Neurology Evaluation Flashcards
5 Level of Consciousness
ALSOC: Alert, Lethargic, Obtunded, Stupor, Coma
Level of Consciousness: Response to loud voice and painful stimuli
Obtunded
Level of Consciousness: Cannot be aroused
Coma
Level of Consciousness: Normal, attentive, appropriate
Alert
Level of Consciousness: Movement caused by Motor Reflex
Coma
Level of Consciousness: Responds to painful stimuli
Stupor
Level of Consciousness: Drowsy and has a tendency to fall asleep
Lethargic
Level of Consciousness: Can be aroused
Lethargic
Hallmarks of Coma
(-) EO, Verbal Response, Motor Response
Glasgow Coma Scale: Eye-Opening Range
1-4
Eye-Opening Score: 4
Spontaneous EO
Verbal Response Score: 2
Incomprehensible
Glasgow Coma Scale: Verbal Response Range
1-5
Motor Response Score: 3
Decorticate
Eye-Opening Score: 2
As to Pain
Motor Response Score: 6
Follows Command
Verbal Response Score: 4
Confused
Verbal Response Score: 3
Inappropriate
Eye-Opening Score: 3
As to Speech
Motor Response Score: 5
Localizes
Verbal Response Score: 5
Oriented
Motor Response Score: 4
Withdrawal
Motor Response Score: 2
Decerebrate
Glasgow Coma Scale: Motor Response Range
1-6
Mild Score for Glasgow Coma Scale
13-15
Severe Score for Glasgow Coma Scale
<8
Moderate Score for Glasgow Coma Scale
9-12
Physiological readiness to the body system to activity
Arousal
Neurologic Evaluation for learnings and Experiences
Cognition
Selective awareness of the environment
Attention
Neurologic Evaluation for time, person, and place
Orientation
3 areas of cognition
Fund of knowledge, Calculation, Proverbs of Interpretation
Inability to count
Acalculia
Neurologic Evaluation for one’s ability to recall
Memory
The assessment used to test Visual Acquity
Snellen Chart
Difficulty in counting
Dyscalculia
The assessment used to test STM
Telephone number, Repeat after me (5 mins, 30 mins)
“Exteroreceptors”
Superficial Receptors
“Cortical”
Combined Receptors
“Proprioceptors”
Deep Receptors
Two Primary Spinal Pathways
Anterolateral Spinothalamic Tract and Dorsal Column Medial Lemniscal Tract
Signals that ascends in Anterior Spinothalamic Tract
Touch and Pressure
Signals that ascends in Dorsal Column Medial Lemniscal Tract
Proprioception, Kinesthesia, Vibration
Signals that ascends in Posterior Spinothalamic Tract
Pain and Temperature
Sensory Examination: Superficial Receptors
Touch, Pressure, Pain, and Temperature
To assess the pressure of the Achilles
Pinch area with thumb and index finger
The temperature in assessing warmth
40-degree Celcius or 45-degree Celcius
The temperature in assessing cold
5-degree Celcius or 10-degree Celcius
Sensory Examination: Deep Receptors
Proprioception, Kinesthesia, Vibration
Awareness of the position sense at rest
Proprioception
What frequency is used in assessing vibration
128 Hz
Ability to perceive the joint movement
Kinesthesia
Areas to assess vibration
Sternum, UE, LE
Ability to identify the location of the touch
Tactile Localization
Weight Recognition
Barognosis
Tactile object identification
Stereognosis
Ability to identify 2 point touch stimulus
Two-point discrimination
Traced figure identification
Graphesthesia
The resistance of the muscle to passive elongation and contraction
Tone
Three factors affecting the tone
Inertia, Mechanical Body Stiffness, Tonic Stretch Reflex
Hypokinetic motor disorder (UMNL)
Spasticity
Increased resistance initially followed by sudden inhibition
Claps Knife response
Uniform passive resistance all throughout the ROM
Rigidity
Cyclic, spasmodic alteration of muscle contraction and inhibition
Clonus
Velocity Independent
Rigidity
Velocity Dependent
Spasticity
Hypokinetic motor disorder (LMNL)
Flaccidity
Sudden loss of muscle tone
Spinal or Cerebral Shock
Abnormal Flexor Tone
Decorticate
Strong & Sustained muscle contraction of neck and trunk extension
Epistothonus
Abnormal Extensor Tone
Decerebrate
MAS: Considerable increase of resistance all throughout ROM
3
MAS: Minimal increased of resistance at half of ROM
1+
MAS: Catch and Release
1
MAS: No icnrease of muscle tone
0
MAS: Rigid
4
MAS: Minimal increase of resistance at End of ROM
1
MAS: Marked increase of resistance at most ROM
2
MAS: Passive ROM is difficult
3
Spastic Reflex: DF of Ankle
Babinski Reflex