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OCTH 721 final
| Question | Answer |
|---|---|
| sensory system related to light touch, pain, temp, pressure, vibration, proprioception, and kinesthesia | primary somatosensory |
| sensory system related to two-point discrimination, stereognosis, graphesthesia, and distinction of simultaneous stimulation | secondary somatosensory |
| sensory system related to vision, olfaction, gustation, audition, and equilibrium | special sensory |
| primary somatosensory screening: lightly stroke region of skin using cotton swab or finger, apply stimulation 3x and as yes/no if felt, impairment=2/3 answers incorrect | light touch |
| primary somatosensory screening: randomly apply dull or sharp end of safety pin, apply stimulation 3x and ask for sharp/dull when stimulus felt, impairment=2/3 incorrect answers | pain |
| primary somatosensory screening: randomly apply test tubes of hot and cold water, apply stimulation 3x and ask for hot/cold when stimulus is felt, impairment=unable to distinguish hot and cold or unable to recognize stimulus | temperature |
| primary somatosensory screening: position affected extremity and ask client to name position OR match/replicate with other arm, repeat for all joints, impairment=unable to stay in position or reproduce position with uninvolved extremity | proprioception / kinesthesia |
| primary somatosensory screening: apply light touch using fingertip/esthesiometer for 1-2 seconds and ask client to touch exact spot with other hand, impairment=unable to localize tactile stimulation within 1 inch of stimulated area | tactile stimulation |
| primary somatosensory screening: strike a tuning fork and place stem of fork on skin and ask client if they feel vibration, impairment=unable to id vibratory stimulation | vibration |
| secondary somatosensory screening: apply an esthesiometer to thumb then index finger and ask client if they feel 1 or 2 points, impairment=unable to discriminate between distances of points | two - point discrimination |
| secondary somatosensory screening: place 1 object at a time in client's hand and allow them to manipulate it for 5-10 seconds before naming, occlude vision, repeat with involved hand, impairment=unable to id 3 or more/5 items | stereognosis |
| secondary somatosensory screening: occlude client's vision, place 1 texture at a time in client's hand and allow them to manipulate for 5-10 seconds before naming, repeat with involved hand (alt. order), impairment=unable to id 3 or more/5 | ahylognosia |
| secondary somatosensory screening: occlude vision, place 1 shape in client's hand at a time and allow them to manipulate for 5-10 seconds before naming, repeat on involved hand (alt. order), impairment=unable to id 3 or more/5 | amorphagnosia |
| secondary somatosensory screening: inform client you are going to write letters in palm, write 5 letters in palm 1 at a time and ask client to id letter, impairment=unable to id 3/5 letters | graphesthesia |
| secondary somatosensory screening: involved side 1st(!), touch involved hand and ask client where they're being touched, touch uninvolved hand and ask client where they're being touched, simult. touch both hands and ask client where they're being touched | simultaneous stimulation |
| secondary somatosensory screening: impairment=can id area of stimulation on involved side when touched on that side alone but can't id on involved side when touched on both sides simult. | simultaneous stimulation |
| motor screening: continuous state of muscle contraction at rest; assessed during PROM, move each joint segment quickly through PROM 4x and note response in muscle tone | tone |
| motor screening: not performed if tone is suspected/present, also assess grip and pinch strength with it, this test increases tone | manual muscle testing |
| used to assess hyperreaction reflexes with UMN injury and hyporeactive reflexes with LMN injury, supported extremity being tested and ask client to relax, tap tendon using reflex hammer, impairment=reflex is hyperreflexive, hyporeflexive, or absent | deep tendon reflexes |
| CN screening: assess=screen 1 at a time, occlude both eyes and 1 nostril, present 1 odor at a time (4 scents), ask client what they smell (can provide options if needed), impairment=difficulty smelling 3/4 odors aka anosmia | olfactory nerve |
| CN screening: assess=visual acuity-Snellen Eye Chart, visual field-area of peripheral vision, fundoscopic exam | optic nerve |
| part of optic n. screening: assess=client is 20 feet from Snellen Eye Chart and performs it, unilateral then bilateral, note line on which they id more than 1/2 of letters correctly and record score; impairment=refer to eye doctor for 20/40 or worse | visual acuity |
