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88 Cards in this Set
- Front
- Back
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What is a sustained emotion?
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A Mood
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Any impairment of voice: a difficulty in speaking, volume, quality, pitch.
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Dysphonia
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The unpleasant emotional state in response to anticipation of unreal or imagined danger is what?
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Anxiety
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A memory serviceable for events long past, but not able to acquire new recollections is?
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Long term memory
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Imapairment of speech, with lack of coordination and failure to arrange words in proper order, due to a central lesion?
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Dysphasia
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A newly coined word?
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Neologism
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Loss of voice is?
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Aphonia
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A recurrent, persistent thought, image, or impulse that is unwanted and distressing?
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Obsession
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A false belief that is firmly maintained in spite of proof or evidence to the contrary?
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Delusion
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Loss of ability to carry out familiar, purposeful movements in the absence of paralysis or other motor/sensory impairment?
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Apraxia
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Defective speech due to lack of phonation and resulting in whispering?
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Hypophonia
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Lack or loss of memory
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Amnesia
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Inability to recall events that occurred befor the actual onset of amnesia?
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Retrograde amnesia
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Defect power of expression by speech, writing or signs, or of comprehending language, due brain pathology?
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Aphasia
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A persistent and irresistible impulse to perform an irrational or apparently useless act?
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Compulsion
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The external expression of emotion?
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Effect
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Impairment of memory for events occurring after onset of amnesia?
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Anterograde amnesia
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Memory that is lost within a brief period unless reinforced?
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Short term memory
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Unconscious filling in the gaps in memeory with frabricated facts and experiences?
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Confabulations
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A sense of perception without a source in the external world?
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Hallucinations
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Loss of the power to recognize the import of sensory stimuli?
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Agnosia
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What 4 catergories are assessed during the mental status examination?
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Appearance and behavior
Cogntitive Abilities Emotional Stability Speech and Language |
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What is the expected state of consciousness?
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Alert and oriented to person, place, and time
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How can you evaluate abstract reasoning?
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Ask pt. to tell you the meaning of a fable proverb, or metaphor
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What are the 4 ways judgment can be assessed?
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Ask if pt. is meeting social and family obligations
Ask what are the pt. plans for the future. Have pt. provide solutions to hypothetical situations Have pt explain fables or metaphors |
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What are tactile hallucinations most commonly associated with?
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ETOH withdrawal
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What 5 items are assessed for speech and language during the mental status exam?
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Voice quality
Voice Articulation Comprehension Coherence Aphasia |
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During the mental status exam, what 3 items are evaluated to assess appearance and behavior?
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Grooming, Emotional status, and body language.
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What 2 cognitive abilities are evaluated when asking a pt to add "8 to 50 till they reach 98"?
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Attention and Arithmetic
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A lower level of consciousness manifested by pt. responding by moaning and groaning to vigorous or painful stimuli?
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Stupor
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Disturbed orientation in regard to time, place or person?
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Confusion
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Drowsy, falls asleep quickly, but when aroused responds appropiately
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Lethargy
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A state of unconsciousness from which the pt. cannot be aroused?
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Coma
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Describe the eye opening scale in the Glasgow coma scale?
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1 none
2 to pain 3 to verbal stimulus 4 Spontaneously |
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Describe the verbal respone scale in the Glasgow coma scale?
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1 none
2 incoherent 3 Inappropiate words 4 confused 5 oriented |
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Describe the best motor respone scale in the Glasgow coma scale?
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1 none
2 extension to pain 3 flexion to pain 4 withdraws from pain 5 localizes pain 6 obeys commands |
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How is prognosis related to Glasgow coma scale score?
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The higher the score, the better the prognosis (chance of recovery)
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Which posture is associated with rigid flexion with arm flexed tightly at sides?
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Decorticate
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Which posture is associated with rigid extension with arms fully extended?
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Decrebrate
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What things should be evaluated for a pt. with suspected depression?
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Sadness
Insomnia Guilt Energy Concentration Anhodenia Psychomoter agitation or retardation Suicidal ideation SIG E CAPS |
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Which CN is first affected by increased intracranial pressure and what abnormality would you see?
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CN VI Abducens Nerve which results in abnormal lateral gaze in EOM exam or medial deviation of the eye in resting state.
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Having a pt. say light, night, and dental test which CN?
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CN XII
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Having a pt. say bum, papa, mama test which CN?
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CN VII
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Paralysis of CNIII will result in what physical examination findings?
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Miosis, external deviation of the eye and superior lid ptosis
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What functions does cerebellum control?
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Coordination and fine motor skills.
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What is the inability to preform rapid alternating movements called?
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Dysdiadochokinesis
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What is a Pos. Romberg sign?
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Inability of pt. to balance c eyes closed, feet together
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Why is heel to walking preformed?
