Term
| will you often perform a complete "neurological examination: |
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Definition
| no, rarely. Instead, you'll discern what you need and combine neurological examination with elements of PT examination |
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Term
| what to look at first in neuro patient evaluation |
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Definition
| functional issues/concerns/goals of patient and family. |
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Term
| what to do after learning concerns/issues/goals of patient |
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Definition
| try to determine which impairments may be contributing to functional impairments. Could be environmental, could be physical. |
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Term
| what to do after identifying which impairments are contributing to functional impairments |
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Definition
| identify which impairments and functional limitations you can change with PT |
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Term
| what to determine in history |
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Definition
| Nature of the movement/functional problem; Circumstances, time frame, environmental factors; results of neuroradiological, EMG, NCV tests; surgeries; medications/treatment; social history, occupation, living environment; equipment |
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Term
| what are components of a basic neurological examination |
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Definition
| mental status, communication/language, cranial nerves, reflexes, sensation/perception, motor, cerebellar, gait |
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Term
| what are components of a basic PT evaluation |
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Definition
| vital signs, PROM, movement control (jerkiness, difficulty moving), posture, function |
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Term
| what are the general guidelines for prioritization of PT + neuro examination components |
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Definition
| quick check of mental status; vital signs; motor screen; function; gait; sensation maybe; reflexes maybe; cranial nerves maybe; cerebellar maybe |
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Term
| what to look for in the motor screen part of PT/neuro examination |
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Definition
| What movement abilities does patient have? Try MMT, describe what you're seeing |
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Term
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Definition
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Term
|
Definition
|
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Term
| if a patient is alive, what is the lowest GCS score they can get |
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Definition
|
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Term
| what 3 things are looked at in the gcs |
|
Definition
| eye opening, best motor response, verbal response |
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Term
| describe the scoring of eye opening |
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Definition
| spontaneous 4; to speech 3; to pain 2; no response 1 |
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Term
| describe the scoring of best motor response in GCS |
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Definition
| follows motor commands 6; localizes 5; withdraws 4; abnormal flexion 3; extensor response 2; no response 1 |
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Term
| describe the scoring of verbal response in the GCS |
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Definition
| oriented 5; confused conversation 4; inappropriate words 3; incomprehensible sounds 2; no response 1 |
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Term
| how to cause noxious feelings |
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Definition
| sternal rub, nailbed pressure |
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Term
| what does it mean that a patient localizes motor response |
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Definition
| they don't squeeze your hand as commanded but they do move that arm |
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Term
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Definition
| abnormal flexion, extension |
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Term
| what is the term for abnormal flexion with arms crossed up over chest |
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Definition
|
|
Term
| what does decorticate flexion indicate |
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Definition
| serious damage of major descending spinal cord pathway that originates in midbrain such as vestibulospinal, reticulospinal, rubrospinal |
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Term
| what is the term for abnormal extension posturing |
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Definition
|
|
Term
| is the prognosis better for decerebrate or decorticate posturing |
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Definition
|
|
Term
| what to look for in motor function part of exam |
|
Definition
| is strength movement bilateral? |
|
|
Term
| what is the ashworth scale |
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Definition
| a scale for evaluating tone |
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|
Term
| what is a 0 on the ashworth scale |
|
Definition
| normal: no increase in tone |
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Term
| what is a 1 on the ashworth scale |
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Definition
| slight increase in tone. Small catch with movement at end of ROM |
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Term
| what is a 1+ on the ashworth scale |
|
Definition
| catch followed by minimal resistance throughout less than half of ROM |
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|
Term
| what is a 2 on the ashworth scale |
|
Definition
| more marked increase in tone but affected part can still be flexed |
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|
Term
| what is a 3 on the asworth scale |
|
Definition
| considerable increase in tone; passive movement difficult |
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|
Term
| what is a 4 on the ashworth scale |
|
Definition
| affected parts rigid in flexion or extension |
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Term
|
Definition
| resting tone is higher than normal |
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|
Term
| is hypertonia always nervous system related? |
|
Definition
| no. muscle tissue can also change |
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Term
|
Definition
| velocity dependent increase in resistance to passive stretch. Hyperactive stretch reflex |
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Term
| how to check for spasticity |
|
Definition
| move extremity at different speeds. If you feel a catch when moving quickly, that is spasticity |
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Term
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Definition
|
|
Term
| are kids with cp hyper or hypotonic |
|
Definition
| often hypertonic in limbs and hypotonic in trunk |
|
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Term
| what is a technique for reducing hypertonia |
|
Definition
| abduct thumb away from palm. Work on extending fingers. Pronate/supinate forearm |
|
|
Term
| what is huntington's chorea |
|
Definition
| involuntary movement throughout body |
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|
Term
|
Definition
| involuntary movement of hand |
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|
Term
|
Definition
| involuntary moement of hand that is writhig and less sporadic than chorea |
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Term
|
Definition