| part of optic n. screening: assess=1 eye at a time, client looks directly ahead and you move finger from 90 degree position to 0 degree, client indicates when they see finger, assess in different planes; impairment=scores more than 5 degrees below norms | visual fields |
| CN screening: assess=darken room to enlarge pupils with client looking straight ahead, shine penlight into tested eye, repeat on other eye and for both simult.; impairment=pupil of 1 or both constricts sluggishly or if both don't dilate/constrict simult. | oculomotor nerve |
| part of oculomotor n. screening: assess=darken room to enlarge pupils, place 1 hand on client's nose, shine penlight into 1 eye and observe reflex in other eye (both should constrict); impairment=pupil of unstimulated eye doesn't constrict at same time | consensual light reflex |
| part of oculomotor n. screening: assess=hold object in front of client and instruct them to fixate on it, move object in straight line towards client's nose, observe for symmetrical medial eye movements and record distance that convergence was broken | convergence |
| part of oculomotor n. screening: impairment=pupils don't constrict as eyes converge, broken greater than 3-4 inches from nose | convergence |
| part of CN III, IV, and VI screening: asses=screen 1 eye at a time and occlude opposite eye, client maintains head position while visually scanning a moving stimulus in an "X" and "H" shape, note smoothness of movement and how eye follows stimulation | eye muscle function |
| part of CN III, IV, and VI screening: impairment=eyes can't scan entire distance in any direction, eyes don't follow/track smoothly | eye muscle function |
| CN that does up, down, and medial movements | oculomotor nerve |
| CN that does down and lateral movements | trochlear nerve |
| CN that does lateral movement | abducens nerve |
| part of CN III, IV, and VI screening: assess-darken room and shine penlight at bridge of nose and observe for symmetrical corneal reflection; impairment=asymmetrical corneal reflex, leads to diplopia | strabismus |
| part of CN III, IV, and VI screening: assess=seat client towards blank wall and have them focus on object ~18 inches in front of them, do "X" and "H" shapes with object, screen for both eyes unless impairment indicated then individually | diplopia |
| part of CN III, IV, and VI screening: impairment=reports double vision for any screening condition | diplopia |
| part of CN III, IV, and VI screening: assess-using eye muscle function screens ("X" and "H" tracking), impairment=elicited when eyes move in any direction or visual field extremes | nystagmus |
| CN screening (sensory): assess=use cotton swab, pin, hot and cold test tubes to assess for areas of head, face, and inner oral cavity and use corneal reflex test; impairment=areas of anesthesia detected for a sensation, absent or sluggish corneal reflex | trigeminal nerve |
| CN screening (motor): assess=occlude vision and ask client to open and close mouth, move jaw side to side, bite on tongue depressor and resist pull; impairment=jaw deviation, decreased jaw strength, and decreased ability to open mouth on involved side | trigeminal nerve |
| part of CN V sensory screening: touch client's cornea lightly with cotton swab to check reflex function, should blink, uninvolved first | corneal reflex test |
| CN screening (sensory): occlude vision, uninvolved 1st(!), apply taste substance 1 at a time to lat. parts of ant. tongue, ask ct. if they can taste and id it as sweet, salty, or sour; impairment=inability to detect taste on 1 or both sides of ant. tongue | facial nerve |
| CN screening (motor): assess=ask client to elevate eyebrows and forehead; ask client to smile, frown, pucker lips; ask client to fill cheeks with air and gently push on cheeks while asking them to resist | facial nerve |
| CN screening (motor): impairment=difficulty elevating eyebrows/forehead, decreased muscle strength or asymmetry | facial nerve |
| assessment of auditory branch of CN VIII: strike a tuning fork and place against middle of client's forehead, ask if sound is heard equally in both ears or louder in 1 | Weber test |
| assessment of auditory branch of CN VIII: strike a tuning fork and place it 1 inch from auditory canal then on mastoid bone, alternate placement until no sound is heard, should be able to hear louder from auditory canal | Rinne test |
| impairment of auditory branch: louder in abnormal ear with conductive loss, louder in unaffected ear with sensorineural loss | Weber test |
| impairment of auditory branch: bone conduction is longer than air conduction with conductive loss, air conduction is longer than bone conduction with sensorineural loss | Rinne test |
