Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
142 Cards in this Set
- Front
- Back
|
Right Upper Quadrant (RUQ)
|
Liver; Gallbladder; Duodenum; Head of pancreas; Right Kidney and Adrenal; Hepatic flexture of Colon; Part of ascending and transverse colon.
|
|
|
Left Upper Quadrant (LUQ)
|
Stomach; Spleen; Left lobe of Liver; Body of pancreas; Left kidney and Adrenal; Splenic flexture of colon; part of transverse and descending colon.
|
|
|
Left Lower Quadrant (LLQ)
|
Part of descending colon; Sigmoid colon; Left Ovary and tube; Left ureter; Left spermatic cord.
|
|
|
Right Lower Quadrant (RLQ)
|
Cecum; Appendix; Right ovary and tube; Right ureter; Right spermatic cord.
|
|
|
Midline
|
Aorta; Uterus (if enlarged); Bladder (if distended).
|
|
|
Suprapubic/Hypogastric
|
Rectum; Ovaries; Uterus; Bladder; Pubic Symphysis; Common iliac artery and vein; External iliac artery and vein; cecum; appendix; Sigmoid colon.
|
|
|
Epigastric
|
Duodenum; Pancreas; Right and Left Kidney; aorta; Inferior Vena Cava; Gallbladder; Liver; Spleen; Stomach.
|
|
|
Bowel Sounds
|
movement of air and fluid through small intestine. Normally are high pitched, gurgling, cascading sounds, occuring irregularly, anywhere from 5-30 times per minute.
|
|
|
Hyperactive Sounds
|
Loud, high pitched, rushing, tinkling, sounds that signal increased motility.
|
|
|
Hypoactive Sounds
|
Follow surgery or with inflammation of the peritoneum.
|
|
|
Borborygmus
|
Hyperactive bowel sound is hyperperistalsis=growling stomach.
|
|
|
Silent
|
Abnormal, need to listen for 5 minutes by watch before deciding BS are absent.
|
|
|
Percussion
|
Tympany should predominate because of air from the intestines rises to surface of abdomen while supine. Dullness occurs over distended bladder, adipose tissue, fluid, or a mass such as an organ or bone. Hyperresonance present with gaseous distention.
|
|
|
Sequencing technique for abdominal assessment
|
Inspection, Auscultation, Percussion, Palpation. This is done because percussion and palpation can increase peristalsis which gives a false interpretation of BS.
|
|
|
Ascites
|
Occurs with heart failure, portal hypertension, cirrhosis, hepatitis, pancreatitis, and cancer. Single curve, taut, glistening skin, recent weight gain, increase in abdominal girth. Normal BS over intestines. Diminished bs over ascitic fluid. Tympany at top where intestines float. Dull over fluid. Produces fluid wave and shifting dullness. Taut skin and increased intraabdominal pressure limit palpation.
|
|
|
Light palpation
|
With 1st four fingers close together, depress the skin about 1 cm. Make a gentle rotart motion, sliding the fingers and skin together. Then lift the fingers (don't drag) and move clockwise to the next location around the abdomen 4 quadrants. Purpose is not to search for organs but to get the overall impression of the skin surface and superficial musculature.
|
|
|
Deep palpation
|
Same technique as light palpation but push down 5-8 cm sometimes using both hands one on top of the other. Purpose is not to search for organs but to get the overall impression of the skin surface and superficial musculature.
|
|
|
Technique for diastasis recti
|
a midline longitudinal ridge, a seperation of the abdominal rectus muscles. Ridge is revealed when intraabdominal pressure is increased by raising head while supine. Occurs congenitally and as a resuly of pregnancy or marked obesity in which prolonged distention or a decrease in muscle tone has occured. It is not clinically significant.
|
|
|
How to assess Abdominal hernia
|
protrusion of abdominal viscera through abnormal opening in muscle wall. Have pt cough look for any protrusions in abdominal wall.
