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314 > Sensory/Mental Status Assessment > Flashcards

Sensory/Mental Status Assessment Flashcards

1
Q

frontal lobe

A

personality, behavior, emotions, and intellectual function

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2
Q

precentral gyrus of the frontal lobe

A

initiates voluntary movement

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3
Q

parietal lobe’s postcentral gyrus

A

primary center for sensation

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4
Q

occipital lobe

A

primary visual receptor center

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5
Q

temporal lobe

A

behind the ear, primary auditory reception center

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6
Q

Wernicke’s area in temporal lobe

A

language comprehension (reception)

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7
Q

Broca’s area in the frontal lobe

A

mediates motor speech (expression)

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8
Q

Damage to specific cortical areas produces:

A
  • corresponding loss of function
  • impaired ability to understand/process language
  • impaired ability to express
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9
Q

spinal cord

A

nervous tissue that occupies upper 2/3 of vertebral canal from medulla to lumbar vertebrae L1 to L2
- main highway that connects the brain to spinal nerves
- mediates reflexes

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10
Q

Left cerebral cortex receives sensory information from and controls the motor function of what side of the body?

A

right side

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11
Q

Components of neurological system?

A

intellectual function (memory, knowledge, abstract thinking, association, judgment) and cranial nerve function

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12
Q

motor function

A
  • coordination of gross and fine motor functioning
    -integrates assessment of neurological system and musculoskeletal systems
  • walking, other gross movements, fine motor movements
  • balance
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13
Q

What is a test to measure balance?

A

Romberg’s test

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14
Q

reflexes

A
  • basic defense mechanisms
  • involuntary, quick reaction to painful or damaging situations
  • helps maintain balance and muscle tone
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15
Q

What are the 4 types of reflexes?

A
  1. deep tendon reflexes (knee jerk)
  2. superficial (ab/corneal reflex)
  3. visceral (pupillary response to light)
  4. pathologic (abnormal)
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16
Q

deep tendon reflexes

A
  • position (have patient relaxed and eyes closed)
  • tap tendon briskly
  • compare bilaterally
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17
Q

Grading the deep tendon reflexes

A

0 = absent/no response
1 = sluggish/diminished response
2 = active/expected response
3 = slightly hyperactive/more brisk than normal; not necessarily pathologic
4 = brisk, hyperactive with intermittent clonus associated with pathology

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18
Q

plantar reflex (Babinski)

A
  • stroke the lateral aspect of the sole from the heel to the ball of the foot, curving medially across the ball
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19
Q

negative Babinski

A
  • desired
  • plantar flexion/scrunching of the toes
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20
Q

positive Babinski

A
  • abnormal finding for anyone over the age of 2 years old
  • extension/fanning of the toes
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21
Q

reception

A

stimulation of a receptor such as light, touch, or sound

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22
Q

perception

A

integration and interpretation of stimuli

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23
Q

reaction

A

only the most important stimuli will elicit a reaction

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24
Q

sensory deficits

A

deficit in the normal function of sensory reception and perception

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25
Q

sensory deprivation

A

inadequate quality or quantity of stimulation

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26
Q

sensory overload

A
  • reception of multiple sensory stimuli and cannot disregard
  • can cause behavioral changes: mood swings, agitation, restlessness
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27
Q

What are the factors affecting sensory function?

A
  • age
  • meaningful stimuli
  • amount of stimuli
  • social interaction
  • environmental factors
  • cultural factors
28
Q

What are the senses?

A
  • sight/visual
  • hearing/auditory
  • touch/tactile
  • smell/olfactory
  • taste/gustatory
  • position and motion/kinesthetic
29
Q

How to test sight?

A

visual acuity

30
Q

How to test hearing?

A

whisper test, audiometer, higher level

31
Q

How to test smell?

A

differentiate scents w/ eyes closed

32
Q

How to test taste?

A

distinct flavors

33
Q

How to test touch?

A

pain, temperature, light/firm/sharp/dull, vibration, position, discrimination

34
Q

discriminatory testing

A

assess the ability of the cerebral cortex to interpret and integrate information

35
Q

stereognosis

A
  1. ask patient to close eyes, place object in hand, and ask to identify it
  2. discriminate shape, size, weight, texture, and form of a familiar object by touching and manipulating it
  3. altered stereognosis may indicate a parietal lobe or sensory nerve tract dysfunction
36
Q

graphesthesia

A
  • ability to discriminate outlines, numbers, words, or symbols traced on the skin
  • if the client cannot distinguish the number or letter, it may indicate a parietal lobe lesion
37
Q

dermatomes

A
  • areas of skin innervated by specific dorsal root nerves
  • location of spinal injury determines area of altered function
  • assesses general skin sensation
38
Q

mental status

A

person’s emotional and cognitive functioning

39
Q

What is the typical sequence of orientation loss?