| assessment of vestibular branch of CN VIII: have client stand with eyes open, check for sway and loss of balance, gently displace client's balance and check for appropriate protective responses, repeat with eyes closed | Romberg test |
| impairments of what branch of CN VIII: nystagmus detected, absent or sluggish protective responses, increased LE tone | vestibular branch |
| CN screening (sensory): assess=apply taste substance 1 at a time to posterior tongue, bitter tastes; impairment=inability to detect taste on 1 or both sides of posterior region of tongue | glossopharyngeal nerve |
| CN screening (motor): assess=attempt to elicit gag reflex with tongue depressor, observe swallowing of multiple food consistencies, observe ability to speak clearly without slurring, check for decreased phonal volume/hoarseness or breathing difficulties | glossopharyngeal and vagus nerves |
| CN screening (motor): impairment=difficulty swallowing (dysphagia) and aspiration of food, dysarthria, dysphonia, or dyspnea | glossopharyngeal and vagus nerves |
| CN screening: assess=check for dysphagia, assess Adam's apple during swallow for rise/fall of larynx; impairment=larynx does not rise/fall normally, dysphagia | cranial root of spinal accessory nerve |
| CN screening: assess=check for asymmetry and atrophy, complete MMT (uninvolved 1st) for SCM and upper traps; impairment=weakness or atrophy of SCM or upper trap | spinal root of spinal accessory nerve |
| CN screening: assess=observe for deviation of protruded tongue, check for tongue tremors or involuntary movements, have client move tongue side to side, ask client to push tongue against 1 cheek then the other and resist attempts to depress cheek | hypoglossal nerve |
| CN screening: impairment=tongue deviation towards side of lesion, tongue tremors, unilateral or bilateral tongue atrophy or weakness | hypoglossal nerve |
| cerebellar screening: assess=finger to nose-alternating index fingers with eyes open and closed, finger to finger-index fingers simult. to midline with eyes open and closed, finger to therapist's finger, alt. nose to therapist's finger | intention tremors |
| cerebellar screening: impairment=increased tremors with movements and/or difficulty touching target, accuracy becomes worse with eyes closed | intention tremors |
| movements that are broken up into their component parts | movement decomposition / dyssynergia |
| cerebellar screening: assess=same as intention tremors; impairment=movement occurs in steps at each involved joint rather than a singular coordinated movement | movement decomposition / dyssynergia |
| cerebellar screening: reach for objects at arm's length as named, place a pencil in a mug and client gets 3 attempts; impairment=over- or undershoots 2/3 objects/attempts, attempts to stabilize UE on table | dysmetria |
| impaired ability to perform rapid, alternating movements; can't quicky pronate/supinate or open/close grasp; bilateral movements no longer simultaneous | dysdiadochokinesia |
| cerebellar screening: assess=have client rapidly pronate/supinate and/or do that while tapping hands on thighs; impairment=difficulty performing motions at same speed and ROM bilaterally, lose rhythm and 1 UE will lag behind | dysdiadochokinesia |
| cerebellar screening: assess=client is seated and has elbow flexed, ask them to resist pulling elbow into ext., release arm and note position when letting go; impairment=inability to regulate speed and force of opposing muscle groups, hit chest | rebound phenomenon |
| cerebellar screening: assess=choose 1-ask client to fixate/maintain a specific position bilaterally OR MMT of major m. groups; impairment=tires quickly and can't maintain for 30 seconds, weakness of involved side or general weakness | asthenia |
| inability to maintain both UEs in same position without client's awareness, looks like UE drifting due to lack of proprioceptive awareness | motor impersistence |
| cerebellar screening: assess=tested with asthenia (fixation/position holding); impairment=involved UE drifts out of position (below 90 degrees) unknown to client | motor impersistence |
| cerebellar screening: assess=seat client and complete PROM; impairment=diminished resistance to PROM, soft or flaccid muscles noted on palpation | hypotoncity |
| cerebellar screening: assess=attempt to elicit deep tendon reflex; impairment=diminished or absent deep tendon reflex | hyporeflexia |
| cerebellar screening: assess=seat client and perform PROM; impairment=increased resistance to PROM, rigid muscles noted on palpation | hypertonicity |
| cerebellar screening: assess=attempt to elicit deep tendon reflex; impairment=increase in deep tendon reflex | hyperreflexia |
