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80 Cards in this Set

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Mental status determine ________ functioning.
cerebral
When is mental status assessed?
during history
True/False:

Mental status remains constant throughout life.
False- age related changes occur during growth and development.
What 5 things compose the mental status exam?
- general appearance and behavior
- state of consciousness
- mood and affect
- thought content
- intellectual capacity
True/False:

When assessing the patient, you should look for symmetry; therefore you always compare left to right.
true
When assessing orientation (state of consciousness), you should ask what type of questions to determine mental status?
Person, place & time

* What is your name? What is your spouse's name?
* Where are you? What is the state capitol?
* What day is it? What year is it?
Eye opening is what component of consciousness?
arousal
(def)

aware of self and the environment with the ability to focus and interact
awareness
If a person if fully conscious, we document this how?
awake, alert, and oriented x 4
What level of consciousness?

disoriented to time, place, person, or situation; short attention span; poor memory; easily bewildered
confused
What level of consciousness?

oriented with slow, sluggish speech and mental processes; responds appropriately
lethargic
What level of consciousness?

arouses to stimulation; responds with 1-2 words; follows 1 step commands to stimulation
obtunded
What level of consciousness?

lies quietly with minimal movement; responds only to vigorous and repeated stimulation; opens eyes and responds to pain appropriately; responds to pain appropriately; makes incomprehensible sounds
stuporous
What level of consciousness?

sleep-like state with eyes closed; does not respond appropriately to bodily or environmental stimuli; no verbal sounds
comatose
True/False:

A person who cannot be woken should be documented as unconscious on the medical chart.
False- this is a non-medical term; refer to proper medical terminology
What are the 5 types of stimuli used to gauge a response (in order, from the first mechanism attempted to the last)?
1. voice
2. touch
3. shaking
4. voice and shaking
5. noxious/painful stimuli
What are the 3 components of the glasgow coma scale?
1. Eye opening
2. Motor Response
3. Verbal Response
A glasgow coma scale score of 13 indicates what?
mild brain injury
A glasgow coma scale score of 9-12 indicates what?
moderate brain injury
A glasgow coma scale score <8 indicates what?
severe brain injury
Language and speech are assessed together. What part of the brain controls this?
The left (dominant) side
Which side of the brain controls written and spoken language, reasoning, number skills, scientific knowledge and right hand control.
The left side
Which side of the brain controls insight, 3-d forms, art and music awareness, imagination, and left hand control?
the right side
(def)

a disorder in processing language
aphasia
(def)

a disorder in programming speech (saying the wrong word)
apraxia of speech
(def)

a disorder in the mechanics of speech
dyarthria
Which Cranial Nerve?

Smell
CN I (Olfactory)
Which Cranial Nerve?

vision
CN II (Optic)
Which Cranial Nerve?

moves eyes in all directions except outward and down&in; constricts pupil; opens eyelid
CN III (Oculomotor)
Which Cranial Nerve?

moves eyes down and in
CN IV (Trochlear)
Which Cranial Nerve?

moves eyes outward
CN VI (abducens)
What 3 cranial nerves do we check when assessing extraocular muscles?
III, IV, and VI (3, 4, and 6 make the eyes do tricks)
How do we assess the pupil's reaction to light?
penlight is moved from the side to in front of the client's eye; pupil should constrict
How do we assess the pupil's accommodation?
The normal pupil constricts when focused on a near object and dilates when focused on a far object
How do we assess convergence of the eyes?
Move your finger towards the client's nose; eyes should converge (cross-eyed appearance)
How are EOM's tested?
BY assessing cardinal fields of vision for coordination and alignment
Which Cranial Nerve?

Has 3 branches- sensation to the face; cornea and the scalp; opens jaw against resistance
CN V (Trigeminal)
Which Cranial Nerve?

moves the face; taste
CN VII (Facial)
Which Cranial Nerve?

Has 2 branches; hearing and balance
CN VIII (Acoustic)
Which Cranial Nerve?

moves the pharynx (swallow, speech & gag)
CN IX (glossopharyngeal)
Which Cranial Nerve?

