Neuro Exam for Geriatrics

Question 1

The number of adults older than 85

Answer 1

/

Question 2

What anatomical changes occur?

Answer 2

eyes

Question 3

What causes sunken eyeballs?

Answer 3

fat atrophy

Question 4

Decreased tearing may lead to ?

Answer 4

dry eyes

decreased corneal luster

Question 5

What happens to pupils as age increases?

Answer 5

pupils decrease in size and may become irregular

-still respond to light and near effort but exam of the ocular fundi become difficult

Question 6

When does visual acuity remain constant?

Answer 6

20-50 yo

and then starts to diminish gradually until age 70

Question 7

Near vision begins to decrease at age ?

Answer 7

40 years

presbyopia

Question 8

What happens to lenses?

Answer 8

• lose elasticity gradually
• less able to accommodate and focus
• lens thickens and yellows which impairs the passage of light to retina

Question 9

What are the cataract ratios for people in their 60s? 80s?

Answer 9

60 - 1 in 10

80 - 1 in 3

Question 10

Lens growth increases the risk of what?

Answer 10

narrow angle glaucoma

Question 11

How does hearing acuity change over time?

Answer 11

decreases with age

Question 12

Which sounds are lost with Presbycusis?

Answer 12

consonants

Question 13

How is the nose, salivary glands and tongue affected with age?

Answer 13

• decreased salivary secretions
• decreased sense of taste
• olfaction decreases with age
• increased sensitivity to bitterness and saltiness

Question 14

How is hearing changed over time?

Answer 14

• high pitched sounds start to decrease

- hearing loss in the middle and lower ranges can cause word distortion, especially in noisy environments

Question 15

What changes happen in mental status?

Answer 15

memory loss - usually “benign forgetfulness”

Question 16

What is an MMSE?

Answer 16

mini mental status exam - help Alzheimer’s disease

Question 17

How would you determine depression versus dementia/delirium?

Answer 17

decreases levels of serotonin etc.

Question 18

What vitamins are decreased in alcoholics?

Answer 18

Thiamine

Niacin

Question 19

What can cause delirium or change in personality?

Answer 19

dehydration

UTI

Question 20

What is Alzheimer’s disease characterized by?

Answer 20

cerebral atrophy

-

Question 21

Motor and Sensory system

Answer 21

• move and react with less speed and agility
• skeletal muscles decrease in builk
• hands look thin and bondy secondary to atrophy of interosseous muscle
• muscle strength may be diminished

Question 22

What types of tremors may appear?

Answer 22

action tremor - occurs when the affected part is actively maintaining a posture

• bilateral and symmetric
• diminished by alcohol

Question 23

Where is vibration sense decreased or lost?

Answer 23

feet and ankles

Question 24

What do you inspect for in the eyes?

Answer 24

• senile ptosis
• sclera
• arcus sinilis - cholesterol
• visual acuity
• presbyopia

Question 25

What 3 things would you check for in the ophthalmoscopic exam?

Answer 25

slide

Question 26

drusen?

Answer 26

/

Question 27

What are the 2 types of macular degeneration?

Answer 27

dry atrophic - more common and less severe

wet exudative - neovascular

Question 28

What eye problem would lead to restricted driving?

Answer 28

macular degeneration

Question 29

What hearing tests can be done?

Answer 29

Rinne

audiologist

Question 30

What do you check in the oral cavity?

Answer 30

oral cavity for odor

• mucosa
• quantity of saliva

Question 31

What may be the cause of decreased salivation?

Answer 31

-decreased salivation my be due to medications, dehydration, radiation, Sjogren’s syndrome (autoimmune disease that causes decreased salivation)

Question 32

Which tests do you use to assess gait and balance?

Answer 32

look up

-check for tremor, rigidity, bradykinesia, micrographia (small handwriting), shuffling gait

Question 33

What disease do you check for in Cog wheel’s rigidity?

Answer 33

Cog wheel rigidity - Parkinson’s