| involuntary muscle contraction that can be either generalized or focal. Tedn to get stuck/postured in a particular position |
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Term
| how to be more specific with light touch sensation testing |
|
Definition
| use cotton swab. Touch patient in aplace you know they can feel it. Then, Ask patient to close eyes and nod when they feel touch |
|
|
Term
| what pathway carries light touch |
|
Definition
| dorsal column medial lemniscus, some spinothalamic |
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Term
| what pathway carries pin pirck |
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Definition
|
|
Term
| how to test proprioception |
|
Definition
| hold DIPJ on lateral sides. Have patient tell you whether it's up or down compared to rest of hand. If finger doesn't do well, go to wrist, then elbow |
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Term
| another way to test proprioception |
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Definition
| move affected arm into a certain position. Ask patient to match with other arm. Then, do with eyes closed |
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|
Term
| what's another test for proprioception |
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Definition
|
|
Term
| which cranial nerves allow eye movements |
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Definition
|
|
Term
| which cranial nerve allows facial expression |
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Definition
|
|
Term
| what does PERRLA stand for |
|
Definition
| pupils equal, round, reactive to light, accommodate |
|
|
Term
| what is pupil accommodation |
|
Definition
| ability to adjust vision from close to far away |
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|
Term
| what shape to use to test eye movement |
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Definition
|
|
Term
| what to look for/ask for in eye movement testing |
|
Definition
| eyes moving conjugately; ask if there is blurred/doublevision |
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|
Term
| what does a positive babinski indicat |
|
Definition
| upper motor neuron problem - brain or spinal cord |
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|
Term
|
Definition
| continues to beat as long as you hold it |
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|
Term
|
Definition
|
|
Term
|
Definition
|
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Term
|
Definition
| elbow flexion or wrist extension |
|
|
Term
|
Definition
| elbow extension or wrist flexion |
|
|
Term
|
Definition
| thumb extension or ulnar deviation |
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|
Term
|
Definition
| finger abduction or adduction |
|
|
Term
| what is another term for the VOR |
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Definition
|
|
Term
|
Definition
| when you turn your head, your eyes turn toward opposite direction by the same amount |
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|
Term
| how to distinguish different levels of hyperactive reflexes on a diagram |
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Definition
|
|
Term
| how to show positive or negative babinski on a diagram |
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Definition
| up arrow = positive, down arrow = negative |
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|
Term
| also be sure to review neuro handout 2010 in handouts folder in 8-22 Neurological Evaluation folder |
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Definition
|
|
Term
| how to test movement control |
|
Definition
| see if patient can isolate movements |
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|
Term
| what is another term for non-fluent aphasia |
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Definition
|
|
Term
| what are the brodman's areas for Broca's aphasia |
|
Definition
|
|
Term
| what is another term for fluent aphasia |
|
Definition
|
|
Term
| what are the brodman's areas for Wernike's aphasia |
|
Definition
|
|
Term
| in which type of aphasia is the patient aware of their deficit |
|
Definition
|
|
Term
|
Definition
| patient knows what she wants to say but can't get it out |
|
|
Term
| describe wernicke's aphasia |
|
Definition
| receptive aphasia; difficulty understanding what is being said to them |
|
|
Term
|
Definition
| combination of fluent and non-fluent aphasia |
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Term
|
Definition
| difficulty related to speech and language. Usually does fine with non-speech kinds of mouth and tongue movements. Motor planning associated with speech is impaired. |
|
|
Term
|
Definition
| articulation disorder. Difficulty with control of muscles of tongue and mouth in speech and in other types of oral motor activities like chewing. Able to read and follow instructions. Hard to understand their speech. |
|
|
Term
| in what lobe is Broca's area |
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Definition
|
|
Term
| in what lobe is Wernicke's area |
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Definition
|
|
Term
| what might happen to cause damage at the optic chiasm |
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Definition
|
|
Term
| what is homonymous hemianopsia |
|
Definition
| loss of half of the visual field in both eyes, usually due to stroke. For example, if stroke is in the left side of the brain, you might see loss of R visual field in both eyes |
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|
Term
| how to test for unilateral neglect |
|
Definition
| have patient draw a clock, house, person |
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|
Term
| what is extinction phenomenon |
|
Definition
| when you give bilateral, simultaneous stimulation, the person attends only to the less involved side; When sensation is not affected but in touching both arms, they only feel touch on one side. |
|
|
Term
| are cerebellar problems ipsilateral or contralateral |
|
Definition
|
|
Term
| what does movement look like in a person with a cerebellar disorder |
|
Definition
|
|
Term
|
Definition
| consistently being unable to reach target in finger nose finger test. |
|
|
Term
|
Definition
| rapid, alternating movements |
|
|
Term
| what is Dysdiadochokinesis |
|
Definition
| trouble with rapid, alternating movements |
|
|
Term
| how to test diadochokinesis |
|
Definition
| have them do 5 on each hand. Time and compare if there is a difference between L and R sides |
|
|
Term
| what is the heel to shin test |
|
Definition
| person slides heel up and down shin |
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|
Term
|
Definition
| person is supine and touches heel to patella and back down |
|
|
Term
| what is the rebound phenomenon test |
|
Definition
| resist elbow flexion then let go, see if patient can stop elbow flexion quickly when it is no longer resisted |
|
|
Term
| what are 4 cerebellar special test |
|
Definition
| finger nose finger, heel to shin, RAM, rebound |
|
|
Term
| what are Semmes Weinstein monofilaments |
|
Definition
| way to document quantitatively and specifically how severe sensory loss is. |
|
|
Term
|
Definition
| increase in tone. Hypertonia. |
|
|
Term
| what is lead pipe rigidity |
|
Definition
| when there's resistance with no threshold angle of the joint. |
|
|
Term
| what is cogwheel rigidity |
|
Definition
| resistance with a catch as you go |
|
|
Term
| what must be documented along with clonus |
|
Definition
| either sustained or number of beats |
|
|
Term
| what does positive babinski indicate |
|
Definition
| upper motor neuron lesion |
|
|
Term
|
Definition
| motor planning problem. Difficulty determining how to do a certain thing: how to tie your shoe, how to sit criss corss, how to transfer, how to dres |
|
|
Term
|
Definition
|
|
Term
| what is the posterior fossa |
|
Definition
|
|
Term
| what indicates a posterior fossa lesion |
|
Definition
| weakness on one side of the body but cranail nerve symptoms on the other side of the body. |
|
|
Term
| what are the anatomical levels of lesions |
|
Definition
| supratentorial, posterior fossa, spinal, peripheral |
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