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Neuromanagment > Neurologic Assessment > Flashcards

Neurologic Assessment Flashcards

1
Q

What factors should you know about an individual’s pain?

A
  • location
  • quality
  • severity
  • duration
  • precipitating factors
  • associated symptoms
  • exasperation/diminished pain
  • onset
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2
Q

What is the Wong-Baker Face Scale

A

A pain assessment

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3
Q

What do headaches signal in neurology?

A

Headaches can be a result of many different causes. Headaches are not a good indicator of neuro trouble.

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4
Q

What is vertigo?

A

Sensation of moving around in space or objects moving around a person. There are associated symptoms which can include lightheadedness, dizziness, and nausea (fall risk)

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5
Q

What should be assessed to determine cerebral function?

A
  • mental status
  • intellectual function
  • thought content
  • emotional status
  • perception
  • motor ability
  • language ability
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6
Q

What is the typical mental status of someone who is alert?

A

Individual is able to open eyes spontaneously, can respond appropriately and briskly, and is oriented

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7
Q

What is the typical mental status of someone who is lethargic?

A

Individual opens eyes to verbal stimuli, is slow to respond but responds appropriately, has a short attention span, or may be obtunded (more depressed level of consciousness)

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8
Q

What is the typical mental status of someone who is in a stupor?

A

Individual responds to physical stimuli with moans and groans, is never fully awake, is confused, and speaks/communicates unclearly (word formation is difficult)

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9
Q

What is the typical mental status of someone who is semi-comatose?

A

Individual responds to painful stimuli (sternal rub), there is no conversation, and protective reflexes are present

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10
Q

What is the typical mental status of someone who is comatose?

A

Individual is unresponsive except to severe pain, does not have any protective reflexes, has fixed pupils, and does not have any voluntary movement

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11
Q

What does unconscious mean?

A

It is a non-medical word that ranges from stupor to coma

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12
Q

What is a persistent vegetative state?

A

Individual has no cognitive brain function, still has wake/sleep cycles, and has a very poor prognosis (3-6 months)

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13
Q

What does brain dead mean?

A

Individual has no brain function and only has reflexive movements

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14
Q

What are different types of stimuli that are used to get a response?

A

1) Voice
2) Touch
3) Shaking
4) Voice and shaking
5) Noxious/painful stimuli (sternal rub)

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15
Q

What are the natures of response to stimuli?

A

1) Eyes open
2) Remove stimuli
3) Abnormal posturing
4) No response

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16
Q

What is the Glasgow Coma Scale?

A

Most commonly used scoring system to describe level of consciousness in a person following a traumatic brain injury. The GCS is not typically used with children. The Pediatric Glasgow Coma Scale is used. The GCS is a strong predictor of patient outcome

Severe: GCS 8 or less (coma)
Moderate: GCS 9-12
Mild: GCS 13-15

17
Q

GCS Eye Opening

A 
Eye Opening:
Spontaneous -  4
To speech - 3
To pain - 2
Nil - 1
18
Q

GCS Motor Response

A 
Best Motor Response:
Obeys - 6
Localizes - 5
Withdraws - 4
Abnormal flexion - 3
Extension response - 2
Nil - 1
19
Q

GCS Verbal Response

A 
Verbal Response:
Oriented - 5
Confused conversation - 4
Inappropriate words - 3
Incomprehensible sounds - 2
Nil - 1
20
Q

What things should you look at when assessing someone’s appearance?

A
  • grooming
  • dress
  • aids
  • eye deviation
  • skin

A visual assessment is used to identify signs of trauma (wounds, scrapes, ecchymosis - discoloration under skin due to bleeding etc.)

21
Q

What does Battle’s Sign indicate?

A

Bruising over the mastoid suggests a skull fracture

22
Q

What do Raccoon’s eyes indicate?

A

Periorbital edema and bruising suggests frontal-basal fracture

23
Q

What does Rhinorrhea indicate?

A

Drainage of CSF from the nose suggests a fracture of the cribiform with torn meninges (commonly seen with gun shot wounds)

24
Q

What does Otorrhea indicate?

A

Drainage of CSF from the ear suggests a fracture of the temporal bone with torn meninges

25
Q

What is decorticate posturing?

A

Flexed posturing:

  • flexed arm/elbow
  • flexed wrists/fingers
  • adducted arms
  • legs with internal rotation
  • feet are plantar flexed

Individuals in decorticate posturing are at risk of contractures because they usually occur in flexors first

26
Q

What does decorticate posturing suggest?

A

Damage to the cortico-spinal tract. This is more favorable than decerebrate posture

27
Q

What is decerebrate posturing?

A

Extension posturing:

  • extended arm/elbow
  • flexed wrist/fingers
  • adducted arm
  • pronation of arm
  • feet are plantar flexed
28
Q

What does decerebrate posturing suggest?

A

Severe injury to the brain at the level of the brainstem

Opisthotonos is a severe muscle spasm of the neck and back

This is a more ominous posture

29
Q

What is orientation?

A

x4

  • person
  • place
  • time
  • situation
30
Q

What are neurological assessments like?

A

Bottom up = measure component skills
Top down = performance in task
Combination of both = dependent on type of eval and clinical reasoning process

31
Q

What is a neurological evaluation like?

A

Gathering data from:

  • Medical record/chart review
  • Observation of client interacting with family, staff, and other clients
  • Interviews with client and family
  • Quantitative assessment - non-numerical: DASH, Wong-Baker Pain Scale, Barthel Assessment
  • Occupation based evaluations
  • Dynamic assessment - evaluates learning potential and detects weakened skills that will affect learning potential
32
Q

What do neurological OT assessments include?

A
  • Sensation - light touch stimulus, proprioception, 2-point discrimination, sharp/dull stimulus
  • ROM/MMT (deformity control)
    (head and neck - posture, UE, and head and UE motor control)
  • Wrist and hand function
  • Trunk control
  • Activities of daily living
  • Vision/visual perception
  • Cognition (thinking, memory, personality)
  • Apraxia/perception
  • Endurance - assess ability to tolerate activity (bed > sitting > EOB > chair > standing) and note type of activity, resistance (if any), and the amount of time the activity is tolerated
33
Q

What psychosocial components should be considered with neurological insult?

A
  • Client’s understanding of the situation
  • Coping skills available
  • Problem solving skills
  • Ability to direct others
  • Family involvement
  • Discharge plans/options
  • Motivation/participation in goal setting
34
Q

What problems should be considered with neurological insult?

A
  • Identify strengths and deficit areas during evaluation
  • Re-evaluate as patient improves
  • Apparent problems are a combination of cognitive, sensory-perceptual, sensorimotor, and behavioral deficits - identify each deficit and determine severity of deficit in relation to other deficits

Neuromanagment (22 decks)

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