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125 Cards in this Set
- Front
- Back
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CN 1
olfactory nerve sensory |
smell odor
have client identify familar odors |
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CNll
optic nerve sensory |
vision acuity and fields
snellen chart or jaeger fields use confrontation test |
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CNlll oculomotor nerve
CNlV trochlear nerve CNVl abducens nerve |
PERLA, accomodation, EOM(cardinal positions of gaze)
nystagmus |
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CN V trigeminal nerve
sensory motor |
muscles of mastication(temporal and jaw)
light touch sensation |
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CNVll facial nerve
sensory motor |
wrinkle forehead, frown, smile and raise eyebrows
identify salty and sweet(anterior of tongue) |
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CNVlll acoustic nerve
sensory |
hearing, balance and head position
Rinne, Weber and whisper test |
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CNlX glossopharyngeal nerve
CNX vagus nerve sensory and motor |
symmetrical rise of uvula soft palate and gag reflex
sensation posterior of tongue |
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CNXl spinal accessory nerve
motor |
test strength of trapezius muscle shrug shoulders against resistance
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CNXll hypoglossal
motor |
controls tongue
tongue should be midline not deviate to side |
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nystagmus
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wiggly iris caused by damage to nerves
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proprioception
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awareness of body position
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neurological assessment
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mental status
cranial nerves motor system sensory system reflexes |
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motor and balance assessment
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walking gait
heel to toe walking cerebellar Romberg test one foot balance |
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Babinski reflex
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light stroking of sole of foot should not cause toe to fan out
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Glascow Coma Scale
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objective measurement of LOC
1. eye opening 2. verbal response 3. motor response each area is scored and total is given fully AAO LOC is highest score 7 or less = coma 3 = deep coma |
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Pupillary assessment
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pupils 2-6mm in size
size and shape should be equal PERLA (normal finding) |
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neuro findings- age related
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loss of neurons
loss of muscle tone/bulk slowing of motor system tremors decreased smell/taste |
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abnormal neurological conditions
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paralysis/hemiplegia(half-paralsis)
cognitive dyfunction parkinson disease aphasia CVA bells palsy |
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Bells palsy
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paralysis of face cause by damage to facial nerve CNVll
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aphasia
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expressive-can't talk
receptive-can't understand global- no ability to communicate |
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neurological tests
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CAT Scan
MRI/MRA Glascow Coma Scale |
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ICP
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intracranial pressure
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peripheral vascular system function
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vessels that transport fluid, lymph and blood
veins and arteries |
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arteries
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temporal,ulnar,radial,femoral,
popliteal,carotid,brachial,dorsalis pedis,posterior tibial |
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intermittent claudication
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muscle cramps in the legs symptom of PAD
could be sign of occlusion |
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Raynauds disease
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reaction to cold-impediment on blood supply (bluish or whitish color change in hands)
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lymphedema
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abnormal build-up of fluid in tissues
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Allen test
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to asses radial and ulnar patency
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pulse palpation rating
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0=absent
1=weak 2=normal 3=increased 4=bounding |
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homans test
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dorsiflex foot....if pain is in calf may indicate thrombosis
not evidance based test |
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arterial- venous deficits
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arterial-pale,painful skin, no pulse ulcerations
venous-pitting edema, brown discoloration |
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peripheral vascular disease risks
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obesity, smoking,cholesterol and diabetes
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lymphatic system function
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retrieve excess fluid
conserve fluid and plasma that leak from capillaries absorb lipids from tissues immunity |
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groups of lymph nodes
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cervical
axillary epitrochlear inguinal |
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organs of immune system
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thymus gland, spleen, bone marrow, lymph nodes, tonsils and lymphoid tissue in the intestines(Peyers patches)
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deep vein thrombosis
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emboli travel through body
deep vien is occluded by thrombus causing inflammation, blocked venous return, cyanosis and edema abdominal surgery produces high risk |
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aneurysms
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dilation in arterial wall (outpouching) common cause atherosclerosis
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venous stasis
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slow blood flow in the veins
can cause brownish coloration mostly occurs in legs |
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edema scale
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1+ mild pitting
2+ moderate pitting 3+ deep pitting 4+ very deep pitting |
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lymphatic drainage
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right lymphatic duct-right head neck, upper right quadrant of body and right arm
left or thoracic duct- serves rest of body left lymphatic |
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vascular diagnostic tests
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doppler studies
ultrasound angiography |
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cardiac valve location
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aortic valve-2 R ICS
pulmomic valve-2 L ICS tricuspid -4 ICS L sternal border mitral/bicuspid-4 or 5 L ICS MCL (midclavicular line) |
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erb's point
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3 or 4 ICS L murmurs heard here
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point of maximal impulse
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apical pulse assessed here
mitral/bicuspid valve |
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S1 lub
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closure of AV valves(mitral,tricuspid
heard at apex(bottom) |
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S2 dub
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end of systole
closure of semilunar valves(aortic, pulmomic) heard at base(top) |
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pulse pressure
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difference between systolic/diastolic
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CNS
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brain & spinal cord
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brain stem controls
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physiological part
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paresis
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weakness
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cerebullum controls
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coordination
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temporial lobe & parietal lobe controls
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speech
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occipital lobe controls
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seeing
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Neurological Assessement entails:
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*mental status
*cranial nerves *motor system *sensory system *reflexes |
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Cranial Nerves
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12 nerves
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Some say marry money but my brother says bad business marries money
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An Old Olympic Towering Tops A Fin And German View Some Hops
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What are the Cranial nerves?