|
|
|
Abdominal Aortic Aneurysm
|
Most commom fusiform in shape extending from below the renal arteries to involve the entire infrarenal aorta and often involve the common iliac arteries. Pressure causes lower ab pain and lower back pain. 95%+ are below renal arteries and extend to the umbilicus. 80% are palpable during routine exam and feel like pulsating mass in upper ab. just left of midline. Hear bruit. Femoral pulses are present but decreased.
|
|
|
Splenomegaly
|
with acute infections (mono) moderately enlarged and soft with rounded edges usually not tender to palpation unless peritoneum is also inflammed. Must be enlarged 3 x normal size to be felt. Reach left hand over ab and behind left side at 11th and 12 ribs. Lift for support. Place right hand obliquely on LUQ with fingers pointing toward left axilla and inferior to rib margin. Push hand down deeply underneath at left costal margin. Ask pt to take deep breath. If Enlarged spleen will bump out fingertips.
|
|
|
Hepatomegaly
|
enlarged liver percuss usually btwn 5th intercoastal space and right costal margin. Listen for dullness vs tympany. Normal is 10.5cm in males to 7 cm in females. Scratch test place stethoscope over the liver and scratch fingernail in short strokes over the abdomen starting in RLQ moving upward toward the liver when magnified sound, you have crossed the border from over a hollow organ to a solid one.
|
|
|
Costal Vertebral Angle (CVA)
|
the 12th rib forms an angle with the vertebral column. Near the left kidney. To assess the kidney place one hand over the 12th rib at the CVA on the back. Thump that hand with the ulnar edge of your other fist. Normally feel thud but no pain. Sharp pain occurs with inflammation of the kidney or paranephric area.
|
|
|
Appendicitis
|
typically starts as dull, difuse pain in periumbilical region that later shifts to severe, sharp, persistant pain and tenderness localized in the RLQ. Aggravated by movement, coughing, deep breathing, associated with anorexia, then nausea & vomitting, fever. Assess with Iliopsoas Muscle Test or Blumberg's sign or Rebound Tenderness Test.
|
|
|
Iliopsoas Muscle Test
|
pt supine life the right leg straight up, flexing at hip. Push down over lower part of right thigh as person tries to hold leg up. Negative=Normal= No pain or change. Positive= Abnormal= pain is felt in right lower quadrant (RLQ).
|
|
|
Rebound Tenderness Test
|
abdominal pain reported by pt. choose a site away from painful area. Hold hand at 90 degree angle perpendicular to ab push down slowly, and deeply. Lift up quickly. Normal=Negative= no pain. Abnormal=Positive= pain= peritoneal inflammation. Do as last part of examination causes pain and muscle rigidity.
|
|
|
Aphasia
|
is the loss of the ability to speak or write coherently or to understand speech or writing due to a brain attack (CVA). Disorder of language comprehension and production secondary to brain damage.
|
|
|
Dysphagia
|
occurs with disorders of throat or esophagus occurs with pharygitis, gastroesophageal reflux disease, pharyngitis, stroke, and other neurologic diseases, esophageal cancer.
|
|
|
Borborygmi
|
loud gurgling sounds, signal increased motility and occur with early mechanical bowel obstruction. High pitched, gastroenteritis, brisk diarrhea, laxative use, and subsiding paralytic ileus.
|
|
|
Black tarry stools
|
Due to occult blood (melena) from gastrointestinal bleeding. Or nontarry from ingestion of iron medications.
|
|
|
Flexion
|
bending a limb at a joint
|
|
|
Extension
|
straightening a limb at a joint
|
|
|
Abduction
|
moving a limb away from midline
|
|
|
Adduction
|
moving a limb toward midline
|
|
|
Rotation
|
moving head around central axis
|
|
|
Protraction
|
moving a body part forward and parallel to ground
|
|
|
Pronation
|
turning forearm so that the palm is facing down.
|
|
|
Retraction
|
moving a body part backward and parallel to ground.
|
|
|
Supination
|
turning forearm so the palm is facing up.
|
|
|
Circumduction
|
moving the arm in a circle around the shoulder.
|
|
|
Inversion
|
moving side of foot inward at the ankle.