A

time, then place

40
Q

When is a comprehensive mental status exam is necessary?

A
  • initial screening suggests an anxiety or depression
  • behavior changes: memory loss, inappropriate social interaction
  • brain lesions: trauma, tumor, CVA/stroke
  • aphasia: impairment of language ability
  • S/S of psychiatric mental illness, especially with acute onset
41
Q

subjective mental status assessment data

A

medical history, medications, recent changes in senses, behaviors, cognition, OLDCART

42
Q

objective mental status assessment data

A

level of consciousness, behavior/appearance, language

43
Q

level of consciousness

A

assess on a continuum: fully awake to nonresponsive

44
Q

alert

A

awake or readily aroused

45
Q

lethargic (somnolent)

A

not fully alert, drifts off to sleep when not stimulated

46
Q

obtunded

A

sleeps most of the time, difficult to arouse

47
Q

stupor/semi-coma

A

sleepy, limited/minimal response

48
Q

coma

A

completely unconscious, minimal/no response to stimuli

49
Q

Glasgow Coma Scale

A

standard assessment for anyone with altered LOC; assess for eyes opening, verbal response, motor response

50
Q

Screening for suicidal thoughts

A
  • when person expresses sadness, despair, hopelessness, or grief
  • assess for any risk of physical harm to self
  • begin with general questions
  • if you hear affirmative answers, continue with more specific probing questions
51
Q

aphasia

A

impaired/absent ability to speak, interpret, or understand language

52
Q

expressive aphasia

A

difficulty expressing thoughts through words, spoken or written

53
Q

receptive aphasia

A

difficulty receiving/understanding language, spoken or written

54
Q

global aphasia

A

inability to understand language or communicate orally

55
Q

intellectual function assessment

A
  • memory: recent/remote
  • knowledge: level of understanding of what they “should” understand
  • abstract thinking
  • association
  • judgment
  • developmentally/age appropriate
56
Q

Mini-Mental State Exam

A
  • concentrates on cognitive functioning, not mood or thought processes
  • standard questions, 5-10 minutes to complete
  • numerical scale of 1-30 (higher score is better; 20-30 normal)
  • good tool to detect dementia and delirium
57
Q

Mini-Cog

A
  • reliable, quick, and available instrument to screen for cog impairment in healthy adults
  • three-item recall test and clock drawing test
  • tests person’s executive function
  • those with no cognitive impairment or dementia can recall the three words and draw the clock
58
Q

executive function

A

ability to plan, manage time, and organize activities as well as work from memory

59
Q

remote memory

A
  • lost when storage area for the memory is damaged
  • ask person verifiable past events
  • Alzheimer’s, dementia, any disease/trauma to cerebral cortex
60
Q

recent memory

A
  • assess in context of interview by 24-hour diet recall or by asking time person arrived
  • ask questions you can corroborate to screen for occasional person who confabulates or make sup answers to fill in gaps of memory loss
61
Q

Developmental competence in infants/children?

A
  • abnormalities are more often that the child does not achieve expected milestone or are significantly delayed
  • follow similar guidelines, with consideration for developmental milestones (appearance, behaviors, cognition, thought processes)
62
Q

Developmental care of aging adults

A
  • check sensory status, vision, and hearing BEFORE any aspect of mental status
  • confusion is the most common and easily misdiagnosed
  • highest risk for sensory alterations
63
Q

What is the orientation of aging adults?

A
  • many aging adults experience social isolation, loss of structure without a job, change in residence, or some short-term memory loss
  • considered oriented if they know generally where they are the present period
  • consider oriented to time if year and month are correctly states
  • orientation to place is accepted with correct identification of the type of setting
64
Q

What are the three most common cognitive problems in adults?

A
  1. delirium (acute confusion)
  2. dementia
  3. depression

these problems often occur together

65
Q

Acute care of patients with altered sensation

A
  • orientation to the environment
  • communication
  • controlling sensory stimuli
  • safety measures
66
Q

Restorative and continuing care of patients with altered sensation

A
  • orientation to the environment
  • communication
  • controlling sensory stimuli
  • safety measures
  • maintaining health lifestyles
  • understanding sensory loss
  • socialization
  • promoting self-care

314 (4 decks)

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