Neuro and Mental Assessment Flashcards
What is 13 items of subjective data you could collect?
- headache?
- head injury?
- dizziness/vertigo?
- seizures?
- tremors?
- weakness?
- coordination?
- numbness/tingling?
- difficulty swallowing?
- difficulty speaking?
- environmental/occupational hazards?
- problems with attention span, memory, reasoning?
- are they meeting developmental milestones?
If they had a head injury what do you ask?
new or old?
loss of consciousness?
What do you ask if a child had a head injury?
Did they cry right away? most likely didn’t lose consciousness
What is vertigo?
inner ear problem
What factors do you take into consideration when asking about past seizures?
duration?
type?
aura?
What is aura?
warning of impending seizure
What does weakness on one side of the body indicate?
stroke
What is a word salad?
words are mixed up
What do you ask pertaining to drugs?
current medications?
alcohol use?
mood-altering drugs?
When should babies have head control?
by 4 months old
When is a child’s sensory assessed?
7-9 months
What is the babinski reflex?
fanning of toes
Where do senile tremors start?
hands and head
What is the most sensitive indicator of neurologic function?
consciousness
How do you describe obtunded consciousness?
transitional state between lethargy and stupor
-mostly sleeps, difficult to arouse
-acts confused when aroused
How do you describe stupor consciousness?
responds only to vigorous shaking or pain with groans and mumbling
What is 7 pieces of objective data that you could collect?
- consciousness
- language
- mood and effect
- orientation
- attention
- memory
- abstract reasoning
How is mood displayed?
by emotion
How is affect displayed?
by facial expression
What is dementia in relation to memory?
impaired recent memory and intact remote memory
At what age should a child be able to communicate?
4
At what age do children become logical and concrete?
7
At what age do children have abstract thinking?
12-15
What does ABCT stand for during a mental status exam?
Appearance
Behavior
Cognitive function
Thought process and perceptions
When under the influence of alcohol or drugs or extremely fatigued what can be impaired?
cognitive function
What is a mini-mental state exam assessing?
Recall
Orientation
Registration
Attention and calculation
Language
What does a score of 24-30 on a mini-mental state exam mean?
normal
What does a score of <16 on a mini-mental state exam mean?
more severe mental impairment
Cranial nerves:
On Old Olympus Towering Top A Finn And German Viewed Some Hops
Olfactory
Optic
Oculomotor
Trochlear
Trigeminal
Abducen
Facial
Acoustic
Glossopharyngeal
Vagus
Spinal
Hypoglossal
What is the scale used for strength
0-5
What is involved when inspecting tone?
ROM should produce some resistance to stretch
What is tandem walking?
heel-to-toe
What is the Romberg test?
eyes close, 20 seconds with feet together and arms at sides
What does RAM stand for?
rapid alternating movements
What is another word for pain?
spinothalamic tract
How are reflexes graded?
0-4+
What is clonus?
abnormal rapid contraction of muscle
What is the normal pupil size?
3-4mm
What does PERRLA stand for?
Pupils are Equal, Round, Reactive to Light and Accommodation
What is the highest score a person can achieve on the Glasgow Coma Scale?
15
What is the lowest score a person can have on the Glasgow Coma Scale?
3
What does the Glasgow Coma Scale Assess?
eye opening, motor response, verbal response
What 10 factors does the Clinical Institute Withdrawal Assessment of Alcohol Scale (CIWA) assess?
- agitation
- anxiety
- auditory disturbances
- orientation/clouding of sensorium
- headache
- nausea and vomiting
- paroxysmal sweats
- tactile disturbances
- tremors
- visual disturbances
What does paroxysmal mean?
sudden
How would you describe tactile disturbances?
abnormal or false sensation of touch or perception of movement on the skin or inside the body
What score on the CIWA is concerning and needs medication for withdrawal?
20-67
What score on the CIWA is mildly concerning?
9-20
How would you test CN III?
reactive to light and accommodation
6 fields of gaze
How would you test CN IV?
6 fields of gaze
How would you test CN V?
clench teeth
facial sensation, corneal reflex
How would you test CN VI?
6 fields of gaze
How would you test CN VII?
raise eyebrows
frown
close eyes tightly
show upper and lower teeth
smile
puff out cheeks
taste test
How would you test CN VIII?
whisper test
nystagmus (involuntary movements)
How would you test CN VIII?
whisper test
nystagmus (involuntary movements)
How would you test CN IX?
ahh movement of soft palate and pharynx
voice quality
gag reflex
How would you test CN X?
ahh movement of soft palate and pharynx
voice quality
gag reflex
taste test
How would you test CN XI?
rotate head against resistance
shrug shoulders against resistance
How would you test CN XII?
stick out tongue, say “light, tight, dynamite”