|
|
|
Eversion
|
moving sole of foot outward at the ankle.
|
|
|
Elevation
|
raising a body part
|
|
|
Depression
|
lowering a body part
|
|
|
Tempromandibular joint (TMJ)
|
with pt seated insepct area just anterior to ear. Place finger tips in front of each ear. Ask pt to open and close mouth. Drop fingers into depressed area over the joint, note smooth motion of mandible. Audible and palpable snap/click occurs in many healthy people. Check vertical movementby having pt open mouth maximally, lateral motion partially open mouth, protrude lower jaw, move side to side. Protrude without deviation stick out lower jaw. Compare right and left sides, firmness, and strength.
|
|
|
Bursa
|
enclosed sac filled with viscous synovial fluid like a joint. Located in areas of potential friction help muscles and tendons glide smoothly over bone.
|
|
|
Tendons
|
Strong fiberous cords attach skeletal muscle to bone.
|
|
|
Ligaments
|
surrounds joints, fiberous bands running from one bone to another. Strengthen the joint and help prevent movement in undesireable directions.
|
|
|
Cartilage
|
avascular recieves nourishment from synovial fluid that circulates during joint movement. Stable, connective tissue with a slow cell turnover. Tough, firm consistency, yet flexible. Cushions the bones and gives smooth surface to facilitate movements.
|
|
|
Kyphosis
|
Outward curvature of spine, exaggerated posterior curvature of thoracic spine, "humpback."
|
|
|
Scoliosis
|
Lateral S shape curvature of the thoracic and lumbar spine, Asymmetrical, ribs hump on one side as child bends forward and with unequal landmark elevations.
|
|
|
Phlen's Test
|
pt holds both hands back to back while flexing the wrists 90 degrees. Acute flexion of the wrist for 60 seconds produces no symptoms in normal hand. Reproduces numbness and burning in a person with carpal tunnel syndrome.
|
|
|
Ulnar Drift
|
fingers drift to ulnar side because of stretching of the articular capsule and muscle imbalance. Also note subluxation and swelling in the joints and muscle atrophy on the dorsa of the hands. Caused by chronic rheumatoid arthritis.
|
|
|
Swan Neck Deformity
|
flexion contracture resembles curve of a swan's neck. Note flexion contracture of metacarpophalangeal joint, then hyperextension of the proximal interphalangeal joint and flexion of the distal interphalangeal joint. It occurs with chronic rheumatoid arthritis and often is accompanied by ulnar drift of the fingers.
|
|
|
Pedal Erythema
|
is an intense redness of the skin from excess blood (hyperemia) in the dialted superficial capillaries. Expected with fever inflammation, emotional reactions.
|
|
|
Crepitation
|
audible and palpable crunching of grating that accompanies movement occurs when articular surfaces in the joints are roughened as with RA.
|
|
|
Clubbing of Fingers
|
occurs with congenital chronic cyanotic heart disease, emphysema, and chronic bronchitis. Early on nail bed straightens to 180 degrees and nail base feels spongy.
|
|
|
Carpal Tunnel Syndrome
|
atrophy occurs from interference with motor function from compression of median nerve inside carpal tunnel. Caused by chronic repetitive movements. Occurs between 30-60 year olds, 5x more common in wpmen. Symptoms: pain, burning, numbness, positive Phalen's test, [ositive Tinel's sign, and often atrophy of thenar muscle.
|
|
|
Small Bowel or Small Intestine
|
Vast majority of digestion and absorption of food takes place here. Also absorption of nutrients here. Most chemical digestion takes place here. It is about 7 m long and 2.5-3 cm in diameter.
|
|
|
Large Bowel or Large Intestine
|
Last part of digestion . Absorb water from remaining indigestible food before passing as waste material. It is about 4.9 feet long. It also absorbs vitamins here. Can take from 10-12 hours to finish up digestive process here. Wider than the small intestine. Contains a lot bacteria here.
|
|
|
Peristalsis
|
Muscular wave like contractions. Contraction of smooth muscle to propel contents through small intestine in the digestive tract.