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Olfactory, optic, oculomotor, trochlear, trigeminal, adbucens, facial, acoustic, glossopharyngeal, vagus, spinall accessory, hypoglossal
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Trigeminal Nerve #5
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*in the area of TMJ
*controls motor 7 sensory *test for motor - hold tmj and PT should be able to resist when you pull down |
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How do you assess for sensory on the Trigeminal Nerve #5?
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Take soft whip and with the PT's eyes closed...touch 3 parts of the face forehead, cheek & chin area...should be able to feel
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If you have Bells Palsey what never is damaged?
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Facial nerve #7
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How do you assess the spinal nerve # 11?
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Test the strength of the trapezus muscle ( muscle by shoulder blade)
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How do you do a motor system tone assessment?
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squeeze the right hand
the squeeze the left hand, then have PT squeeze both hands |
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Muscle testing pronation is?
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Is when you place your hand on the PT's forearm and put your other hand in the hand and they pull up. PT should be able to resist you.
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Motor & balance assessment?
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* Walking gait
*Heel to toe walking *Cerebellar Rombering Test * One Foot balance |
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Romberg Test
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1. Stand together with feet together w/ eyes closed
2. ask to move arms out making sure there is no swaying Positive romberg =pt is not able to maintain a normal stance(no swaying) |
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What is coordination assessment?
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* Finger to finger test
* Finger to nose test |
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Light touch sensation
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pt's eyes are closed and you run a tongue depressure from ankle to toes and do the same with a pen
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What is stereognosis?
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Have PT close their eyes. take a familiar object and out it in their hand and see if they can identify the object.
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Graphesthesia?
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PT's eyes are closed, hand is open and you draw letters or numbers in the palm to see if they can identify them.
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RAM
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Rapid Alternating Movement - flipping hands up & down rapidly. Shows you have coordination
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Heel to shin
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Start at the knee and place your heel along the shin
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Sensory Assessment for touch
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*Pain - pinch skin rt. above nipple - should react
* light touch Tactile discrimination - seeing if PT can tell the difference from soft touch(cotton ball) to rough(sand paper) touch *Stereognosis *Graphesrthesia *Dexterity |
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Reflex Assessment
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* Biceps Reflex
* Babinski Reflex Normal - plantar flexion Abnormal - fanning toes * Patellar-knee jerk reflex |
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Reflex Grading
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0 = Absent (no reflex)
1+= hypoactive 2+ = normal 3+ = hyperactive 4+ = hyperactive with Clonus (rhythmic contractions) |
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Biceps Reflex
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Use reflex hammer - put thumb in the anticubidal space & tapping the hammer on the thumb
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Plantar Babinski Reflex
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Stroke the bottom of the foot from the heel to the call and then across. Should see a nrmal plantar extension
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Knee Jerk Reflex
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hitting the knee to see if the spinal cord & reflex ctrs are intake
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Triceps reflex
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Hitting the hammer in the elbow to see if you have a reflex
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Glascow Coma Scale
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*Objective measurement of LOC
*Areas of Assessment 1. eye opening 2. verbal presence 3. motor response *each area is given a numberical value & a sum total is obtained |
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Glascow Coma Scale
total mean? |
* 15 is the highest score & reflects a fully AAO LOC
* a score of 7 or less = coma * a score of 3 or less = deep coma |
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Pupillary Assessment is?
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Tests the occular motor nerve.
