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Neuromus 1 > neuro comps 1 > Flashcards

neuro comps 1 Flashcards

1
Q

what are the two components of mental status: basic

A

level of consciousness

and

orientation

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2
Q

level of consciousness - how do we test

A

able to follow commands such
as
1) eye movements/responses
2) motor responses
3) verbal responses

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3
Q

level of consciousness - outcome measure used

A

glasgow coma scale

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4
Q

orientation - what to ask

A

Ask for patient’s
1) full name, age, birthplace

2) where they are now, type of
place, city they are in

3) the date, day of week, what
time it is, season
note the response

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5
Q

what is the common outcome measure for orientation

A

MOCA

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6
Q

what is the purpose of the MOCA

A

rapid screening instrument for mild cognitive dysfunction.

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7
Q

mental status: complex includes

A

language
memory
visuospatial functions

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8
Q

lang is assessing what types

A

receptive and
expressive language

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9
Q

receptive lang

A

the paitient is asked to follow commands to see if they understand what they have just read or heard

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10
Q

expressive lang

A

pt asked to perform at task that requires spontaneous speech of writing, naming an object, or repeating phrases,

looking at the fluency and correct use of words

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11
Q

what outcome measure is used to look at lang

A

MOCA

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12
Q

receptive aphasia

A

world salad

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13
Q

Expressive aphasia

A

a condition where a person may understand speech, but they have difficulty speaking fluently themselves

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14
Q

Global aphasia

A

People with global aphasia may only say a few words, such as “no” or “hey” or “what”, or they may speak in “stereotypies”. Stereotypies are words or phrases that are said over and over with different intonation. Examples may be “ding da ding”, “I love you” or “something wonderful”.

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15
Q

how do we assess memory - immediate recall (STM)

A

repeat these three words

temporal lobe

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16
Q

how do we assess memory - LTM

A

spell WORLD backwards
count back from 100’s using 7

frontal lobe

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17
Q

what outcome measure do we use for memory

A

MoCA

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18
Q

visuospatial function - test

A

bisect a line

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19
Q

what causes visuospatial dysfunction

A

damage to the right (parietal
lobe) hemisphere

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20
Q

what is Hemineglect

A

(unilateral)
inattention to one side that is
not due to a primary sensory
or motor impairment

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21
Q

what are we looking at with meta cognition

A

executive functioning
self awareness

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22
Q

what is taken over by meta cognition

A

-Inability to divide attention

-Inability to generalize

-Decreased safety awareness
and judgment

-Poor insight to condition

-Problem-solving deficits

-Impaired executive function:

  • inability to:
    -prioritize or select a behavior
    that is appropriate to the
    situation.
  • inhibit inappropriate behaviors
  • to maintain focus to a task
    despite distractions
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23
Q

I- Olfactory

A

Each nostril separately

 Have the patient report if they can smell a non-
noxious odorants

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24
Q

Anosmia-

A

loss of the sense
of smell

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25
Q

II-Optic - 4 tests

A

Visual acuity
visual fields
pupillary light reflex
accommodation (convergence)

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26
Q

Visual acuity

A

ability to discern letters or numbers at a given distance according to a fixed standard.

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27
Q

visual fields

A

Normal VF for each eye extends out from the
patient in all directions

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28
Q

field cut

A

specific regions where patient lost ability to see

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29
Q

pupillary light reflex

A

bring penlight from the side of the patient’s head
into the eye

 both eyes should constrict *direct light reflex and
indirect (consensual) reflex

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30
Q

what is accommodation (convergence)

A

Comes into play when there is a need to view an object at near distances without double vision

Automatic response to adjust the position of the eye so that the image falls on the fovea of both eyes and to adjust the lens to maintain sharp focus at near distance

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31
Q

accommodation (convergence)

A

Tested by asking the patient to focus both eyes on
a target ( ~ 14-point font size)

 Patient focuses on the target at arm’s length and slowly brings it to the tip of their nose

 Patient is instructed to stop moving the target when they see 2 distinct images or when the examiner
observes outward deviation of one eye.

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32
Q

action of III

A

up, down, up and in

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33
Q

action of Trochlear Nerve

A

down and out

34
Q

action of Abducens Nerve (CN VI)

A

moves eye laterally, out

35
Q

Cranial Nerve III
Oculomotor extras

A

involved with
pupillary light reflex, near point
convergence-NPC and elevation
of the eye lid

36
Q

Oculomotor, tochlear, abducens

A

Conjugate movement - H test

37
Q

what are Smooth Pursuits

A

ability to follow
an object across full range of
vertical and horizontal eye
movements

38
Q

what are Saccades

A

are eye movements
used to rapidly refixate from
one object to another

39
Q

what are Nystagmus

A

quick jumping eye movement

40
Q

Saccade intrusion

A

eyes jumping to track the object

41
Q

Cranial Nerve V
Trigeminal - sensory component

A

Facial Sensation–face, head, cornea, mucosa of
nose, mouth, hard and soft palate, and tongue