|
|
|
Hyperperistalsis
|
loud-high pitched and rushing bowel sounds can be heard when auscultated. Ex: gastroenteritis, diahrrea.
|
|
|
Absence of peristalsis
|
No metallic tinkling bowel sounds would be auscultated. Need to listen for 5 minutes before determining. Not normal. Means the bowels are not functioning.
|
|
|
Peritonitis
|
inflammation of the peritoneum or the serous membrane which lines part of the abdominal cavity and some of the viscera it contains. Can be vocalized or generalized.
|
|
|
Peritonitis Causes
|
Usually has acute course, may be from infection (due to rupture of a hollow organ or from abdominal trauma), or non-infectios process (leakage of sterile body fluids into the peritoneum, sterile abdominal surgery). Can lead to septis which you can die from.
|
|
|
Peritonitis Bowel Sounds
|
friction rub high pitched grating sounds caused by rubbing together of organs or an organ rubbing on the peritoneum. Indicate inflammation of peritoneal surface of the organ from tumor, infection, or infarction. Could have no Bowel Sounds, after surgery before anything is placed back through system.
|
|
|
Contours of Abdomen
|
Flat, Scaphoid, Protuberant, Obese.
|
|
|
Flat Abdomen
|
Normal look of abdomen.
|
|
|
Scaphoid Abdomen
|
Concaved abdomen, poor nutrition.
|
|
|
Rounded Abdomen
|
Convex, bulging flanks (ascites), local bulges (pregnancy, distended bladder, tumor). Asymmetrical (enlarged organs or masses), visible organs or masses.
|
|
|
Protuberant Abdomen
|
Fluid filled, pregnancy, fat, obese, etc. 9 F's: Fat, Fluid, Feces, Fetus, Flatus, Fibroid, Full bladder, False pregnancy, Fatal tumor.
|
|
|
Assessing for distended Urinary Bladder
|
Oval in form, Directed upward and forward.
|
|
|
Frank Bleeding
|
Not normal stool, could be caused by hemorrhoids, colon cancer, GI Bleed. Usually evaluated with colonoscopy. The color of the blood can suggest the location of the bleeding.
|
|
|
Anasarca
|
Extreme generalized edema. Widespread swelling of the skin due to effusion of fluid into the extracellular space. Usually caused by congestive heart failure, liver failure, renal failure or disease. Severe malnutrition protein deficiency.
|
|
|
Scleroderma
|
Chronic autoimmune disease characterized by hardening or sclerosis in the skin or other organs. Localized rash. Can lead to systemic sclerosis-generalized type of disease. Can be fatal as a result of heart, kidney, lung, or intestinal damage. Not sure what causes this.
|
|
|
Pedal erythema
|
Get with Diabetes, gout, erythromelalgia. Extreme intense redness of the skin from excess blood (hypermia) in the dilated superficial cappillsries ecpected with fever, inflammation, and emotional reactions.
|
|
|
Ataxia
|
a neurological sign and symptom consisting of gross lack of coordination of muscle movements. Non-specific clinical manifestation implying dysfunction of parts of the nervous system that coordinate movement, such as the cerebellum.
|
|
|
Cerebellar Ataxia
|
ataxia due to dysfunction of the cerebellum. Varity of elementary neurological deficits such as antagonist hypotonia, asyngergy,dysmetria, dyschronometria, and dysdiadochokinesia. Determined by where abnormalities manifest as well as if bilaterl or lateral.
|
|
|
Dizziness
|
impairment in spacial perception and stability. Many causes equilibrioception, hypotension, cerebral hypoxia, reaction to environmental chemicals or drugs, and psychiatric causes.
|
|
|
Central Nervous System (CNS)
|
brain and spinal cord. Efferent motor messages from CNS out to muscles and glands.
|
|
|
Peripheral Nervous System
|
12 pairs of cranial nerves, 31 pairs of spinal nerves, all their branches. Carries afferent/sensory messages to CNS from sensory receptors. Also autonomic messages that govern the internal organs and blood vessels.
