Neuro 2023 Flashcards
What is Ataxia?
movements that are un-coordinated and jerky
eg. fx activites, walking, looks unsteady & arm movements are difficult to control leading to overshooting or undershooting of the hand to a target
what causes ataxia?
result of damage to the cerebellum, sensory and vestibular systems
what is dystonia?
Mx produces are writhing, slow & lead to abnormal sustained postures being adopted
ie. generalised dystonia may produce gross movements of the arms & legs
Purpose of an assessment:
- chief complaints/problems
- establish/define the px level of impairment
- short & long term goals
- functional activity ability
- help develops a relevant tx/mx plan
- build rapport
What is included in a subjective assessment?
Check Ax sources (medical notes, nursing notes, the patient, relatives & carers)
Background Hx:
- demographic details
- past medical Hx
- Diagnosis
- HPOC
- Medications
- Social Factors
- Details of the involvement of other healthcare professionals
what is the purpose of an objective assessment?
gather information about the patient’s movement disorder & level of functional ability
what is involved in an objective assessment?
- observe functional activity
- PROM, AROM, RROM
- posture & movement analysis
in sitting, lying to sitting, sit-to-stand, transferring from bed to chair, standing & walking etc.
Vision (objective Ax)
Does the patient wear glasses?
What do they wear them for?
Will they need them on for therapy?
When was their last eye check? - Often individuals have retained old glasses that are now unsuitable.
Hearing (objective Ax)
Do they wear a hearing aid? Is it switched on? Is it clogged with wax?
If they are not wearing one, should they be? Be sensitive when questioning the patient, poor concentration/attention may present similarly.
Communication (objective Ax)
Does the patient have a problem expressing her/himself or understanding your requests? This could be related to the points above or a deficit of speech or cognition.
Cognition & Perception (objective Ax)
Does the patient have trouble concentrating during the assessment?
Do they have difficulty understanding instructions or solving a simple problem?
Do they have difficulty dressing or undressing?
Do they perform tasks in the wrong order or miss out elements of the task?
General Appearance (objective Ax)
Does the patient appear unkempt? -This may indicate that the patient is not coping at home.
Presentation of certain postures may also be indicative of a clinical pathology. - For example, a slouched, flexed posture in combination with other signs and symptoms may suggest clinical depression.
Behaviour (objective Ax)
Does the patient behave inappropriately (physically or verbally)?
Are they inappropriately euphoric or tearful?
Are they aggressive? -Any aggressive behaviour needs to be highlighted to the rest of the multidisciplinary team (MDT). These presentations could indicate damage to the frontal lobe, limbic system or may reflect a mental health problem.
Exercise tolerance (objective Ax)
Do they fatigue very quickly on activity?
Do they become breathless?
