Module 3 Flashcards
ID impairments, ID additional needs, measure recovery of function, create realistic goals, aid in appropriate discharge planning, assess the effectiveness of interventions
reasons for neurological examination
HOAC step 1
initial information
HOAC step 2
conducting neurologic PT examination - movement analysis
HOAC step 3
physical therapy diagnosis + treatment strategies align with goals of pt
HOAC step 4
evidence based treatment that create functional recovery or maintain functional competence
re-evaluate
HOAC step 5
community engagement or reintegration
- basic mental functions, complex, mentl functions and meta-cognitive functions
mental status exam
third part of exam
crainal nerve integrity exam
- light touch screen, S/D. proprioception
sensory exam
- muscle mass, ROM, tone, muscle capacity, endurance, motor control of movement/stability, observation of involuntary movements
motor exam
- FTN, HTS, Alt. Movements
coordination exam
7, static standing balance, dynamic standing balance, walking balance
balance screening
- changing and maintaining body positions, mobility, hand and arm use
functional skills examand movement analysis
discription of what the partient exerpeiences or believes is wrong, specific details about the problem, nature or extent of the disability, pts concerns
chief complaint
date of onset (duration), manner of onset, whether the problem has remained the same over time or has changed for the better or worse
history of present illness
previous injuries or illness, previous hospitalization, surgical procedures (dates, interventions, and outcomes)
past medical history
allergies, medications, tests specific to diagnosis, precautions
pertinent health information
use of assistive devices, driving status, need assistance for ADLs or IADLS, activities, work, social roles
prior level of function
live alone or with others, caregiver, steps, bathroom/bedroom set up, width of halls, size of rooms
home environment
positiong/posture, verbal communication, non-verbal communication (facial expression, emotional response, eye contact), movement (gait, transfers)
observation
cardiovascular.pulmonary system, integumentary system, MSK, neuromuscular, gastrointestinal, genitourinary/reproductive, hematologic/lymmphatic, psychological, endocrine
review of system
Why should you assess mental status first?
determine extent of congitive impairment, identify disease processes, determine the client’s ability to participate in exam/treatment, development of strategies, referral
Alertness, Arousal, Awareness, Attention, ___, Memory, Reasoning
Executive function
Three components of Basic Functions
level of consciousness
awareness
alertness
three components of complex functions
language, memory, sequencing
three components of meta-cognition
executive functions
self awareness
mood/motivation
Correct sequencing of tests
arousal, attention, cognition/executive function
Arousal/Level of Consciousness
alert, lethargic, delirium obtunded, stupor, coma
Orientation
Person, Place, Time
Attention
Ability to follow commands, sustain motor activity, two things at once, ability to ressit distractions
common tests used to assess attention
spell a word backwards, count backwards, digit repetition test, moss attention rating scale
cognition
signs of agitation, difficulty word finding, difficulty past events or details of illness
common outcome measures
mini-mental status examination (MMSE) and Montreal Cognitive Assessment (MoCA)
Language and Communication: Observe
Quality, comprehension, ability to write, name objects and repeat words
Language and Communication: receptive language
pt is asked to follow commands in order to demonstrate that they understand the meaning of what they have heard or read
Language and Communication: expressive language
the pt is asked to perform a task that requires spontaneous speech or writing, or naming of objects, repeating phrases, not fluency and correctness of words
examples of disorders of speech
aphasia, verbal apraxia, dysarthria
Memory: Short term memory, immediate recall, delayed (5 mins) –> pt is asked to perform a three word recall
temporal lobe
memory: subtract by 7’s
Frontal lobe –> working memory
memory: pt is asked to problem solve, verbal similariities and interpret proverbs
frontal lobe - abstract reasoning
Visual Spatial Function and Perception
the patient is asked to bisect a line, draw a face, clock or geometric figures
examples of dficits that result in paeietal association areas
body image.body scheme
visual discrimination
Apraxia
Agnosia
Other executive functions
problem solving, judgement, reasoning, insight, safety awareness
Self-awareness
ability recognize ones own behavior, character, personality ,etc
restorative approaches focus on skill-based training augmented by:
strategy training programs
cognitive exercise programs
compensatory approaches focus on skill-based training augmented by
habit training
environmental adaption