|
|
|
Frontal lobe in brain
|
personality, behavior, emotions, and intellectual functions voluntary movements in precentral gyrus.
|
|
|
Broca's Area
|
In frontal lobe, mediates motor speech.
|
|
|
Parietal lobe in brain
|
post central gyrus primary center for sensation.
|
|
|
Temporal lobe in brain
|
primary auditory reception center.
|
|
|
Wernicke's Area
|
in temporal lobe, associated with language comprehension.
|
|
|
Occipital lobe in brain
|
primary visual receptor center.
|
|
|
Cerebellum
|
Operates entirely below the conscious level. Under Occipital concerned with motor coordination of voluntary movements, equilibrium, and muscle tone. Coordinates and smooths muscle movements. Adjusts and corrects voluntary movements. DOESN'T ORIGINATE MOVEMENTS!
|
|
|
Medulla
|
Continuation of spinal cord in the brain contains all ascending and descending fiber tracts connecting brain and spinal cord. Vital autonomic centers for (repiration, heart, gastrointestinal, functions)as well as nuclei for cranial nerves 8-12.
|
|
|
Pyramidal decussation
|
located in medulla crossing of motor fibers occurs here.
|
|
|
Spinal Cord
|
long cylindrical structure of nervous tissue about as big around as a pinkie finger. Main highway for ascending and descending fiber tracts connect the brain to the spinal nerves, mediates reflexes.
|
|
|
Hypothalamus
|
major control centerfunctions include temperature, heart rate, blood pressure, sleep center, anterior and posterior pituitary gland regulation, coordinator of autonomic nervous system activity, and emotional status.
|
|
|
Brain Stem
|
central cord of brain consisting of mostly nerve fibers. Contains three areas midbrain, pons, and medulla.
|
|
|
Spinothalamic Tracts
|
contains sensory fibers that transmit the sensations of pain, temperature, and crude or light touch. Not precisely localized. At thalamus the fibers synapse with 3rd sensory neuron, carries message to sensory cortex for full interpretation. Lateral fibers carry pain and temperature sensations ascend here. Anterior fibers carry crude touch sensations ascend here.
|
|
|
Corticospinal tracts
|
(Pyramidal tracts)originiates in pyramidal shaped cells in the motor cortex. Motor nerve fibers orginate in motor cortex travel to brain stem to cross to opposite sides, pass down lateral column of spinal cord. 10% don't cross descend in anterior column of spinal cord. Mediate voluntary movement very skilled movements, discrete or purposeful movements. Ex writing. Homunculus map based on these.
|
|
|
Recent Memory
|
assess in the context of the interview by the 24hr diet recall. Or by asking time person arrived at facility. Ask questions that you can corroborate. This screens for pts who make up answers to fill in gaps of memory loss.
|
|
|
Remote Memory
|
assess in the context of the interview ask the pt verifiable past events, past health, first job,birthday, anniversary dates, historical events, relevant to that pt's age.
|
|
|
New Memory
|
highly sensitive and valid memory test requires more memory effort than recall of personal or historical events. Avoids material you can't verify. Ask to remember four words unrelated. Ask pt again at end of interview to see if remember the four words. Normal for 60 yo or under to remember three to four of the words. Alzheimer's, dementia pts score zero or one.
|
|
|
Judgement
|
when a person can compare and evaluate the alternatives in a situation and reach an appropriate course of action. Note what pt says about job plans, social or family obligations, and plans for the future. Should be realistic. Unrealistic plans are common with mental retardation, emotional dysfunction, Schizophrenia, and organic brain disease.
|
|
|
Mental Status
|
minimental state is a scored form of cognitive functions of mental status examination. Quick, easy, set standard of 11 questions, requires 5-10 minutes. Good for initial and serial measurement. Demonstrate worsening or improvement of cognition over time and with treatment cognitive function is all it looks at. Not mood or thought processes. Can detect dementia, delirium, and mental illness. Max score is 30. Normal range is 24-30. 27 is average for no cognitive impairment.