Voice Quality
CN X (Vagus)
Which Cranial Nerve?

turns head and elevates shoulders
CN XI (Spinal Accessory)
Which Cranial Nerve?

moves tongues
CN XII (hypoglossal)
What is sixth nerve palsy? How do you assess for it?
double vision- cover one eye, should correct if positive. Offer a patch over the "good" eye
(def)

involuntary eye movement
nystagmus
Describe how to do a sensory assessment?
use a wisp of cotton and lightly touch one specific spot, and then the same spot on the other side of the body. Patient says yes when cotton if felt.
What is a pain assessment?
using the blunt and sharp points of a reflex hammer, have the client say sharp or dull as you touch anatomical areas at random
What assessment is done if the pain sensation test results show an area(s) non-reactive to pain?
the temperature sensation test (test temperature sensation by using hot and cold vials against the skin)
What are purposeful movements?
direct, specific movements (scratching nose,etc)
What are localizing movements?
moving toward or removing a painful stimulus/moving away from a stimulus
Moving towards a painful stimulus is an action triggered in what part of the brain?
cortex
Moving away from a painful stimulus is an action triggered in what part of the brain?
hypothalamus
What are non-purposeful movements?
flexion, abnormal extension, fisted hands, flexed wrists, etc.
The cerebellum controls what 3 things?
1. balance
2. coordination
3. ability to perform skilled movements
What part of the brain is tested when assessing coordination, smooth movement, and position sense?
cerebellum
How do you perform a cerebellar test?
- observe for leaning to one side
- test finger to nose, making sure patient fully extends arm
**weakness occurs on the side with the deficit**
(def)

Loss of the ability to coordinate muscular movement.
ataxia
(def)

a lack of coordination of movement typified by the undershoot or overshoot of intended position with the hand, arm, leg, or eye
dysmetria
What is the Romberg test and how is it performed?
- neurological test to detect poor balance and coordination
- have patient stand still with heels together and to close their eyes. If the patient loses their balance, the test is positive
What does a Heel-to-toe test assess for?
Abnormalities in coordination, balance, and ability to perform skilled movements
How do you assess the motor function of this nerve?:

Radial Nerve
have client move wrist back and forth
How do you assess the motor function of this nerve?:

Median nerve
have client perform thumb opposition with remaining 4 fingers
How do you assess the motor function of this nerve?:

Ulnar nerve
abduction of fingers (spread fingers apart)
How do you assess the motor function of this nerve?:

Femoral nerve
have the client perform a straight leg raise
How do you assess the motor function of this nerve?:

Tibial nerve
have the client plantar flex foot (down)
How do you assess the motor function of this nerve?:

peroneal nerve
have the client dorsiflex foot (up)
How do you assess the sensory function of this nerve?:

radial nerve
touch the space between the thumb and 2nd finger
How do you assess the sensory function of this nerve?:

median nerve
touch or stroke the tip of the second finger
How do you assess the sensory function of this nerve?:

Ulnar nerve
touch or stroke tip of the 5th finger
How do you assess the sensory function of this nerve?:

Femoral Nerve
stroke the anterior thigh
How do you assess the sensory function of this nerve?:

tibial nerve
stroke the sole of the foot
How do you assess the sensory function of this nerve?:

peroneal nerve
stroke the web space between the 1st and 2nd toe
What are 3 causes for injury to the radial nerve?
1. direct trauma (broken arm)
2. prolonged pressure on the nerve (under arm pressure such as "crutch palsy")
3. compression of the nerve due to swelling or injury to nearby structures
How can the median nerve be injured? (3)
1. trauma
2. entrapment (pressure where the nerve passes through a narrow structure)
3. inflammation
Carpal tunnel syndrome is linked to what nerve?
median nerve
How can the ulnar nerve be damaged?
- direct pressure
- prolonged exposure to pressure
- compression due to injury or swelling
What nerve is commonly injured at the elbow due to elbow fracture or dislocation?
ulnar nerve
Prolonged pressure to the base of the palm of the hand may injure what nerve?
ulnar nerve
The tibial and peroneal nerves are branches of what larger nerve?
sciatic nerve
Injury to the knee, leg, or fibula could damage what nerve?
peroneal nerve