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7333 Bringman > Exam 2- Neuro Exam > Flashcards

Exam 2- Neuro Exam Flashcards

1
Q

In your Neuro Exam, you want to figure out..

A

~nature/ cause
~location
~extent of severity (Will I get this person better/ can I get this person better)
~benefit of therapy (Will normally take longer to find out if the pt will benefit from therapy)

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2
Q

Organic causes

A

~Is there a structural reason

~Swelling, scarring, space (after), bleeding, clots, etc

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3
Q

Inorganic causes

A

~We do not have a structure, but have a functional loss
~Mental disorders
~Munchausen’s (by Proxy) you want to make yourself ill; you cannot trick yourself into showing that you are doing it (our parents are doing it)
~PTSD- nothing is organically wrong, but their body cannot deal with what is going on with them (start treating them and they get better
~Malingering s/s to test to see if they are faking
~NOT phatom limb because there is still part of the nerve here

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4
Q

Localized causes

A 
~myopathy
~neuropathy
~plexopathy
~radiculopathy
~myelopathy
~encephalopathy
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5
Q

myopathy

A

muscle

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6
Q

neuropathy

A

peripheral nerve

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7
Q

plexopathy

A

nerve plexus

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8
Q

radiculopathy

A

nerve root

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9
Q

myelopathy

A

spinal cord

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10
Q

encephalopathy

A

BRAIN

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11
Q

diffused causes

A

~No specialized terms for these

~Ex: GBS, MS, AIDS, cancer

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12
Q

etiology (10)

A 
~Congenial/ hereditary (Huntington)
~Chromosomal/ Genetic (Downs) 
~Traumatic/ Post traumatic
~Infections/ Post-infection
~Idiopathic
~Environmental
~Vascular (stroke)
~Autoimmune
~Neoplastic (cancerous)
~Toxic metabolic
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13
Q

what does CC stand for?

A

chief complaint

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14
Q

What does HPI stand for?

A

history of present illness

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15
Q

What does PMH stand for?

A

past medical history

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16
Q

What does PHI stand for?

A

pertinent health info

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17
Q

What does FH stand for?

A

family history

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18
Q

What does SH stand for?

A

social history

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19
Q

What does OH stand for?

A

occupational history

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20
Q

What does ROS stand for?

A

review of system

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21
Q

details on CC

A

~What their complaint is (I cant walk, etc), will not be the stroke, it will be the most annoying problem/ what problem that they want to solve first
~We have to let them tell us what is bothering us; let them tell us how the pain is (don’t give them adjectives)
~Will help to make goals

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22
Q

details on “how do they feel about it?”

A

~How does that affect your life?
~If you are now in a wheel chair, were you in one before or were you running?
~Will like to tell you what other clinicians have diagnosed them with; you don’t want get the wrong idea (don’t get a biased before)
~Do not use adjectives when evaluating a neuro patient
~if they don’t come up with something, do not prompt them! Ask them to pay attention to their complaint over the next few days/hrs, etc so they can describe it to us next time.
~Ask how they feel about the problem/limitation

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23
Q

details on HPI

A

~Get a chronically history of the present illness
~If you are in the hospital, you should be able to look in the chart
~Onset- sudden, etc; constant, gradual,
~Agg/ease factors

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24
Q

details on PMH

A

~Neuro can be huge; ortho can be short
~Need to look at what is important
~Venous wound- CHF important
~Brain injury- concussions in the past could be important information; ankle sprain not as important
~Birth conditions- can decrease the chance of getting back to function
~Surgeries before the stroke, etc

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25
Q

details on PMI

A

~Allergies: drugs, food, env
~Immunizations
~Smoking, drinking, illegal drugs
~If you are in outpatient, have them bring their bag of meds (and ask them if you take them all)
~BLOOD PRESSURE- always take blood pressure!!
~Sleep patterns- if your patterns are flipped, you need to know that
~Eating habits- are they eating enough, the right foods

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26
Q

details on FH

A

~Could be the most important part of the eval or have no help
~CVD, neuro, osteoporosis, stroke, HD, etc

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27
Q

details on SH

A

~Relationship info with family, etc
~Who are they going home to, are they going to supportive env, abusive env,
~Level of education- need to know how intelligent the pt is; they may not be able to read or they may be highly educated
~If they are a native speaker or not- get a translator; try not to use a family member as a translator
~Need to be aware of the different cultures

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28
Q

details on OH

A

~Can give you more goals
~Do they have a job; how long have they have they had the job; did they have an accident on the job
~Are they exposed to hazardous chemicals
~May not want to tell you all the s/s bc a neuro diag may not allow them to go back to their job

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29
Q

details on ROS

A

~Typically done by the doc if it is in the hospital
~HEENT- head eyes ear neck throat
~Some may be important, but some may be able to shed some light on the diagnosis and will tell you where to go next

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30
Q

objective exam: pain

A

~What is their pain, did we make it worse, when it is worse, etc

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31
Q

what does LOC stand for?