|
|
|
Rapid Alternating Movements (RAM)
|
have pts pat knees with both hands, lift up, turn hands over, and pat knees with back of hands, continue doing. Ask pt to go faster and faster. Normally done with equal turning and quick rhythmic pace. no problems
|
|
|
Cerebellar Disease/ dysdiadochokinesia
|
lack coordination, slow, clumsy, and sloppy response to RAM.
|
|
|
Finger to Nose Test
|
have pt close eyes stretch out arms ask pt to touch tip of their nose with each index finger alternating hands and increasing speed. Normal accurate, smooth muscle movements.
|
|
|
Cerebellar Disease/
alcohol intoxication |
pt misses nose, worsening coordination with eyes closed for Finger to Nose Test.
|
|
|
Deep Tendon Reflexes (DTR)
|
Biceps; triceps; brachiradialis; quadriceps; achilles; abdominal; cremasteric; & plantar.
|
|
|
Biceps
|
C5-C6 place your finger on biceps tendon strike blow to your thumb feel and see response of pt contraction of biceps muscle and flexion of forearm.
|
|
|
Triceps
|
strike triceps tendon directly above elbow of pt. Normal extension of forearm.
|
|
|
Brachioradialis
|
Hold thumb suspend forearm. Strike directly 2-3 cm above radial styloid process. Normal flexion and supination of forearm.
|
|
|
Quadriceps
|
strike tendon driectly below patella extension of lower leg is normal response. Palpate quadriceps contract as well.
|
|
|
Achilles
|
dorsiflex pt foot, strike achilles directly. Normal foot plantar flexes against your hand.
|
|
|
Abdominal
|
move edge of instrument toward midline on upper/lower ab levels. Normal ipsilateral contraction of ab muscle wall.
|
|
|
Cremasteric
|
on male stroke inner near thigh, see elevation of ipsilateral testicle.
|
|
|
Plantar
|
stroke up the lateral side of sole of foot inward across ball of foot. Normal plantar flexion of toes except in infants opposite action of toes.
|
|
|
Babinski's Reflex
|
stroke finger up lateral edge and across the ball of infant's foot. Fanning of toes is a positive reflex present at birth and disappears changes to adult response by 24 months. If positive still after 2-2.5 yo occurs due to pyramidal tract disease ex stroke trauma.
|
|
|
Gaits/
Scissor |
knees cross of are in contact, like holding an orange between thighs. Short steps, requires effort to walk. Due to paraparesis of legs, MS.
|
|
|
Gaits/
Steppage |
Slapping quality like walking up stairs without any stairs present. Lifts knee/foot high and slaps down hard, flat, compensate for foot drop. Due to peroneal and anterior tibial muscles. Decreased motor neuron lesion on spinal cord. Ex polio.
|
|
|
Gaits/
Parkinsons |
stooped posture, trunk pitched forward, elbows, hips, knees flexed. Short shiffling steps. Hesitation to begin walking. Rigid body. Hard to stop suddenly, one fixed uit. Hard to change direction suddenly.
|
|
|
Gaits/
Spastic hemiparesis |
arm immobile vs body, flexion of shoulder, elbow, wrist, fingers, and adduction of shoulder. Leg stiff and extended, circumducts with each step (drags toe in semicircle). Due to upper motor neuron lesion of corticospinal tract. Cerebrovascular accident, trauma.
|
|
|
Posterior Dorsal Columns
|
fibers conduct the sensations of position, vibration, finely localized touch.
|
|
|
Vibration
|
tuning fork over bony prominences. Hold the base of a struck tunning fork on the fingers, great toe. Ask pt to tell when stops. If feel=normal. If don't feel move proximally and test ulnar processes; ankles patellae; iliac crests. Compare Right and Left. If find deficit note if gradual or abrupt.
|
|
|
Kinesthesia/Position
|
move pt finger, big toe, up and down. Ask pt to tell what direction you are moving with their eyes closed. Careful to hold on sides to avoid giving cues with pressure. Normally can detect within a few millimetes. Loss of position sense if can not detect.
