the neuro exam - preliminary considerations

reason for neurologic screen

• determine whether there is a _____

• determine whether _____ are consistent with diagnosis

• determine whether patient requires _____

• determine whether symptoms require more ____

neurologic, signs and symptoms, referral, investigation

reasons for a comprehensive neuro exam

• abnormal response to _____

• thoroughly assess all aspects of known or suspected _____

screen, neruologic diagnosis

8 elements of neruo exam

history, preliminary considerations, sensory exam, cranial nerves, motor exam, reflexes, coordination, functional mobility

to screen for orthostatic hypotension, take vitals in ____vs____ or ____vs_____

supine, seated, seated, standing

orthostatic hypotension

• systolic drop: more than _____mmHg

• diastolic drop: more than _____mmHg

20, 10

your ____ start when you enter the room, assess patient ability to _____ on and _____ to the battery of test items

preliminary considerations, concentrate, respond

two general categories of preliminary considerations

1. ______

2. ______

arousal level, attention span, orientation, cognition

memory, hearing, visual acuity

is the patient altert, lethargic, coma, etc is the _____ preliminary consideration

arousal

does the patient have selective awareness of the enviornment/assess responsiveness to a stimulus or task is the _____ preliminary consideration

attention

patients awarenss of the time, person, and place is the _____ preliminary consideration

orientation

patients awareness and judgement is the _____ preliminary consideration

congition

patients willingness to work together is the _____ preliminary consideration

cooperation

spontaneous speech, comprehension, naming, repetition, reading, writing is _____ preliminary consideration

language

_____ - area of testing cogntivie-dependent function: ask questions based on sum of an individuals learning and experience in life (highly variable)

fund of knowledge

_____ - area of testing cogntivie-dependent function: ask questions that examine foundational mathemetical abilities

calculation ability

_____ - area of testing cogntivie-dependent function: ask questions to examone patients ability to intrepret use of words outside of their usual context or meaning

proverb interpretation

language disorders where there is a comprehension impairment

receptive aphasia, wernickies, fluent

language disorders where there is a production impairment

expressive aphasia, brocas, nonfluent

language disorder where there is both a production and comprehension impairment

global aphasia

language disorder where there is a weakness with muscles that produce speech

dysarthria

dysarthria is a ____ disorder

motor

aphasia is a ____ disorder

language

impairment of motor planning

apraxia

when have the strength to produce the movement but cant seem to make it happen

apraxia

unable to produce movement on command but can move automatically

idemotor

inability of the patient to produce movement either on command or automatically

ideational

asking “how is my brother related to me sister” is testing language and speech _____

comprehension

ask patient to identify objects or body part is testing language and speech ____

naming

“name as many animals as you can in 1 minute” is _____ test that is testing language and speech

one-minute category naming test

one minute category naming test - less than ____ would indicate a language deficit, normal performance is more than ____ words

15, 21

ask the patient to read a simple paragraph aloud is testing ____ aspect of language and speech

reading

inability to read or comprehend written language

alexia

inability to write

agraphia

asking the patient to write answers to simple questions is testing ____ aspect of language and speech

writing

perception deficit resulting in decreased ability to recognize one side of space/body

unilateral neglect

when touch right side and left side independently can tell the difference, but when at the same time cant tell the difference

unilateral neglect

further unilateral neglect assessment

drawing, visual scanning, identification, ask patient to bisect line

asking patient to repeat a series of three words and remember them 5 min later is testing ____

short term memory

individuals with normal memory fucntion should be able to recall a list of _____ words 5 min later and at least ____ of the items after 30 minutes

3, 2

note alterations in voice volume and tone influence patient response

hearing

snellen chart tests _____

visual acuity