CNS- 10?s Flashcards
What are the components of the mental status exam
appearance and behavior mood/affect speech/language thoughts/perceptions cognitive/executive function
what can cause changes in the level of consciousness
disease of brainstem reticular activating system
damage both parts hemisphere
what is a stuporous level of consciousness
fallsing asleep unless vigorously stimulated
what is a comatose level of consciousness
sleep like state from which the patient cannot be awakend
Appearance and behavior includes a General assessment of what
posture, motor activity
hygiene
What can explain affect of depression, fatigue, insomnia, concentration
drugs, ETOH, Meds, Steroids, Endocrine
what can cause anxiety
palpitations, tremors, dry mouth, ETOH withdrawal, hyperthyroid, breathless, numbness
Clinical exam of language includes what
assessment of spontaneous speech, naming, comprehension, repetition, reading, writing
What is Aphasia
disorder in producing or understanding language (spoken or written)
when evaluating spontaneous speech what do you look for
articulation
verbal fluency
what is paraphasia
substituting similar sounding syllables or words
what are paraphasic errors
pen for pencil
plentil for pencil
what is prosody
the melody of speech
How do you test for aphasia
naming, comprehension, repetition, reading and writing
What is anomia
loss of ability to name common objects
what is an example of comprehension of language
say point to nose, and then patient does it
What is dysphasia
impairment in use of speech that is clear.
failure to arrange properly in sentence
What is dysarthria
imperfect articulation due to lack of motor coordination
damaging event CNS or PNS
language comprehension may be fine
What causes aphasia
localized lesion of dominant hemisphere of the brain
What is clinically important about aphasia
only sign of new neurological disease, stroke, tumor or head trauma or recent seizure
What is Wernickes area responsible for
transforms sensory input into neural word representations to give a word meaning
What is Brocas area responsible for
transforms these neural word representations into actual articulations that can be spolen
Describe Brocas aphasia
“expressive” understanding of spoken language mostly preserved
Describe Wernickes aphasia
“receptive” fluent speech that makes no sense
What is apraxia
inability to turn verbal request into motor performance
What do you assess while evaluating thoughts and perception
process, content, insight and judgment
what do you assess while evaluating cognitive function
orientation, attention, and memory
what is considered executive function
abstract thinking/insight
calculation
constructional ability
What are the two types of memories that you assess in a patient
recent and remote
alzheimers dementia begins how and progresses how
beings as progressive loss of memory
first recent
then distant
Testing for executive function or insight is mainly looking for what
dementia
disease of frontal lobes and their connections
Describe how to test for insight
proverbs, situational questions for choice, similarities
what is delirium
acute confusion episode, may be due to infection, uremia, alcohol withdrawal
what is dementia
insidious, slowly progressive, affect often flat, maintains orientation and attention
What are causes of dementia
altzheimers, B12 deficiency, hypothyroid, head trauma
describe testing calculation of executive function
number span
spelling word
months of year backwards
doubling numbers
what is it called when you ask a patient to copy a figure
constructional ability
on the Mini mental status exam what is ranked borderline impaired
19-23
What are the 3 main tests for cerebellar function
gait (ataxia)
heel to knee and slide down shin (heel to shin ataxia)
rhomberg/pronator drift
describe rhomberg test
closing eyes removes visual input and you have ataxia
cerebellar ataxia is present with eyes open or closed
What is pronator drift specific for
contralateral corticospinal tract lesion/ disease
When do you do a CN exam
headache ( new kind) dysarthria asymmetric facial features dysphagia hearing complaints visual disturbance ataxia/asymmetric motor use
abnormalities with CN I are seen with what
concussion
What are the parts of CN II exam
acuity
pupillary reflex
visual field exam
What is esotropia
exotropia
CN III
esotropia- medial deviation
exotropia- lateral deviation
abducen palsy is seen with what
increased intracranial pressure
describe testing for CN V
sensory all face
motor V3
describe corneal reflex
afferent- V
efferent- VII
consensual response
how do you test for CN VII
mm facial expression taste ant 2/3 lacrimation salivation stapedius m of middle ear
describe difference of CN VII central vs peripheral
central- mm of lower face contralaterally
peripheral- mm unilateral upper and lower
in peripheral CN VII lesion what happens
weakness hemifacial
how do you check for CN VIII lesions
hearing and balance
Gag reflex tests what
afferent- IX
efferent- X