A

level of consciousness

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32
Q

what are the 5 levels of consciousness?

A 
~alert
~lethargic
~obtunded
~stupor
~coma
33
Q

AAOx3

A

~person
~place
~time

34
Q

AAOx4

A

~person
~place
~time
~oriented (where they are

35
Q

Details on alert

A

awake/ attentive

36
Q

Details on lethargic

A

drowsy

37
Q

Details on obtunded

A

~Difficulty to arouse
~actions largely non-productive
~frequently confused when awake

38
Q

Details on stupor

A

~Only respond to hard, strong noxious stimulus

~how to wake up these pts: Sternal rub, pick the nail bad, nipple twist, thenar pinch

39
Q

Details on coma

A

cannot be aroused by any stimulus

40
Q

attention

A

Ability to focus/ stay on task without being distracted on another stimuli
*can do a mini-mental exam

41
Q

mini-mental exams

A

~say 2 objects, have them repeat it- immediate recall then you have them repeat it later- short term recall then act something from the past- long term
~Can you count backwards from 100 by 7
~spell world backward

42
Q

Orientation: person

A

name, age, birthplace, etc

43
Q

Orientation: place

A

Where are you, address, where are you (hospital)

44
Q

Orientation: time

A

What time is it, season, year, morning/afternoon

45
Q

Orientation: situation

A

Why are you there? I had a stroke. I don’t know- being held here.. etc

46
Q

details on language function

A

~Verbal may not always be possible
~Can also visually, pictorially (can point to pictures to express their needs/ sign names)- are universal (a glass of water is a glass of water no matter where you go

47
Q

Language function problems (3)

A

~aphasia
~dysphonia
~dysarthria

48
Q

details on aphasia

A

~Problem with speak
~Cortical
~Broca’s and Wernickes
~Global

49
Q

details on dysphonia

A

~cranial nerve problem (X) with the vocal cords

~low speak, low volume, hoarse

50
Q

details on dysarthria

A

non-cortical

51
Q

What are the two types of language functions that need to be able to work?

A

~receptive

~expressive

52
Q

Expressive is associated with (Wernicke’s or Broca’s)

A

Broca’s

53
Q

Receptive is associated with (Wernicke’s or Broca’s)

A

Wernicke’s

54
Q

3 different types in expressive language problems

A

~broca’s
~stutter
~stammer

55
Q

Broca’s area

A

~Difficulty expressing oneself
~Nouns easier to express
~Not much flow to speak

56
Q

stutter

A

~always on the first phoneme

~always at the beginning of the word

57
Q

stammer

A

can get stuck on any part of the word

58
Q

details on receptive language problems

A

~Comprehension
~Can test comprehension
~Word finding: what is the object? knowledge is there, but finding the word is difficult
~Perseveration

59
Q

Comprehension

A

Ability to understand and give correct meaning to sentences

60
Q

how to test comprehension

A

~Give yes or no question and see if they can answer (they may only say yes/no or want to please)
~Is my sister’s brother a man or a woman?
~If the lion killed the dog, which animal died?

61
Q

Perseveration in receptive language

A

~Get stuck on something; yes is the only thing they say; get stuck on one topic
~Can also get stuck on a task

62
Q

3 levels of memory

A

~immediate recall
~short term
~long term

63
Q

immediate recall

A

can recall immediately after

64
Q

short term memory

A

can recall minutes after

65
Q

long term memory

A

~can recall days to years after

~from the past

66
Q

What are the two types of amnesia?

A

~retrograde

~anterograde

67
Q

retrograde amnesia

A

~Forget long time ago/ from your past

~Can tell you about his day, but cannot tell you about his past

68
Q

anterograde amnesia

A

~Can’t make new memories

~Can’t tell you what they had for lunch, why they are there, etc but can tell you about the War

69
Q

Cognitive function

A 
~fund of knowledge
~proverbs
~gnosia/ agnosia
~praxia/ apraxia
~mood
~affect
~thought content
70
Q

fund of knowledge

A

~All of our experiences to help grow our knowledge

~If you have a larger fund of knowledge, it will take longer for the knowledge to be lost

71
Q

proverb

A

~Takes higher function to understand them

72
Q

Gnosia

A

ability to perceive stimuli

73
Q

Agnosia

A

inability to perceive stimuli

74
Q

Praxis

A

ability to complete a task

75
Q

Apraxia

A

inability to complete a task

76
Q

Mood

A

~Feeling about a certain situation

~Being able to pick up on nonverbal communication is an important skill

77
Q

Affect

A

~How the person looks
~The outward sign on the mood
~Flat affect

78
Q

Thought content

A

~The fullness of a pts thinking

~Their conversation, interaction, emotions; you should get a lot of this just from talking with them

79
Q

flat affect

A

~no reaction
~doesn’t really react to anything
~hard to work with these pts bc they don’t give you any reactions

7333 Bringman (23 decks)

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