| cerebellar screening: assess=observe posture with eyes open and closed (Romberg's); balance on 1 foot; displace balance; walk in straight line, sideways/backward, march in place, or walk on heels or toes | ataxia |
| cerebellar screening: impairment=easily loses balance when displaced, inability to maintain balance on 1 foot, inability to maintain upright posture with eyes closed, loss of proprioception if they can maintain balance with eyes open but not eyes closed | ataxia |
| cerebellar screening: assess=observe during visual field testing ("X" and "H"), note jerky eye movements at end range; impairment=cerebellar damage may be indicated if present in visual field extremes/end ranges | nystagmus |
| impairment of motor movements of speech with lack of enunciation; broken speech with prolonged, slow, slurred syllables | dysarthria |
| cerebellar screening: assess=observe client's speech during screenings, ask client to read a paragraph or repeat phrases; impairment=damage is indicated if speech is slowed, slurred, prolonged, and/or broken/staccato | dysarthria |
| involuntary, oscillating movement at rest; worsen with emotional distress; seem to stop when voluntary movement initiated | resting tremors |
| BG screening: assess=observe client at rest and note if tremors are present, if present have client perform an activity to see if tremor disappears; impairment=tremors detected at rest but decrease/disappear when voluntary movement is initiated | resting tremors |
| BG screening: assess=perform PROM; impairment=lead pipe-uniform and continuous resistance throughout range, cogwheel-alternating release and resist pattern throughout range | rigidity |
| inability to initiate voluntary movement; fixed posture and significant mental concentration is needed to complete basic motor tasks | akinesia |
| slowed or decreased movement; delays in changing movement; may present as lack of facial expression, monotone speech, and reduced eye movement | bradykinesia |
| BG screening (2 screened together): assess=observe during screening procedures and note if client can initiate voluntary movement, if client's movements are abnormally slow, of if client has difficulty switching from 1 motor pattern to another | akinesia and bradykinesia |
| BG screening (2): impairment=mask-like facial expression, inability to initiate voluntary movements or slowed voluntary movements, monotone speech, inability to change movement patterns in a timely manner | akinesia and bradykinesia |
| BG screening: assess=ask client to walk along straight line and observe initiation of walking, arm swing, and speed of gait; ask client to change speed and direction and then stop; assess balance and protective responses | cunctation - festinating gait |
| BG screening: impairment=difficulty starting/stopping walking, difficulty changing speed or direction, hurried gait with small shuffling steps, decreased balance, absent or exaggerated arm swing | cunctation - festinating gait |
| BG screening: assess=observe for symptoms-shoulder shrugging, hip movement, facial grimaces, crossing/uncrossing legs, tongue protrusions; impairment=presents with symptoms | chorea |
| BG screening: slow, flailing, twisting movement; combo of spasticity and hypotonicity; involve neck, face, trunk, and extremities; assess=observe for symptoms; impairment=presents with symptoms | athetosis |
| BG screening: assess=observe for symptoms-violent, thrashing movements of extremities on 1 side; impairment=presents with symptoms | hemiballismus |
| BG screening: assess=observe for symptoms-torsion spasms, forced eyelid closing, truncal dystonia, torticollis; impairment=presents with symptoms | dystonia |
| BG screening: assess=observe for symptoms-brief, isolated movements, variety of sounds; impairment=presents with symptoms | tics |
| gait condition: circumduction of paretic side with elbow flexed, shoulder adducted, forearm pronated, extended leg, cerebral palsy | hemiparetic gait |
| gait condition: both LEs demonstrate flexion at hips and knees, knock-kneed, feet extended, internal rotation of hip, and circumduction pattern | diplegic / spastic gait |
| gait condition: distal LE unable to dorsiflex causing foot drop, increased knee and hip flexion to clear foot, diabetes | neuropathic gait |
| gait condition: weakness of pelvic girdle causing non weight bearing hip drop, muscular dystrophy | myopathic gait |
| gait condition: stooped over with difficulty initiating steps, small festinating steps, and difficulties turning, Parkinson's | hypokinetic gait |
| gait condition: associated movements while walking (grimacing, UE movement) that doesn't affect balance, chorea | hyperkinetic gait |
