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Adv. Health Assessment- Al > Week 7 > Flashcards

Week 7 Flashcards

1
Q

pediatric neuro exam- provider needs to consider what three factors when considering the findings?

A
  • age
  • developmental level
  • temperament (shy, happy etc.)
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2
Q

6 cafe-au-lait spots can indicate what syndrome?

A

neurofibromatosis

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3
Q

port wine stain over the eye can be a sign of what neuro syndrome?

A

sturge-weber symdrome

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4
Q

do port wine stains go away?

A

no but they can now be lasered

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5
Q

neuro exam order: from the highest level of neuro functioning and conducting to the lowest

A
  1. cerebral functioning (behavior and mental status)
  2. cranial nerves
  3. motor function
  4. sensory function
  5. reflexes

think about carly- she was disabled in points 2-5 but lost them in the opposite order

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6
Q

when do we start to evaluate abstract reasoning (age)?

A

11 years

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7
Q

cranial nerve abnormalities found on assessment and what nerve they are associated with:
Ptosis
facial symmetry
horse voice
expressive language difficulties
abnormal eye position
abnormal puppillary reactions
shrugging shoulders

A

Ptosis 3
facial symmetry 7
horse voice 10
expressive language difficulties 9, 10 and 12
abnormal eye position 3,4, 6
abnormal pupillary reactions 2, 3
shrugging shoulders 11

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8
Q

accronyms to rember names of cranial nerves and functions of cranial nerves

A

NAMES: Oo Oo Oo To Touch And Feel, Very Good Virgins Always Heal

FUNCTIONS: Some Say Marry Money But My Brother Says Big Brains Matter Most

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9
Q

components of the cerebellar function examination

A

1, gait and balance
2. romberg
3. hopping in place
4. heel to toe walking
5. heel to shin walking
6. rapid alternating movements
7 finger to nose

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10
Q

romburg test

A

stand behind child, they can midly sway but should not lose balence

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11
Q

hop on 1 foot by what age?

A

4 years

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12
Q

heel to toe walking- what is it and what age

A

walking on a tight rope by age 6

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13
Q

heel to shin what is it and when to test for it

A

age 8-9 and adults
sit supine, have patient put heel on shin under the knee and run it down to the top of the foot- as quickly as possible and repeated. abnormalities indicate ipsilateral lesion on cerabellar

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14
Q

what does ipsilateral mean and contralateral mean?

A

same side, opposite side

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15
Q

rapid alternating movement- what to do and what age

A

8-9 years
place hands on thighs and then rapidly turn hands over with palms up quickly alternating and repeating the movements. ask to do for 10 seconds as fast as possible. movements should be quick and rhythmic

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16
Q

light touch exam

A

stretch cotton ball, pt should be able to identify area of the body that is being touched

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17
Q

proprioception sensation

A

move fingers or toes up and down while child closes eyes and they tell you what direction its being moved

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18
Q

pain assessment

A

sharp/dull sensation
use end of reflex hammer

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19
Q

temperature test

A

this should only be assessed when perception of pain is abnormal

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20
Q

vibration

A

low pitched tuning fork placed on bony prominences, repeated on both sides- patient states when the vibration stops

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21
Q

stereognosis

A

placing a familure object in childs hand (paperclip, pencil, coin) and asking them to name it with their eyes closed

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22
Q

graphestesia

A

writing a number on the palm of the hand of a child and having them identify which number you drew

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23
Q

when does the tricep reflex appear?

A

6 months

24
Q

when does the patellar relex appear?

A

birth

25
Q

what are the superficial reflexes

A

abdominal, plantar, cremasteric and anal wink. evaluated as present or absent (not graded)

26
Q

abdominal reflex

A

reflex hammer is stroked over the abdomen toward umbilicus and the muscles contract

27
Q

Babinski reflex

A

plantar reflex
foot stroke with hammer, normal is flexion of the toes

kids who are not walking yt- positive babinski is normal becuase of the immaturity of the nervous sytem

28
Q

cremasteric reflex

A

male only
cotton applicator is stoked upper, inner thigh of the patient and in response the scrotum on the same side elevates

29
Q

primitive reflexes- what are they and when do they go away?

A

present at birth, go away by age 4-6 mo
should be tested in kids 1 year or younger
postural reflexes replace primitive
- moro
-rooting
-sucking
-stepping (placing)
- palmar grasp
- ankle clonus
- galant (truncal incurvation)
- asymmetric tonic neck reflex

30
Q

two postural reflexes that replace primitive

A
  • landau reflex (superman)
    appears at 3 months, disappears at 12-24 mo
  • parachute reflex
    appears at 6-9 mo, doesn’t disappear
31
Q

major depression mnemonic

A
32
Q

what are ACE’s

A
33
Q

universal screening for depression

A
34
Q

Borderline personality disorder mnumonic

A
35
Q

mnumonic to test for depression

A
36
Q

changes in states of consciousness causes:
Person, place, time

A

person: amnesia, seizures, cerebral trauma
Place: delirium, psychiatric disorder, cognitive impairment
time: anxiety, delirium, depression, cognitive impairment

37
Q

screening tests to assess cognition

A
  • mini mental state examination (most studied)
  • Mini Cog
38
Q

brocha, wernicke and global aphasia
word comprehension, spontaneous speech, reading comprehension and writing for each.

A
39
Q

glasco coma scale used to measure what and how do you score?

A

quantify consciousness in a person with head trauma or hypoxic event.
measures eye-opening responses, verbal, motor
scores range from 3 to 15, 15 being the optimal level of consciousness

40
Q

delirium vs dementia

A

Delirium is acute onset
dementia is a slow progressive

41
Q

tug test

A
42
Q

breast bud happen when

A

ages 8-13

43
Q

menarche happens when

A

appx 2 years after breast buds

44
Q

axillary hair happens when

A

axillary hair happens 2 years after pubic hair

45
Q

thelarche is what

A

start of breast development

46
Q

tanner stages breasts

A
47
Q

tanner stage pubic hair (F)

A
48
Q

nmunonic for tanner stages

A
49
Q

age of puberty onset for males what happens first?

A

9.3 and 13.5- testes enlarge, then pubic hair, then penis size increase

50
Q

tanner staging in males

A
51
Q

kleinfelters syndrome

A

boys are born with an extra X

52
Q

undescended testes can cause what

A

increased risk of testicular cancer

53
Q

peak age of testicular cancer

A

15-25

54
Q

when should you start asking about menstruation

A

8/9

55
Q
A

Adv. Health Assessment- Al (8 decks)

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