Gait and Mental Assessment Flashcards
Spastic hemiparesis
Extension and circumduction of one leg
Unilateral weakness on affected side
Arm flexed, adducted and internally rotated
Leg extension with plantar flexion of foot
Spastic diplegia
stiffness, extension, adduction, and scissoring of both legs
Stance is slightly flexed at hips/knees, narrow, and feet/ankles are internally rotated
Legs drag and toes scrape along the ground
Often seen in cerebral palsy
Steppage/drop foot
weakness of foot dorsiflexion
While walking, knee is lifted higher than normal to allow foot to clear the floor
Cerebellar ataxia
While standing, body may swagger back and forth/side to side
Walking is clumsy, staggering movements with a wide-based gait
Cannot walk heel to toe
Sensory ataxia
Loss of proprioceptive input from feet
Pt will slam foot hard onto ground to sense steps
Dystonia
Sustained abnormal posture of foot or leg
Distorted gait
hyperflexion of hips
Ataxia
Unsteady gait and tendency to stumble
ABductor/ADductor lurch
AB- pelvis drops when opposite leg lifts, indicates weak gluteus medius on opposite side
AD- ?????
Extensor lurch
Gluteus maximus is weak and pt must thrust thorax back to maintain hip extension
Flat foot
Unable to push off with toes when taking forward step
Moves whole foot (flat) when taking a step
Back knee
Quad weakness causes pt to walk with hyperextended knee when weight bearing
Antalgic
Limits amount of time an affected leg bears weight in order to avoid pain
How to test for deficits: physicical appearance and behavior
Grooming: hygiene, appropriate dress
Emotional status: appropriate to situation
Body language: posture, mannerisms, eye contact, body movements, anxiety
How to test for deficits: cognitive abilities
Orientation: person, place, time, purpose
States of consciousness: confused, lethargic, delirious, stuporous, comatose
Abstract reasoning: analogies, proverbs
Arithmetic calculations: serial 7’s or spell WORLD backwards
Writing abilities: write a dictated sentence or draw a picture of a common item
Motor skills: comb hair, put on lipstick
Memory: recent (3 words - registration and recall), remote (verifiable facts)
Attention span: repeat a phrase or short story
Judgement: meeting obligations? spending $? what to do w/ addressed envelope on street?
How to test for deficits: emotional stability
Affect: emotions today
Mood: how it’s going in general (week, month, year)
Thought process and content: observe thinking process; illogical thought, blocking, neologism (made up words), repetitive phrases indicate distress
Perceptual distortion and hallucination: perceived sensations not caused by external stimuli; auditory, visual, tactile hallucinations