| gait condition: wide base of support with difficulty narrowing stance, truncal movements, sideways jerking, difficulty with tandem stance, and difficulty maintaining balance | ataxic gait |
| visual perceptual disorder: assess=show client several familiar objects 1 at a time and ask them to id it; impairment=unable to name 1/2 of present items | visual agnosia |
| visual perceptual disorder: assess=id familiar (family or self) or famous people in photos or in person; impairment=unable to id others and self | prosopagnosia |
| inability to interpret visual stimuli as a whole | simultanagnosia |
| visual perceptual disorder: assess=show photos of detailed scenes and have client describe in detail; impairment=unable to understand scene as a whole or confabulates items that don't exist, may id small details rather than integrate whole scene | simultanagnosia |
| visual distortion of physical properties of objects so they may appear bigger, smaller, heavier, or lighter than they are | metamorphopsia |
| visual perceptual disorder: assess (choose 2)=present ct. w/ puzzle of diff. shapes and ask to complete, ask ct. to estimate weight/size of diff. objects based on just observation, present water glasses of diff. sizes ask to order from most to least full | metamorphopsia |
| visual perceptual disorder: impairment=unable to accurately complete any of the assessments | metamorphopsia |
| visual perceptual disorder: assess=ask ct. to name correct color for objects w/out showing object, present ct. w/ objects 2 of which are wrongly colored and ask to id incorrect 1s; impairment=unable to id correct color for objects or which ones are wrong | color agnosia |
| visual perceptual disorder: assess=show client 6 color flashcards and ask them to name color; impairment=unable to accurately id 3/6 correct colors | color anomia |
| visual spatial perceptual disorder: assess=ask client to point to diff. R and L body parts, ask client to follow R/L commands around environment; impairment=confuses L/R 3/4 times with body parts or directions | right - left discrimination dysfunction |
| visual spatial perceptual disorder: assess=ask client to pick forks out of a disorganized tray with other utensils or find white items on a white sink; impairment=unable to pick out 1/2 of items or easily find objects against background | figure - ground discrimination dysfunction |
| visual spatial perceptual disorder: assess=ask client to id familiar items placed in odd position, ask client to sort shapes of varying sizes into categories; impairment=unable to id objects while placed in odd positions or makes errors sorting shapes | form - constancy dysfunction |
| visual spatial perceptual disorder: assess=ask client to follow at least 2 directions using terms such as up/down, in/out, behind/in front of; impairment=difficulty with 1/2 of commands | position - in - space dysfunction |
| visual spatial perceptual disorder: assess=ask client to find way between 2 locations; impairment=commonly becomes lost when trying to navigate using verbal directions or written map | topographical disorientation |
| visual spatial perceptual disorder: assess=seat ct. in a room or in front of a window and ask them to id objects in room that are closest, furthest, and mid-range; impairment=unable to accurately determine which objects are closest, furthest, or mid-range | depth perception dysfunction |
| body schema perceptual disorder: assess=ask client to carry out commands such as show me your thumbs or press your index fingers together; impairment=unable to demonstrate 1/2 of commands | finger agnosia |
| body schema perceptual disorder: assess=have client draw a clock or human figure and not if numbers/body parts are neglected on 1 side, ask them to read and note if they ignore words to 1 side, observe ADLs | unilateral neglect |
| body schema perceptual disorder: impairment=ignore body or environment on 1 side | unilateral neglect |
| extensive neglect syndrome involving failure to recognize one's paralyzed limb as own | anosognosia |
| body schema perceptual disorder: assess=ask client to show you affected UE, shake hands with affected UE and ask client whose it is, ask client to tap affected LE with unaffected hand; impairment=inability to recognize/id affected limb | anosognosia |
| cannot decipher between stimuli on affected and unaffected extremities | simultaneous stimulation |
| body schema perceptual disorder: assess=touch involved hand and ask where they're being touched, touch uninvolved hand and ask where they're being touched, simult. touch both hands and ask where they're being touched | simultaneous stimulation |
| body schema perceptual disorder: impairment=can id stimulation on involved side alone but can't id stimulation on involved side when touched on both sides | simultaneous stimulation |
