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General neurological assessment

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Guide to Neurological Assessment
dwu py 2 student

Published in: Health & Medicine
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General neurological assessment

  1. 1. GENERAL NEUROLOGICALGENERAL NEUROLOGICAL ASSESSMENTASSESSMENT
  2. 2. ICF –ICF – International Classification ofInternational Classification of Functioning, Disability and HealthFunctioning, Disability and Health • Body structure and functions – Impairments • Problems in body function or structure such as a significant deviation or loss • Activities – Is defined as the execution or performance of a task or action by an individual • Participation – Is an individual’s involvement in life situations in relation to health conditions, body function and structure, activities and contextual factors.
  3. 3. Physiotherapy AssessmentPhysiotherapy Assessment • Subjective – Info comes from patient – Most important is HoPC • Objective Assessment – Measurements taken for objective markers
  4. 4. SubjectiveSubjective AssessmentAssessment What are theWhat are the components?components? General assessmentGeneral assessment
  5. 5. NEUROLOGICAL HISTORYNEUROLOGICAL HISTORY • Age • Sex • Handedness • Occupation • History of present complaint • Neurological screening questions • Past medical history • Drug, family & social history
  6. 6. HoPCHoPC • Start with open question • Time and course – The onset, over few seconds, minutes hours, days, weeks, etc • Progression – Continuous or intermittent, stabilized or progressed • Pattern – Frequency & duration
  7. 7. HoPCHoPC • Also determine aggravating and relieving factors • Prior treatment & investigations • Current neurological state – Abilities and disabilities • Hypothesis generation & neurological symptoms • Screen for other neurological symptoms – Headaches,fits,blackouts,episodes of numbness or tingling
  8. 8. ObjectiveObjective AssessmentAssessment What are theWhat are the components?components?
  9. 9. Neurological objectiveNeurological objective AssessmentAssessment • Speech – Aphasia – a disorder of speech – Dysphonia - Disturbance of voice production – Dysathria – difficulties at different levels
  10. 10. UnconsciousUnconscious Patient!!!!Patient!!!! What do we do???What do we do???
  11. 11. Mental state and higherMental state and higher functionfunction • Mental state – Mood, vegetative symptoms, delusions, hallucinations & illusions • Higher Function – Attention & orientation, memory, calculation, abstract thought, spatial, visual & body perception, Apraxia.
  12. 12. AssessmentAssessment • Divided in 2 parts – Resuscitation – use neurological ABC – Examination – follow Glascow Coma Scale • Aimed at finding or excluding focal neurological abnormalities • Determining the level of consciousness & neurological function
  13. 13. EXAMINATION OF SENSORYEXAMINATION OF SENSORY FUNCTIONFUNCTION •Superficial Sensation •Deep Sensation •Combined Cortical Sensation
  14. 14. MUSCULOSKELETALMUSCULOSKELETAL EXAMINATIONEXAMINATION • Observation/Inspection • Palpation • Range of Motion • Muscle Performance • Special Tests
  15. 15. MOTOR FUNCTION EXAMINATIONMOTOR FUNCTION EXAMINATION • Mental status • Arousal • Sensory integrity and integration • Joint integrity, Postural Alignment and Mobility • Tone Cont…..
  16. 16. Cont………. • Reflex Integrity • Cranial Nerve Integrity • Muscle Performance • Voluntary Movement Patterns • Functional Task Analysis • Postural Control and Balance
  17. 17. EXAMINATION OFEXAMINATION OF COORDINATIIONCOORDINATIION •Equilibrium Coordination Tests •Non Equilibrium Coordination Tests
  18. 18. Examination of Gait The therapist look out forThe therapist look out for symmetry,symmetry, duration of swing, and Stanceduration of swing, and Stance phase, muscle activation around thephase, muscle activation around the ankles, knees, hips and trunk, armankles, knees, hips and trunk, arm swing, trunk rotation, balance andswing, trunk rotation, balance and speed.speed.
  19. 19. Examination of Functional Status and Activity Level
  20. 20. REFERENCEREFERENCE • Fuller.G.(2004).Neurological Examination made easy.3rd ed.UK; Elsevier. • The rehabilitation specialists handbook • Physical Rehabilitation, V Edi., - Susan B. O’ Sullivan

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