation: consistent to person and place in familiar environments, Mod assist for orientation to time.
Awareness: superficial awareness of condition but unaware of specific impairments and disabilities or the limitations they place on their ability to safely accurately and complete and carry out household, leisure, community, and work ADL. unrealistic planning for future, unable to think about consequences. over estimates their abilities
*Attention: highly familiar tasks, non distracting environment for at least 30 minutes with min assist for completion.
*Learning: min supervision and demonstrates carryover for new learning.
Routines: initiates and carryout steps of familiar personal/household routine. Can monitor accuracy and completeness of each step in a personal household ADL routine, and can modify plan with min assistance. minimal supervision for safety in household and community routines.
Memory: shallow recall of what they have been doing
psychosocial: unaware of others feelings/needs, oppositional and uncooperative, unable to recognize inappropriate social interaction behavior.
Ranchos Los Amigos Levels of Cognitive Functioning Scale: Level 8 Orientation: Memory: Awareness: Routines: Learning: social: Behavior:
Ranchos Los Amigos Levels of Cognitive Functioning Scale: Level 8- Purposeful, appropriate: Stand by Assist.
- Orientation: consistently orientated to person/place/time.
- Memory: able to recall and integrate past and recent events. uses assistive memory device with SBA
- attention: independently attends and completes familiar tasks for one hour in a distracting environment.
- Awareness: aware of and acknowledges impairment/disability when they interfere with task completion but requires SBA to take appropriate corrective action. thinks about consequences of a decision or action with min assist. over/underestimates abilities
- Routines: initiates and carries out steps to complete familiar personal/household/community/work/leisure routines with SBA. min assist to modify plan when needed
- Learning: no assist once new task/activities are learned
- social: acknowledges others needs/feelings and responds appropriately with min assist. can recognize and acknowledge inappropriate social interaction behavior while it is occurring and take corrective action with min assist
- Behavior: depressed, irritable, low frustration tolerance, easily angered, argumentative, self-centered, uncharacteristically dependent/independent
Ranchos Los Amigos Levels of Cognitive Functioning Scale: Level 9 Attention Memory routines Awareness/problem solving
Ranchos Los Amigos Levels of Cognitive Functioning Scale: Level 9- Purposeful appropriate: SBA on request
*attention: Shifts back and forth between tasks and completes accurately for at least 2 hours
*Memory: uses assisted memory devices with assistance when requested.
*routines: initiates and carries out steps to complete familiar personal/household/work/leisure tasks independently and unfamiliar tasks with assistance when requested.
*Awareness/problem solving: aware and acknowledges impairments/disabilities when interfere with tasks completion and takes appropriate corrective action but requires SBA to anticipate problem before it occurs and take action to avoid it. accurately estimates own abilities but requires SBA to adjust to task demands. thinks about consequences of decisions or actions with assistance when requested.
Social: acknowledges others needs/feelings/ and responds appropriately with SBA. Able to self monitor appropriateness of social interaction with SBA.
Behavior: may be depressed, easily irritable, or have low frustration tolerance.
Ranchos Los Amigos Levels of Cognitive Functioning Scale: Level 10 Attention to task Memory Awareness social behavior
Ranchos Los Amigos Levels of Cognitive Functioning Scale: Level 10- Purposeful, appropriate: modified independent.
*Attention to task: able to handle multiple tasks simultaneously in all environments but may require periodic breaks. independently initiates and carries out steps to familiar and unfamiliar personal/household/community/work/leisure tasks but may require extended time/compensatory strategies.
*Memory: able to independently procure, create, and maintain own assistive memory devices
*Awareness: anticipates impact of disability/impairment on ability to complete ADLs and takes action to avoid problems before they occur but may require extended time and compensatory strategies. Able to independently think about consequences but may require extended time/compensation. accurately estimates abilities and adjusts to task demands.
Social: able to recognize others needs/feelings and automatically respond in appropriate manner. social interaction behavior is consistently appropriate
Behavior: periodic depression may occur, irritability and low frustration tolerance when sick, fatigued, and/or under emotional stress.
ASIA Impairment scale: Measures degree of impairment and severity following a spinal cord injury. A. B. C. D. E.
ASIA Impairment scale:
A. complete, no sensory or motor function preserved in the sacral segments (S4-S5)
B. incomplete, sensory but no motor function preserved below the neurological level and extends through sacral segments
C. Incomplete, motor function is preserved below the neurological level and the majority of key mm groups below the neurological level have a mm grade less than 3/5
D. Incomplete, motor function is preserved below the neurological level and majority of key mm groups below the level have a mm grade greater than or equal to 3/5
E. sensory and motor function are normal
Parkinson's disease stages diagnosed using Hoehn and Yahr's five-stage scale 1. 2. 3. 4. 5.
Stage 1= unilateral tremor, rigidity, akinesia, min or no functional impact
Stage 2= bilateral tremor, rigidity or akinesia, with or without axial signs, independent with ADL, no balance impairment
Stage 3= worsening symptoms, first signs of impaired righting reflexes, onset of disability in ADL performance, can lead independent life
Stage 4= requires help with some or all ADL, unable to live alone without some assistance, able to walk and stand unaided.
Stage 5= confined to wheelchair or bed, max assist