| language perceptual disorder: assess=ask client simple questions like their name, birthday, or age; impairment=inability to understand questions and answers will not make sense but will be fluent | Wernicke's aphasia |
| language perceptual disorder: assess=ask client to read a simple paragraph; impairment=inability to read after ruling out possible visual problems, visual-perceptual disorders, or illiteracy | alexia |
| language perceptual disorder: assess=ask client to read a simple paragraph; impairment=difficulty reading paragraph because client reverses letter or mixes up sequence of letters | dyslexia |
| language perceptual disorder: assess=demonstrate 5 simple gestures and have client tell you what they mean (ex. wave hello/goodbye); provide 3 verbal, written, or pictoral answer choices if client has word-finding difficulties | asymbolia |
| language perceptual disorder: impairment=unable to understand 3/5 gestures | asymbolia |
| language perceptual disorder: assess; state a neutral sentence but change inflection and ask client to id emotion or provide 3 verbal, written, or pictoral answer choices if client has word-finding difficulties | aprosodia |
| language perceptual disorder: impairment=unable to id appropriate emotional tonal inflections in 2/3 sentences | aprosodia |
| language perceptual disorder: assess=ask client simple questions such as name, birthday, age; impairment=inability to answer questions with clear, fluent speech that makes sense | Broca's aphasia |
| language perceptual disorder: assess=present client with 5 familiar objects or famous/familiar people and ask them to id; impairment=inability to name 3/5 objects or people | anomia |
| language perceptual disorder: assess=ask client to write or repeat sentences; impairment=client mixes up sequence of words in these sentences | agrammatism |
| inability to arrange words sequentially to form intelligible sentences in convo or writing | agrammatism |
| language perceptual disorder (2 disorders): assess=ask client to write name, address, and phone number; impairment=attempt to write but only scribble-(a-), reverse, mix up, or flip letters-(dys-) | agraphia and dysgraphia |
| language perceptual disorder: assess=ask client to calculate simple addition and subtraction problems; impairment=inability to perform math problems | acalculia |
| language perceptual disorder: assess=ask client to calculate simple addition and subtraction problems; impairment=difficulty performing math problems | dyscalculia |
| motor perceptual disorder (2 disorders): assess=observe client during daily routine or observe client carrying out motor sequences with verbal commands (ex. blow a kiss); impairment=difficulty implementing appropriate motor plan for 3/4 motor tasks | ideational apraxia and ideomotor apraxia |
| motor perceptual disorder: assess=observe ct. during ADLs or place 4 dressing objects in front of ct. and say "show me how to use these"; impairment=difficulty dressing, inappropriately uses clothing, or inability to use appropriate motor plan for 3/4 | dressing apraxia |
| motor perceptual disorder: assess=instruct client to build a house with Legos based on 3D object, have client duplicate a series of washers and nuts on a large bolt, instruct client to construct a 3D block design based on 2D picture | two - and three - dimensional constructional apraxia |
| motor perceptual disorder: impairment=unable to accurately construct a duplicate model | two - and three - dimensional constructional apraxia |
| low level vision aspect: present client with high-contrast item and hold 16 inches from face, test 1 eye at a time and move card quickly to L and R; result=nystagmus should be present by indicating client can perceive stimuli and has basic sight | visual acuity / optokinetic response |
| low level vision aspect: assess=observe for symmetrical and normal pupil size; impairment=greater or smaller than 3 mm or asymmetrical | pupillary size |
| low level vision aspect: assess=observe for strabismus; impairment=strabismus present | ocular alignment |
| low level vision aspect: assess=hold an object 16 inches from nose and determine if client can focus/maintain focus on object; impairment=inability to focus | object fixation |
| low level vision aspect: assess=observe ability to follow or present client with high-contrast object, allow for fixation, then move through "X" and "H" patterns; impairment=inability to smoothly track objects in all visual fields | visual pursuit / tracking |
| high level vision aspect: near=Warren Text Card or reading a newspaper, far=Snellen Eye Chart or reading signs and room numbers; impairment=less than 20/40 vision, reports of fuzzy or blurry print, or difficulties bringing things into focus | functional acuity |
