Week 3 Flashcards
Indirect Data
gathering data through the way a patient responds during the interview
when would you conduct a full mental health examination?
if family members express concern about the patients behaviour, if there is a brain injury or aphasia, or if symptoms of a mental illness are observed
Factors that may affect mental health findings
pre-exisiting illnesses or medications. These factors are included in the health history
what are the 4 main components of the mental status exam
Appearance, Behaviour, cognitive functions and thought processes (A, B, C, T
MOCA
a simplified scored assessment of cognitive functions (not mood or thought processes)
The MOCA is used to detect?
dementia and delirium and to differentiate organic brain disorders from psychiatric illnesses
Aging and its effects on the mental status exam?
slower response time may affect learning. Age-related physical changes may also have an affect on the mental status exam (hearing or vision loss)
before assessing an older adults mental status?
check sensory status and correct deficits if possible
set test
assess the mental status by asking the patient to name ten items in 4 categories
Pain is a?
highly complex and subjective experience
phases of nociceptive pain?
transduction, transmission, perception and modulation
nociceptive pain is?
predictable and time limited
neuropathic pain implies?
an abnormal processing of the pain message due to an injury of nerve fibers and is sustained on a neurochemical level
Referred pain
originates in one area but is felt in another. Both areas are inervated by the same spinal nerve so it is difficult for the brain to differentiate the point of origin
acute pain
short and self limiting. follows a predictable tract and ends after the injury heals
Persistant/ chronic pain
Continues for 6 months or longer. results from abnormal processing of pain fibers that do not stop when injury heals.
Pain and infants
Infants have the same capacity for pain as adults do but are at high risk for undertreatment since they are nonverbal
Pain and older adults
although pain is common in older adults, it is not a normal part of aging
pain and genetics
genetic differences in men and women may account for differences in pain perception
Cross-cultural Pain
ask each patient how they typically behave when in pain
subjective report
the most reliable indicator of pain
canthus
inner corner of the eye where the lids meet
caruncle
small fleshy mass containing sebaceous glands located at inner canthus
conjunctiva
thin, transparent mucous membrane covering the exposed part of the eye
lacrimal apparatus
provides continuous irrigation
the muscles that direct eye movement are innervated by
cranial nerves 3, 4 and 6
outer layer of the eye
sclera, cornea, iris and pupil
middle layer of the eye
choroid, ciliary body
choroid
has dark pigmentation to prevent light from reflecting internally and is highly vascular to deliver blood to the retina
ciliary body
controls the thickness of the lens
iris
contracts and dilates the pupil to control how much light is let in to the retina
retina
the visual receptive layer of the eye. Light waves are changed into nerve impulses here
pupillary light reflex
the normal constriction of the pupils when bright light shines on the retina
fixation
a reflex direction of the eye toward and object attracting that persons attention
accomodation
the adjustment of the eye for near vision accomplished by ciliary muscle movement
presbyopia
occurs with aging. lens loses elasticity and decreases its ability to change shape to accommodate for near vision
retinal detachment
emergency situation where the retina becomes detached from the layer of vessels that provide it with oxygen and nutrients
Increased intraocular pressure, gradual loss of peripheral vision and leading cause of irreversible blindness
Glaucoma
Lens opacity, common in elderly population, results from clumping to proteins in lens.
cataracts
breakdown of cells in the macula of the retina, loss of central vision, most common cause of blindness
macular degeneration
microvascular change that is the leading cause of visual impairment in people less than 65
diabetic retinopathy
snellen eye chart tests?
central visual accuity
confrontation test assesses?
visual fields
corneal light reflex assesses?
extraocular muscle movements
conductive hearing loss
involves a mechanical dysfunction of the external or middle ear
sensorineural hearing loss
indicates a pathological condition of cranial nerve 8
presbycusis
age related gradual deterioration of cranial nerve 8 resulting in sensorineural hearing loss
romberg test evaluates
standing balance. Ask the person to stand with their eyes closed
otitis media
middle ear infection resulting from obstruction of the eustachian tube or passage of secretions into the middle ear
adult ear exam
pull pinna up and back
infant and child under 3 ear exam
pull pinna straight down
exostosis
formation of a new bone in the ear
polyp
arises in the canal from granulomatous or mucosal tissue. Red and bleeds easily, foul discharge, indicates chronic ear disease
tympanic membrane in older adults
appears, whiter duller and more opaque
which paranasal sinuses are available for examination
the frontal and maxillary sinuses
1 + tonsils
visible
2 + tonsils
halfway between tonsillar pilars and uvula
3 + tonsils
touching uvula
4 + tonsils
touching each other
