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mental health assessment, rule out medical causes like |
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Definition
central nervous system disorders, metabolic and electrolyte disturbances, infection, nutritional deficiency. |
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Mini-Mental State Examination |
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Definition
what is the year, season, date, day month? where are we? Name three objects, have patient repeat. Spell world backwards. ask for 3 objects again. Name "pencil" and "watch". Repeat: "no ifs, ands or buts. Follow three-stage command. Read and obey the following: close your eyes. Write a sentence. copy the following design. |
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Definition
delirium, dementia, depression, anxiety |
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develops acutely, fluctuating levels of consciousness. reduced ability to maintain attention. Agitation or hypersomnolence. Extreme emotional lability. Cognitive deficits can occur. |
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is usually multifactorial. systemic illness. psychoactive medications can cause it. Risk factors for example: electrolyte abnormalities, infections, endocrine dysfunctions. liver failure, encephalopathy, renal failure,... pulmonary disease, cardiovascular disease,CHF, tumors, strokes, seizures, deficiency states: thiamin, nicotinic or folic acid, B12 |
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Term
Delirium causes, review meidication |
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Definition
anticholinergics, analgesics, steroids, anitparkinson, sedative, anticonvulsatns, antihistamines, antiarrhythmics, antihypertensives, antidepressants, antimicrobials, sympathomimetics |
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memory impairment and one of the following: aphasia (impaired language ability), apraxia (unable to perform movements when asked, disorder of brain and nervous system), agnosia (loss of ability to recognize shapes, people, ...), impaired executive functioning. |
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mini mental state exam (MMSE), clock drawing test (CDT), MIni-Cog, 7-Minute screen. |
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potentially reversible dementias |
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Definition
drug toxicity, metabolic distrubances, normal pressure hydrocephalus, lesion, infectious process (meningitis, syphilis), vascular disease, endocrine disorder (thyroid, parathyroid), nutritional disease (B12, thiamine, folate), other (COPD, cHF, Liver Dz) |
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depression screening tools |
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Definition
beck depression inventory, geriatric depression scale, patient health questionnaire |
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Definition
often one of the first signs of intercranial pressure, projectile, different from GI disturbance, possibly neurologic cause, brain tumor. |
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is most important aspect of neurologic exam. the first thing to deteriorate. composed of arousal and awareness. assess first with speech, then touch, then noxious stimuli like nail bed pressure. |
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1mm discrepancy in pupil size may exist and is considered normal finding, 15-17% of population |
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decreased heart rate, increasing blood pressure, irregular respirations |
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may indicate increased intercranial pressure |
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olfactory, optic, oculomotor, trochlear, trigeminal, abducens, facial, acoustic, glossopharyngeal, vagus, accessory, hypoglossal |
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Definition
assess peripheral vision,visual acuity, snellen chart, |
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PERRLA, six cardinal positions of gaze |
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cranial nerve 5 (trigeminal) |
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Definition
motor: clench teeth, assess masseter muscles, sensory touch: light: touch chin, cheek, forhead |
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kiss mouth, eyeborows up, frown, smile, show teeth, puff cheeks |
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dysfunction of facial nerved - uneven smile |
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weber test (vibration on head), rinne test (vibration behind ear) |
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cranial nerve 9 and 10: Glossopharyngeal, vagus |
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cranial nerve 11: spinal accessory |
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Definition
shrug shulders against resistance, turn head against resistance |
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cranial nerve 12: hypoglossal |
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Definition
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touch, pain, temp, vibration. Disorders of sensory nerves result in decreased sensation, may also result in loss of reflexes, position sense, balance. May cause neuropathic pain. |
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Definition
what is the thing in your hand (closed eyes) |
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Definition
draw something (8) on patients hands. Eyes closed. |
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Term
diseases that affect sensory nervous system |
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Definition
diabetes, herniated disk, guillain barre (immune system attacks nervous system), charcot marie tooth disease (inherited disorder, affects peripheral nerves), HIV neuropathy (peripheral nerve damage) |
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involved in coordination of voluntary motor movement, balance and equilibrium and muscle tone |
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weakness on one side of the body |
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dorsiflexion of big toe and fanning of other toes is positive sign = should only happen in infants up to 6 months |
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assess size, shape, symmetry, strength, test resisted motions, note involuntary movement: fibrillation, fasciculation, asterixis, tics, spasms, jerks |
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Gait, Romberg, Finger to finger, finger to nose, rapid alternating movements, heel shin, Reflexes. |
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involuntary, jerky movements |
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nuchal rigidity or neck stiffness, brudzinski sign, kernig sign |
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1. preadolescent, 2. breast bud. 3 and 4. puberty, 5. mature breast |
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most common caucasian males 15-30 years |
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common in older males. most common in AA |
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ER! Severe testicular pain. Can lead to loss of testis |
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