| high level vision aspect: assess="X" and "H" patterns; impairment=inability of eye to complete full ROM in each direction | extraocular ROM |
| high level vision aspect: assess=same manner as CN testing; impairment=complains of double image/shadowing, overshoots when reaching, closes 1 eye or alters head position during functional tasks, or has nystagmus | diplopia |
| high level vision aspect: assess=hold 2 differently colored targets in front of client, ask client to hold head still and move eyes from 1 target to the other, when fixated on 1 move the other, assess all quadrants | saccades |
| high level vision aspect: impairment=demonstrates under/overshooting between targets, shifts into all fields of gaze, nystagmus, or inability to isolate head and eye movement | saccades |
| high level vision aspect: assess=present bright targets and move toward nose while ct. fixates and note distance ct. no longer focuses on it; impairment=eye don't converge equally, constriction is delayed, or unable to maintain acuity 4-5 in. from nose | accommodation |
| high level vision aspect: assess=functional observation (ex. reading a menu, getting dressed); impairment=demonstrates an abbreviated and disorganized scanning pattern, drifts when writing, collides with obstacles, hesitates to cross midline | visual attention |
| high level vision aspect: assess=ask ct. to fill clear glass w/ water, sort pile of white laundry, dist. similar dark material, observe negotiating steps/curbs; impairment=difficulty with any of assessment tasks or difficulty distinguishing similar colors | contrast sensitivity |
| low level cognitive aspect: assess=often assessed with consciousness, observe; impairment=decreased/impaired levels | alertness / arousal |
| low level cognitive aspect: assess=ask name, place of living, location, and why or time, date, season; impairment=disorientation, unable to answer 3 or more of questions | orientation |
| low level cognitive aspect: assess=ask client to name friends, family, or familiar individuals and ask for relationship to individuals and what they are known for; impairment=decreased/impaired, unable to name family or more than 1/2 of famous photos | recognition |
| low level cognitive aspect: assess=note it client is consistently able to attend to screenings or becomes distracted by extraneous noise; impairment=decreased/impaired attention, consistently becomes distracted and requires redirection | attention / concentration |
| low level cognitive aspect: assess=complete functional activities (ex. give sandwich materials and ask what to do); impairment=difficulty with or lack of initiation, unable to complete task at hand without further cuing | initiation of activity |
| low level cognitive aspect: assess=observe client to complete task and if they can carry out activity without cuing to stop; impairment=unable to stop activity without verbal cues, continue to perform gross/fine movements | termination of activity |
| low level cognitive aspect: assess=ask client at least 4 questions about remote memories (ex. birth year, names of siblings); impairment=cannot answer more then 2 of 4 questions | long - term memory |
| low level cog. aspect: assess=ask ct. about events of last 24 hrs. (ex. what they had for breakfast) or to remember 3 items, engage in activity, and to recall 3-5 mins. later; impairment=inability to answer more than 1/2 of questions or recall 1 or no ite | short - term memory |
| low level cognitive aspect: assess=ask 4 questions (ex. current president, weeks in a year); impairment=unable to answer more than 2 of 4 questions | fund of knowledge |
| assesses semantic memory or recall of facts | fund of knowledge |
| low level cognitive aspect: assess=ask client to complete 2 tasks (ex. months in order, steps of laundry); impairment=incorrectly does more than 2 steps of each task | sequencing |
| low level cognitive aspect: assess=ask client to name as many items as possible in a category (ex. farm animals); impairment=inability to generate more than 3-5 items in each category | categorization |
| low level cognitive aspect: assess=ask client to complete 2-3 step task (ex. write name, address, phone number); impairment=unable to correctly carry out 2 or more directions/commands in task | command - following |
| low level cognitive aspect: assess=observe for safety concerns, describe 3 emergency situations and ask client what they would do; impairment=demonstrates unsafe behaviors during your observation or is unable to offer appropriate solutions for emergencies | safety / judgement |
| low level cognitive aspect: assess=note whether client demonstrates disinhibition (ex. inappropriate sexual comments, impulsivity); impairment=demonstrates impulsivity, aggression, irritability, agitation, sexual inhibition, disinhibition | self - control |