- pupils 2-6mm in size - size & shape should be equal - normal findings should be PERLA |
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PERLA
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Pupils Equal Qnd Reactive To Light Accomodation
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What are the age related findings? neuro
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* loss of neurons
* loss of muscle tone * slowing of the motor system * tremors * decreased smell / taste |
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Abnormal Conditions Neuro
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* paralysis/hemiplegia
* cognitive dysfunction * parkinson disease * aphasia * CVA * Bell's Palsy |
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Hemiplegia
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1/2 of body is paralized
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TBI
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Traumatic Brian Injury
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Parkinson Disease is?
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Lack of dopamin(neurotransmitters)
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Expressive Aphasia is?
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you can understand but you can't ask for what you want
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CVA?
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Cerebral Vascular Accident - can cause:
-emboli -thrombus -hemaratic(most serious) think of paper towel example told in class |
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TIA's?
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warning signs for CVA
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Neuro Diagnostic Tests
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* CAT-
* MRI * Glascow Coma Scale * LP * EEG |
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How do you test olfactory nerve #1?
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Have client identify smells. Test with 1 eye closed & 1 nostril closed
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How do you test optic nerve #2?
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Do the snellen or jaeger test
do the confrontation test |
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How do you test oculomotor#3, trochlear #4, abducens #6?
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Assess PERLA
Assess for accomodation Assess EOM's(cardinal positions of gaze) Assess for Nystagmus(the iris wiggles) |
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How do you test trigeminal #5 nerve?
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MOTOR: assess muscles of mastication(TMJ)
palpate w/ teeth clenched & try opening jaw SENSORY: assess light touch sensation(cotton whisp on face) |
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How do you test facial #7 nerve?
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MOTOR: assess ability to wringle foreheas, smile, frown & raise eyebrowsSENSORY: assess taste for sweet & sour on anterior of tongue
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How do you test acoustic #8 nerve?
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Do the Rinne, Weber and whisper test
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How do you test glossopharyngeal #9 & Vagus #10 nerve?
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MOTOR: assess for symmetrical rise of uvula & soft palate
assess gag reflex sensory sensation in posterior of tongue |
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How do you assess spinal #11 nerve?
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assess strength of the trapezus muscle
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How do you assess the hypoglossal # 12 nerve?
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Assess & note any lateral deviation.
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earliest sign of oxygen deprivation to heart
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anxiety
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Bottom of heart is called?
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APEX
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Top of heart is called?
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BASE
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MSL
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mild sternium line
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MCL
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mild clavical Line
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AAL
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anterior axillary line
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CAD
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Carinary artery disease
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orthopnea is what?
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needs extra pillows sleeping
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nocturia
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walking up at night for air
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What questions do you ask the PT for cardiac?
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Any chest pain
dyspnea - difficulty breathing orthopnea? Nocturia? Cough, fatihue? Edema? Past / family history |
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CAD Risk factors?
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*hypertension
* smoking * stress * diabetes *obesity *triglycerides *sedentary Lifestyles *Cholesterol |
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Non modifible factors for heart
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*Race
*age *genetics Afircan Americans are high risk for heart attacks |
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Objective Assessment Heart
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Carotiod arteries - no bruits
Ext. Jugular Veins (JVD) Apical impulse - located at the 4th * 5th ICS at L MCL |
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Cardiac Pulse = Apical Pulse
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4th or 5th Left MCL - under breast
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Pericardial Rub
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sounds like sand paper
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Pulse deficit is ?
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the difference btw the radical & apical pulse
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Age related finds to cardiac?
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*increase systolic reading(top #)
(arteries are getting narrow) * widening pulse pressure(difference systolic & diasystolic) *increase peripheral resistance *orthostatic hypotension(when u get up and your dizzy) |
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Cardiac Abnormal Findings are?
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*murmurs
* friction rub = pericardium rub * CAD |
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What are the symptoms of fluid overload? heart
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*cough
* SOB *JVD *Rales(crackles) *Fatigue - left side heart failure *Dyspnea - left side heart failure |
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Diagnostic tests for cardiac?
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*CPK - MB Troponins - blood test
(when heart muscle has been damaged) *PT/PTT - clots *Echocardiogram *EKG *Cardiac Cath *Stress test |
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Edema can indicate what regarding the heart?
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Right sided heart failure
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Fluid overload can indicate?
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Left sided heart failure
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When assessing the carotiod artery you want
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a smooth upstroke feel
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What degree to you elevate the HOB when assess the Jugular?
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30 degrees if u still see elavate it to 45 degrees
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What degree do you elevate the head of the bed when you are assessing the carotid?
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Elevate HOB to 45 degrees
Turn head |
