Neuro Flashcards

Question

PNS: somatic ?

Answer 1

Regulates muscle movement and response to touch and pain

Answer 2

internal organs, autonomic reflex response ?

Answer 3

mobilizes organs during stress and arousal - fight or flight

Answer 4

conserves energy during times of rest and relaxation - rest and digest

Answer 5

somatic symptoms Ex: stress causing headaches

Answer 6

mental symptoms Ex: dementia causing memory loss

Answer 7

``` Mental Status Exam Cranial Nerves Motor Sensory Reflexes ```

Answer 8

history * *idea of alter-ness and educational level * *

Answer 9

Head and Neck **hit them when doing HEENT exam**

Answer 10

MS / extremity exam ** done alot in MS**

Answer 11

Done throughout the interview ↑ detail if a problem is suspected Be tactful Don’t offend, frighten or embarrass the pt

Answer 12

Level of consciousness

Answer 13

Awareness of environment Do they understand conversation or lose track? Timely responses? Falling asleep?

Answer 14

drowsy but arousable. Opens eyes, answers questions, then back to sleep

Answer 15

opens eyes, responds but slow and confused ( harder for them to wake up)

Answer 16

require painful stim to arouse from LOC knuckle on sternum, squeezing finger

Answer 17

unarousable

Answer 18

Level of activity vs. immobility Ability to relax Voluntary control of motor movements **look at how they are holding thmeselves **

Answer 19

Change with discussion of certain topics? hyper mobility - anxiety, tapping hands etc slowed mobility

Answer 20

Clothing, hair, nails, teeth Compared to their age and social group Decreased attention - depress , schizo, Increased attention One-sided neglect - lesion of opposite parietal cortex **depress , schizo, OCD - increased attention**

Answer 21

At rest When interacting With different topics - generate spark /response ? Are these reactions: - Appropriate? - Immobile? **appropriate amount of facial expression labile - big swings, manic depressives bipolar flat - low we want to be in the middle, blunted dull - not interested in being there schizo**

Answer 22

Labile Blunted Flat Does it vary appropriately?

Answer 23

Quantity Rate Loudness Fluency and articulation

Answer 24

spontaneous vs. wont stop

Answer 25

Dysarthria – defective articulation ( stroke) Aphasia – disorder of speech Hesitancies, gaps, disturbed inflection - monotone voice - true aphagia they dont talk at all

Answer 26

More sustained than affect, more overall picture “Mood is to affect as climate is to weather” Ex: sad, melancholic, euphoric, angry, worried, indifferent Intensity Lability Appropriateness Ask patient, significant others **affect is right now mood is more this month ( overall picture) **

Answer 27

If depressed – ask about suicidal ideations -“Do you ever feel that life isn’t worth living?” Does NOT implant the idea DOES open it up for discussion

Answer 28

tell HOW a patient thinks, relevance, organization, sequence, coherence, logic Ex: flight of ideas or echolalia **do there thoughts end in a conclusion**

Answer 29

tells WHAT a patient thinks, recurring thoughts, obsessions, phobias, anxieties, delusions ** content - recurrent thought, obsession though **

Answer 30

awareness of things and their interrelationship

Answer 31

misinterpretation of real stimulus

Answer 32

subjective sensory perception without relevant stimulus “Do you hear/see things that other people don’t?”

Answer 33

``` Auditory Visual Tactile Olfactory Gustatory Somatic ```

Answer 34

“What do YOU think is wrong?” “Why are you here?”

Answer 35

response to a situation, ability to compare and evaluate alternatives Mature? Realistic? Impulsive? “If you lost your job, what would you do?”

Answer 36

Person Place Time

Answer 37

whats your name, who are you ?, do you know this person and its there son ?

Answer 38

where are you ? home address ? do you know what floor or hospital , what about city and state

Answer 39

wat day of week is it, month, season, years - keep getting broader if they keep getting it worse

Answer 40

problem with memory or attention

Answer 41

ability to focus and concentrate Digit span – forward/backward Serial 7’s Spell WORLD backwards Note speed, effort, accuracy **up to 4 is average , take effort and attention to do this, it might be a problem with math, spelling, or attention**

Answer 42

birthdays, anniversaries, SSN ↓ in late stage dementia

Answer 43

events of day, meals, weather ( this goes first in dementia) ↓ in dementia, delirium, anxiety, depression, MR

Answer 44

3 or 4 words Repeat immediately Repeat in 3-5 minutes

Answer 45

Occupation, current events, 5 large cities, president ↓with ↓ intelligence, dementia, aphasia

Answer 46

Math problems Change from a dollar ↓with ↓ intelligence, dementia, aphasia **tells you that something is going on**

Answer 47

Interpret a proverb -A stitch in time saves 9 fixing something before situation gets worse -Don’t count your chickens before they’re hatched its about bigger things ( thinking beyond the literal words) Similarities -How are a cat and mouse alike?

Answer 48

Copy figures Clock drawing task ↓ with dementia, ↓ attention, MR, visual or motor problems, etc. so it’s just a screening test **see if there has been 5 sides and that they are crossing \, does tell us what are wrong, maybe they have visual problem, motor not what is wrong, its a screening test—— if pos, you need to look at it closer **

Answer 49

S – subjective (what patient tells you) O – objective (what you observe) not so much touching or listening A – assessment (diagnosis) P - plan

Answer 50

S: This is a 42 y.o. female presenting for f/u of anxiety, depression and dissociative identity d/o. She has continued to feel very anxious and out of control. She reports she has been obsessed with counting things like people and dashed lines on the road. She becomes frustrated while counting if the objects move, for example people in the grocery store. She has locked herself inside her home to avoid the anxiety associating with going out. She is requesting something “to take the edge off” of her anxiety. She denies any personality switches since her last appointment 1 month ago. S. This is a 55 y.o. female presenting for f/u of depression. She reports that she is feeling good today, but her stress level has not decreased any since her last visit. Her depression has not worsened. One of the stressors in her life is her son, who was recently diagnosed with malignant melanoma. He also has a hx of several psychiatric illnesses and she continues to worry about him more than her own problems. She has been having financial difficulties but is receiving aid from Agency for the Elderly which helps her stress level somewhat.

Answer 51

O: App/Beh: Pt was alert and very anxious and agitated. Her dress and grooming were appropriate. Pt. had reactive facial expressions and a broad affect. Speech/lang: speech was fast, coherent and goal-directed. Mood: very anxious. No suicidal/homicidal ideations. Thought/percep: concrete and goal-directed thoughts with no A/V hallucinations. Pt’s insight and judgment were good. Cogn: A&Ox3 with good attention span and preserved recent and remote memory. New learning ability was not tested. Abstraction was good. O: App/Beh: pt is sitting, relaxed with neatly pressed clothes, well-groomed, hands clenched in lap. Pt appeared anxious. Speech/lang: speech is full and fast and stuttery when speaking of stressors Mood: depressed, no suicidal/homicidal ideations Thought/Percep: pt’s thoughts seem disorganized at times and hard to follow, slightly circumstantial. Pt was very worried about stressors in her life. Insight is good with limited judgment. Cogn: A&Ox3, pt has limited attention span, but good remote and recent memory, good new learning ability. Abstraction good.

Answer 52

A: Dissociative identity d/o Depression Anxiety A: Major depression with generalized anxiety d/o

Answer 53

P: Increase Zoloft to 100 mg po q AM Continue other medications Enter the partial hospitalization problem if sxs get worse f/u in month, sooner prn P: ↑ Imipramine to 50 mg every am and 100 mg at hs Pt was encouraged to think of herself, and not only her son Continue psychotherapy F/U in 3 weeks