|
|
|
Tactile Discrimination/Fine Touch
|
Discrimination ability of sensory cortex. Problems occur w lesions of sensory cortex or posterior column.
|
|
|
Stereognosis
|
ability to recognize objects by feeling forms, sizes, weights with eyes closed. Normally feel with fingers then identify. Test left agains the right. If can't identify Astereognosis. Occurs with sensory cortex lesions or stroke.,
|
|
|
Astereognosis
|
If fail stereognosis test. Sensory cortex lesions or stroke pt.
|
|
|
Graphesthesia
|
ability to read the number or letter traced on skin with eyes closed. If can not identify may be lesion of sensory cortex.
|
|
|
Two Point Discrimination
|
test person's ability to identify and distinguish the seperation of two points onthe skin at the same time. Note distance no longer feel two points. When they just feel one point instead of two. Most sensitive in fingertips 2-8mm. Least sensitive on upper arms, back, and thighs. 40-75 mm. Increase in distance =sensory cortex lesions.
|
|
|
Extinction
|
touch both sides of body at the same point. Normally both felt by pt. Abnormal sensory cortex lesion extinguished on side opposite cortex lesion.
|
|
|
Point Location
|
touch pt have pt touch where you just touched. Sensory cortex lesion pt can't localize sensation.
|
|
|
Vertigo
|
rotational spinning caused by neurologic disease in vestibular apparatus in ear, or in vestibular nuclei in brain stem.
|
|
|
Syncope
|
sudden loss of strength, tempory loss of consciousness (faint) due to lack of cerebral blood flow. Ex low blood pressure.
|
|
|
Astereognosis
|
inability to identify objects correctly occurs in sensory cortex lesions. Ex brain attack or stroke.
|
|
|
Graphesthesia
|
ability to read a number that's traced on skin with eye's closed Good measure for sensory loss.
|
|
|
Tactile discrimination
|
fine touch. Problems with lesions of the sensory cortex or posterior column.
|
|
|
Anosmia
|
decrease/loss of smell occurs bilaterally with tobacco smoking allergic rhinitis, and cocaine use. Unilateral loss in the absence of nasal disease is neurogenic anosmia. Ex on pg 701.
|
|
|
Prebyopiaq
|
the decrease of accommodation with aging. Lens looses ability to change shape to accommodate for near vision.
|
|
|
Nystagmus
|
occurs with disease of vestibular system, cerebellum, or brain stem. Back and forth oscillation of the eyes.
|
|
|
(CVA) Cerebral Vascular Accident
|
an upper motor neuron lesion (central) "stroke" is an acute neurologic deficit caused by an obstruction of a cerebral vessel, as in atherosclerosis, or rupture in a cerebral vessel. Note paralysis of lower facial muscles, upper half of face not affected-nerve of unaffected hemisphere still works.
|
|
|
Dysdiadochokinesia
|
slow, clumsy, sloppy, response occurs with cerebellar disease. Lack of coordination.
|
|
|
Parkinson's Disease
|
deficiency of nerotransmitter dopamine and degeneration of basal ganglia of the brain. Immobility of features produces flat face expressionless "mask like" stooped posture.
|
|
|
Cerebral Palsy
|
mixed group of paralytic neuromotor disorders of infancy and childhood due to damage of cerebral cortex caused by developmental defect, intrauterine meningitis, encephalitis, birth trauma, anoxia, and kernicterus.
|
|
|
Homan's Sign
|
occurs in 35% of DVT cases. Not specific to DVT. Occurs with superficial phlebitis, Achilles tendinitis, gastrocnemius, and plantar muscle injury and lumbosacral disorders. Get Calf pain when dorsiflex foot toward tibia. Pressure on posterior tibial vein.
|
|
|
Romberg's Sign
|
pt stands with feet together and arms at sides ask pt to close eyes hold position for ~20 secs. Normally holds posture can have a bit of swaying. Positive= loss of balance. Occurs from cerebellar ataxia, MS, Alcohol intoxication, loss of proprioception, loss of vestibular functioning.
|