| high level cognitive aspect: should be aware of environment | alertness / arousal |
| high level cognitive aspect: assess=ask name, place of living, location and why, time of day/date; impairment=disorientation, unable to answer more than 1/2 of questions | orientation |
| high level cognitive aspect: assess=ask to name friends, family, famous individuals, or staff members; impairment=decreased/impaired recognition, unable to recognize close family, friends, staff of more than 1/2 of famous photos | recognition |
| high level cognitive aspect: assess=observe ability to attend to a task without becoming distracted (ex. writing a check) impairment=decreased/impaired attention, consistently becomes distracted and requires verbal cues to attend to task | attention / concentration |
| high level cognitive aspect: assess=ask to perform functional tasks (ex. toasting toast), assess if they switch back and forth between 2 tasks selectively attending to each; impairment=becomes confused while performing task, forgets to return to 1st task | mental flexibility |
| component of selective attention, ability to switch back and forth between 2 or more separate tasks | mental flexibility |
| high level cognitive aspect: assess=complete functional activities; impairment=does not initiate or initiates and then drifts into inactive states and fails to fully complete task | initiation of activity |
| high level cognitive aspect: assess=observe client complete task and if they can carry out activity without cuing to stop; impairment=unable to stop activity without verbal cues, perseveration | termination of activity |
| high level cognitive aspect: assess=ask client at least 3 questions about remote memories (ex. birth year, name of siblings); impairment=cannot answer more than 1/2 of questions | long - term memory |
| high level cognitive aspect: assess=ask client about events of last 24 hours, ask client to remember 3 items, engage in activity, and ask to recall 3-5 minutes later; impairment=cannot answer more than 1/2 of questions or can only recall 1 or no items | short - term memory |
| high level cognitive aspect: assess=ask client about new info learned since injury occurred (ex. names of staff), teach client new game or compensatory technique; impairment=unable to answer more than 1/2 of questions or has difficulty with new activity | new learning |
| high level cognitive aspect: assess=observe if client can transfer previously learned skill to new skill/environment; impairment=unable to generalize existing knowledge in new situations after significant repetition | generalization of learning |
| high level cognitive aspect: assess=ask 3 questions (ex. first president, city in NE); impairment=unable to answer more than 1/2 of questions | fund of knowledge |
| high level cognitive aspect: assess=ask client to complete 2 tasks with steps (ex. months in order, steps of laundry); impairment=demonstrates more than 3 errors in steps of task | sequencing |
| high level cognitive aspect: assess=ask ct. to name as many items as possible in a particular category (ex. types of transport) or ask ct. to sort items into piles; impairment=inability to integrate more than 3-5 items in category, 2-3 errors in each task | categorization |
| high level cognitive aspect: assess=ask client to perform functional task (ex. cold meal prep); impairment=unable to follow directions without making 2-3 errors in 1 task | direction - following |
| high level cognitive aspect: assess=ask client to describe strengths and weaknesses and note their awareness of deficits; impairment=lack of awareness of deficits | insight |
| high level cognitive aspect: assess=observe for safety concerns, describe 3 emergency situations and ask client what they would do; impairment=demonstrates unsafe behaviors during observation or is unable to offer appropriate solutions for emergencies | safety / judgement |
| high level cognitive aspect: assess=ask client to plan a task (ex. weekly grocery list); impairment=difficulty planning a basic task of 2-3 steps | planning |
| high level cognitive aspect: assess=ask client to solve functional scenario (ex. got on the wrong bus...what do you do?); impairment=inability to offer appropriate resolution | problem - solving |
| high level cognitive aspect: assess=note whether client demonstrates disinhibition (ex. inappropriate sexual comments, impulsivity); impairment=demonstrates impulsivity, aggression, irritability, agitation, sexual inhibition, disinhibition | self - control |
Created by:
emma.scarmon-coyotes
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