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Exaggerates any potential abnormality in the gait exam.
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How can you test for balance and equilibrium?
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Romberg
Push standing pt. Balance on 1 foot Hop on one foot |
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What three ways can accuracy of movement be tested?
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Finger to finger
finger to nose heel down shin |
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Define proprioception
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Sensation of body or joint positions
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How is superficial touch evaluated?
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Touch pt with a wisp of cotton or soft brush and confirm they felt it?
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How is superficial pain evaluated?
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With a broken tongue blade touch skin have pt tell you if its sharp or dull.
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How is temp. evaluated?
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touch areas of body with test tubes filled with hot and cold water
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When do you test for deep pressure?
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When superficial pain is not intact
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How is vibration tested?
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Place a vibrating tuning fork over distal joints?
If it is felt distal no need to do proximal |
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Define stereognosis.
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Ability to recognize common objects by touch alone.
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Define graphesthesia.
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Ability to recognize symbols traced on palm.
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What are primary sensory functions?
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Superficial touch
Superficial pain Temp. & deep pressure Vibration Position of joints |
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What are the cortical sensory functions?
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Stereognosis
2 point discrimination Extinction phenomenon Graphesthesia Point location |
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What areas of the body may require increased stimulation for primary sensation to be perceived due to skin being less sensitive?
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Back, butt, and araes with thick skin.
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Describe diabetic neuropathy.
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Polyneuropathy caused by DM characteristics are
Foot muscle wasting Absent ankle & knee reflexes Decreased vibratory sense below knees Loss of pain or sharp touch to mid calf |
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What is parathesia?
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An abnormal touch sensation such as burning, prickling, formication, often in the absence of an external stimulus.
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What type of exam finding is parathesia?
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They are subjective
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Describe the grading system for scoring DTR.
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0 no response
1+ sluggish 2+ active, expected response 3+ more brisk than expected, slightly hyperactive 4+ brisk, hyperactive with intermitten or transiet clonus |
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Name the nerve roots and muscles the Biceps DTR assesses, and what are the expected results?
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C5 & C6
musculocutaneous nerve Flexion of the elbow |
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Name the nerve roots and muscles the Brachioradialis DTR assesses and what are the expected results?
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C5 & C6
radial nerve Supination & flexion of wrist |
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Name the nerve roots and muscles the Triceps DTR assesses and what are the expected results?
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C6, C7, & C8
radial nerve Extension at Elbow |
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Name the nerve roots and muscles the Patellar DTR assesses and what are the expected results?
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L2, L3, & L4
Femoral nerve Extension at knee |
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Name the nerve roots and muscles the Achilles DTR assesses and what are the expected results?
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S1 & S2
Tibial nerve Plantar flexion |
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What 2 maneuvers can you have the pt. do if you having difficulty assessing DTR?
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Jendrassik maneuver where hands are hooked together pulling apart
Clench teeth |
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How do you preform umbilical reflex?
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Pt. supine stroke each quadrant obliquely from bellybutton
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How do you preform cremaster reflex?
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Stroke inner thigh in male.
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How do you preform anal wink?
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Stroke perianal skin or mucosa causes contraction of external anal sphincter
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How do you preform the plantar reflex (Babinski)?
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Using reflex hammer quickly and firmly stroke sole of foot from lateral to medial area across ball of foot.
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What is a Pos. Babinski?
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Dorsiflexion of great toe.
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What are the 2 test for meningitis?
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Kernig
Brudzinski |
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Describe Kernig sign and what is Pos.
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Flex leg @ knee & hip in the supine pt.and attempt to straighten leg
Pos. is pain in lower back and resistance to passive straighting of flexed knee |
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Describe Brudzinski sign and what is Pos.
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Pt supine passively flex neck trying to touch chin to chest
Pos. is involuntary flexion of hips and knees when flexing the neck |
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What are signs and sx of Meningitis?
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Fever & chills
Nuchal rigidity H/A Vomiting Severe SX are seizures followed by alteration in LOC |
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What are the risk factors for CVA?
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HTN
Hyperlipedemia DM Smoking Obesity Sedentary Stress |
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What charectarizes general seizure disorders?
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Episodic, sudden, involuntary contractions of a group of muscles
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What is a upper motor neuron?
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Neurons in the brain that conduct impulses from the motor cortex to cerebral nerves or spinal cord.
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What is a lower motor neuron?
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neurons that conduct impulses from spinal cord to body.
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In sustained clonus the lesion would be a UMN or a LMN
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Upper motor neuron
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The lesion causing Bells Palsy would be a UMN or a LMN?
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LMN
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The lesion causing spastic paralysis after a stroke would be a UMN or a LMN?
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UMN
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The lesion causing muscle atrophy or wasting would be a UMN or a LMN?
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LMN
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