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Acute Care > Nervous System > Flashcards

Nervous System Flashcards

1
Q

Screening of Cortical Function

A

Frontal
Parietal
Temporal
Occipital

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2
Q

Frontal lobe Screening

A

State months backward, alertness, orientation (name, place, time), follows 1

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3
Q

Parietal lobe Screening

A

Pin prick testing, light touch , position sense (proprioception), perceptual sense, impaired reading writing (L)

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4
Q

Temporal lobe Screening

A 
Hearing screening (finger rub), ability to follow verbal 
cues/commands, memory tests.
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5
Q

Occipital lobe Screening

A

Homonymous hemianopsia

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6
Q

Homonymous Hemianopsia

A

Damage to the left side of the brain/ occipital. Would cause inability to see on the right

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7
Q

Neurologic Examination

A

Patient history
Observation
Mental status examination
Vital sign measurement
Cranial nerve examination
Motor function
Sensation
Coordination
Diagnostic testing

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8
Q

Neurologic Examination (Pt Hx)

A

A detailed history, initially taken by the physician (true neurologic event or another process?).

Is typically presented by the pt or a family member

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9
Q

Pt History (Suggested Framework)

A
  • What is the pt feeling
  • When did the problem initially occur , and has it progressed
  • What relieves or exacerbates the problem?
  • What are the onset , frequency , and duration of S&S
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10
Q

Pt History (related questions)

A
  • Does the problem involve loss of consciousness
  • Did a fall precede or follow the problem?
  • Is there headache, dizziness , or visual disturbance?
  • What are the functional deficits associated w/ the problem?
  • Is there an alteration of speech ?
  • Does the pt demonstrate memory loss or altered cognition
  • Does the pt have an altered sleep pattern?
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11
Q

Neurological Examination (Observation)

A
  • Alertness, arousal
  • head, trunk, extremity posture
  • Active movement
  • ease or difficulty w/ ADLs
  • presence of involuntary movements
  • muscle atrophy
  • RR & patter
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12
Q

Mental Status Examination (LOC)

A
  • Alert
  • Lethargic
  • Obtunded
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13
Q

Mental Status Examination (LOC)

Alert

A
  • Completely awake
  • Attentive to normal levels of stimulation
  • Able to interact meaningfully with clinicians
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14
Q

Mental Status Examination (LOC)

Lethargic

A
  • Arousal w/ stimuli
  • Falls asleep when not stimulated
  • Decreased awareness
  • Loss of train of thought
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15
Q

Mental Status Examination (LOC)

Obtunded

A
  • Difficult to arouse
  • Constant stimulation to maintain consciousness
  • Confused when awake
  • Unproductive interactions
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16
Q

Mental Status Examination (LOC)

Stupor (semicoma)

A
  • Arousal only with strong stimuli , returns to unconscious, when stimulation is stopped
  • Patient is unable to interact w/ clinician
17
Q

Mental Status Examination (LOC)

Coma

A
  • Unarousable to any type of stimulus
  • Reflex motor responses may or may not be seen
18
Q

Mental Status Examination (LOC)

Delirium

A
  • State of disorientation marked by irritability or agitation , paranoia , and hallucinations
  • Pt demonstrates offensive, loud, and talkative behaviors
19
Q

Glascow Coma Scale

A
  • Measures the level of consciousness
  • ≤8 signifies coma
20
Q

Mental Status Examination (Cognition)

A

Attention: have them repeat a sequence of numbers or words back to you

Orientation

Memory

Calculation

Abstraction: metaphor

Judgement:

21
Q

Mental Status Examination (Cognition)
Clinical Tip

A
22
Q

Mental Status Examination (Speech and language)

A
  • SLP is often consulted to perform a more in depth examination of cognition , speech , and swallow .
  • PT should be aware of appropriate types of commands , activity modification, and positioning as related to risk of aspiration according to the SLP’s suggestions.
23
Q

Homeostatic center of the body

A

The brain (BP, HR, RR, temp control)

24
Q

Cranial Nerve Examination

A
  • PERRLA
  • If vision or pupil size /shape changes during PT session, discontinue –> notify the nurse/physician immediately.
  • Nystagmus during the visual exam should also be noted.
25
Q

Cranial Nerve Examination

Clinical Tip

A
  • Diplopia: double vision or seeing double
    • Eye patch can be worn temporarly improve PT participation
26
Q

Dtermining Motor Function

A
  • Strength testing
  • Muscle tone
  • DTR
27
Q

Modified Ashworth Scale

A

Acute Care (7 decks)

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