42
Q

Cranial Nerve V
Trigeminal - motor component

A

muscles of mastication

43
Q

VII-Facial - motor

A

Show Teeth superior levator
Smile buccinatior

Eyes Closed Tight orbicularis, frontal belly

Elevating Eyebrows epicranius

Contract Platysma platysma

*Note efferent limb for the Corneal reflex

44
Q

VII-facial - sensory

A

Taste Anterior 2/3 of the tongue

45
Q

issues with facial nerve

A

bell’s palsy

46
Q

Horizontal and Vertical VOR- VIII Vestibulocochlear

A

A target ( of 14 point font size) is held in front of the patient in
midline at a distance of ~3’)

 Patient rotate head horizontally and maintains focus on the target
(stable) at a quick speed ( metronome set at 180 beats/minute).

 Patient rotate head vertically and maintains focus on the target
(stable) at a quick speed ( metronome set at 180 beats/minute).

47
Q

Glossopharyngeal does what

A

taste to posterior 1/3 of tongue

48
Q

Dysphagia-

A

difficulty in swallowing

49
Q

how to test gloss and vagus

A

Observe the movement of the uvula* and soft
palate with phonation and elicitation of the
pharyngeal reflex

 Say AH

50
Q

test Spinal
Accessory

A

Trapezius
SCM

51
Q

Cranial Nerve XII
Hypoglossal

A

Motor to tongue

52
Q

Sensory - light touch

A

Use cotton wisp

Apply gentle touch (don’t drag
the stimulus)

Eyes are closed and the patient
reports YES, every time he
perceives the stimulus

53
Q

Sensory - pain and temp

A

testing the anterolateral spinothalamic
system

Use cold reflex hammer handle
Ask the patient if he perceives
the handle as cold

54
Q

sensory - JPS is testing what

A

DCML system

55
Q

testing JPS

A

Eyes closed (EC)
Hold the digit lightly by the
sides while moving the patient’s
finger or toes up or down.
Ask the patient to report after
each movement the direction of
the movement

56
Q

Kinesthesia testing

A

Patient describes the direction
of limb movement while in
motion

57
Q

Vibration

A

Vibration Apply stimulus (128 Hz
vibration fork) over the distal
phalanx of the index finger or
great toe

Ask the patient to report
whether they feel the vibration
sense and then to report when it
stops.

testing the DCML

58
Q

what is Combined Cortical
sensation
EX: Stereognosis

A

test for lesions of the sensory
cortex

59
Q

how to testCombined Cortical
sensation

A

Eyes closed

Place an item such as a coin,
key, paper clip in the hand of
the patient.

The patient is to manipulate the
stimulus and identify the item

60
Q

Muscle mass-

A

Inspect bulk, girth

61
Q

Passive movement

A

Assess soft tissue limitations
and tone*
Goniometry

62
Q

*Tone

A

Ask to patient to relax. Move
each limb at several joints to get
a feel for any resistance or
stiffness that may be present

63
Q

what is Spasticity

A

a condition in which there is an abnormal increase in muscle tone or stiffness of muscle, which might interfere with movement

as
a “catch” or a very stiff
limb that cannot be moved
passively

64
Q

Spasticity is a
manifestation of what

A

an UMN issue

65
Q

Rigidity

A

“lead pipe or
cogwheel” resistance to
passive movement and is
seen with disorders such as
Parkinson’s disease

66
Q

hypotonia is seen with what issue

A

LMN issue

67
Q

tests for coordination

A

Finger to nose

Heel to shin

Rapid alternating
Movement:
Supination/pronation
Toe/finger tapping

68
Q

what is Dysmetria-

A

inability to
judge distance or range of
movement

69
Q

test for Dysmetria-

A

finger to nose
shin and heel

70
Q

hypometria

A

underreaching an object during voluntary motor activity

71
Q

hypermetria

A

overreaching an object during voluntary motor activity

72
Q

Dysdiadochokinesis

A

difficulty with reversal of
movements

73
Q

Dysdiadochokinesis test

A

Rapid alternating
Movement:
Supination/pronation
Toe/finger tapping

74
Q

Ataxia-

A

uncoordinated
movement

75
Q

Ataxia- test

A

watch someone move

76
Q

Static Standing
balance two tests

A

Sensory Organization (orientation)/ CNS
Integration

and

Reactive postural
control

77
Q

Sensory Organization (orientation)/ CNS Integration

A

Ask the patient to maintain
standing with EO/ EC
on floor
and
EO/EC on foam

looking at the ablity to use sensory input

78
Q

Reactive postural
control

A

Ask the patient to maintain a
posture or steady oneself with
perturbation

79
Q

how to assess Dynamic standing
Balance

A

Voluntary (selfgenerated) postural
control

80
Q

Voluntary (selfgenerated) postural
control

A

Ask the patient to while
standing to perform a voluntary
activity

Neuromus 1 (15 decks)

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