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Neuro 1 - Exam 4 > Clinical Manifestations - Lecture 14 > Flashcards

Clinical Manifestations - Lecture 14 Flashcards

1
Q

measures of arousal, cognition and memory

A

orientation

glasgow coma scale

rancho los amigos level of cognitive fxning scale

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2
Q

testing orientation

A

A+O *4

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3
Q

A+O*4

A

alert and oriented

self

location

date

situational awareness

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4
Q

glasgow coma scale (GCS)

A

defines severity of TBI w/in 48-72 hrs

simple, reliable, correlates well with outcomes

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5
Q

what can the outcome of a pt be associated w/

A

best response in their first 24 hrs after injury

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6
Q

grading

A

GCS 3-8

GCS 9-12

GCS 13-15

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7
Q

GCS 3-8

A

severe injury

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8
Q

GCS 9-12

A

moderate injury

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9
Q

GCS 13-15

A

minor injury

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10
Q

what is the critical score

A

8

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11
Q

GCS score 8

A

90% of pts less than or equal to 8 are in a coma

50% die at 6 hrs

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12
Q

pts with greater than or equal to 9

A

typically not in a coma

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13
Q

pts with higher levels

A

better outcomes at 6 hrs

eye opening = 1 in 5 chance of good recovery

w/o eye opening = 1 in 10 chance

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14
Q

no motor response

A

3% chance of good recovery

show flexion = better than 15% chance

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15
Q

no noise

A

8% chance of recovery

groan = 30% chance

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16
Q

GCS =

A

highest score for correct prediction of outcome

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17
Q

Rancho los amigos scale

A

defines the severity of deficit in cognitive fxning

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18
Q

how many levels does ranchos los amigos have

A

10

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19
Q

level 1

A

no response

total assistance

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20
Q

level 1 details

A

complete absence of observable change in behavior when presented visual, auditory, tactile, proprioceptive, vestibular or painful stimuli

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21
Q

level 2

A

generalized response

total assistance

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22
Q

level 2 response to painful stimulus

A

generalized reflex response

inconsistent and non-purposeful

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23
Q

responses may be –> level 2

A

the same regardless of type and location of stimuli

significantly delayed

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24
Q

level 3

A

localized response

total assistance

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25
level 3 details
localized withdrawal or vocalization (inconsistently) to stimuli (pain, simple commands)
26
level 4
confused/agitated maximal assist
27
level 4 --> state of activity
alert and heightened
28
what does a level 4 pt exhibit
agitation and aggressive behavior mood swings
29
attention span of a lvl 4 pt
brief
30
short term memory of a lvl 4 pt
absent
31
level 4 pts also have
confabulation confused, with incoherent/inappropriate verbalizations
32
level 5
confused, inappropriate non-agitated maximal assist
33
level 5 pts are
alert and confused but not oriented
34
what do level 5 pts respond to
simple commands fairly consistently
35
when may level 5 pts become agitated
in response to external stimulation or lack of structure
36
attention of a lvl 5 pt
gross attention to environment highly distractible
37
memory of a lvl 5 pt
severely impaired recent memory
38
other details of a level 5 pt
absent goal-directed, problem solving, self-monitoring behavior inappropriate use of objects unable to learn new info
39
level 6
confused, appropriate mod assist
40
level 6 orientation
inconsistently oriented consistently follows simple commands
41
what can level 6 pts do
attend to highly familiar tasks in non-distracting environment for 30 min with moderate redirection
42
level 6 behavior
goal directed but depending on external direction
43
level 6 pts carry over
relearned tasks but not new tasks
44
what do level 6 pts use
assistive memory aide with max assist
45
level 6 pts verbal expressions
appropriate in highly familiar and structured situations
46
level 7
automatic, appropriate min assist
47
how are level 7 pts oriented
consistently except to time
48
what do level 7 pts attend to
highly familiar tasks for over 30 min w/ min assist to complete tasks
49
level 7 supervision
minimal carryover of new learning minimal supervision for safety in routine activities
50
level 7 recall
shallow superficial awareness of his/her condition
51
what are level 7 pts unable to do
think about consequences of a decision or action they overestimate their abilities unable to recognize inappropriate social interaction behavior
52
what are level 7 pts unaware of
others needs and feelings
53
level 8
purposeful, appropriate stand by assist
54
level 8 pts are consistently
A&O*3 1 hour attention in distracting environments
55
level 8 pts can complete
familiar routines with stand-by assist
56
level 8 pts can also
recall and integrate past/recent events carryover of new learning
57
level 8 pts use
assistive memory devices with stand by assist
58
level 8 pts require no
assistance once new tasks or activities are learned
59
level 8 pts are aware of
impairments but require stand by assist to correct
60
what do level 8 pts think about
consequences of a decision with min assist
61
level 8 pts acknowledge
others needs/feelings and response appropriately with min assist
62
what do level 8 pts recognize
inappropriate social interaction and corrects w/ min assist
63
level 9
purposeful, appropriate stand by assist on request
64
level 9 pts are able to
shift attn and sustain it for more than 2 consecutive hours
65
level 9 pts are aware of
impairments and takes appropriate corrective action requires standby by assist to anticipate a problem before it occurs and takes action to avoid it
66
level 9 thinks about
consequences of decisions w/ assist when requested
67
what can lvl 9 pts accurately estimate
abilities but requires stand-by assist to adjust to task demands
68
level 9 pts acnkowledge
others needs and feelings responds appropriately with stand-by assist
69
what may continue in level 9
depression and irritability/ low frustration
70
level 9 self monitors
appropriateness of social interaction with stand-by assist
71
level 10
purposeful, appropriate mod 1
72
what can lvl 10 pts handle
multiple tasks simultaneously
73
level 10 pts can independently
create/maintain own assistive memory devices complete familiar and unfamiliar tasks --> but may require extra time and/or compensator strategies
74
what do lvl 10 pts anticipate
impact of impairments and avoid problems before they occur may require extra time and or compensatory strategies
75
what do lvl 10 pts independently think about
consequences of decisions --> may require extra time and or compensatory strategies to select appropriate action
76
level 10 pts may have
periodic depression and irritability when sick, fatigue and or under emotional stress
77
level 10 social interaction
consistently appropriate

Neuro 1 - Exam 4 (12 decks)

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