Hemineglect and mental status exam Flashcards Preview

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Flashcards in Hemineglect and mental status exam Deck (16)
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1
Q

Hemineglect

A

Impaired ability to orient toward one side
- PRESERVED motor and sensory functions
-

2
Q

How do you test for hemineglect

A
  1. Double simultaneous stimulation - visual or tactile
  2. Line bisection
  3. cancellation test
3
Q

If you have a LEFT parietal lesion - look for

A

DOMINANT hemisphere -

GERSTMANNS SYDROME

4
Q

Characteristic features of gerstmann’s

A
  1. acalculia
  2. agraphia without alexia
  3. Finger agnosia
  4. Impaired left/right discrimnation
    - ideational apraxia
5
Q

Other tests of cortical sensory fxn

A
  1. Graphesthesia
  2. 2-point discrimination
  3. Point localization
6
Q

Hemineglect OFTEN indicates a

A

RIGHT parietal lesion

- right parietal lobe attends to both hemispheres - dont see neglect with a left stroke

7
Q

If it’s not in the right parietal lobe

A
  1. Right prefrontal
  2. Right cingulate gyrus
  3. Right striatum, posterior internal capsule, and thalamus
8
Q

Causes of hemineglect

A

STROKE
STROKE
POST-ICTAL

9
Q

Which artery often affected in parietal lesion

A

MCA

10
Q

Neighbourhood signs of MCA infarct

A
  1. Anosagnosia

2. Field cut

11
Q

Attention can defy localization how

A
  1. monitor
  2. select
    NOT JUST FRONTAL LOBE - brainstem thalamic arousal system and cerebellum
12
Q

What is apraxia

A

inability to perform movements in response to a command - often skilled or learned movements

13
Q

ideomotor vs ideational

A

ideational is sequence problem

14
Q

How do you lose praxis?

A
  1. Disconnection/destructtion of DOMINANT HEMISPHERE association areas
  2. NOT hemiparesis, hemisensory deficits, cerebellar, or aphasias
15
Q

Differential diagnosis of Ideomotor apraxia

A
  1. 80-90% non fluent primary progressive/corticobasal syndrome
  2. 70-80% Alzheimer’s disease
  3. 70& PSP
  4. 28-57% STROKE
  5. 25% Parkisons
16
Q

Frontal lobe functions

A
  1. sustained attention’
  2. set shifting
  3. self-monitoring
  4. energization -