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What questions should be part of a general systems review?
- Fever
- Diaphoresis
- Night sweats
- Nausea
- Vomiting
- Diarrhea
- Pallor
- Fatigue
- Dizziness/Syncope
- Weight loss
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What is inc in mini mental state exam?
- orientation
- registration (repeating names of things)
- attention/calculation
- recall
- language
- construction (copying a figure)
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Wernecke's aphasia
receptive, fluent, can't understand language
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Broca aphasia
expressive, non-fluent, difficulty producing language
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Fasciculations
- irregular flickerings of muscle contraction (due to individual motor unit contractions)
- most common with anterior horn disorders
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Hypotonia
- flaccidity; reduced resistance to passive mvmt
- usually due to LMN injury, also can be from cerebellar disease, muscle disorders, sensory dysfunction, or acute neuro injury
- will happen immediately after s.c. injury
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Hypertonia
increased resistance to passive mvmt; either spasticity or rigidity
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Spasticity
- "Clasp knife response": sudden relaxation as mvmt continues
- can be assessed on Modified Ashworth scale
- assoc with UMN injury
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Rigidity
- inc resistance to passive mvmt regardless of direction (agonist and antagonist affected equally)
- Lead pipe rigidity: constant through movement
- Cog-wheel rigidity: pattern of inc and dec in resistance to movement (parkinsons)
- assoc with extrapyramidal dysfunction (basal ganglia)
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UMN
everything rostal to AHC
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LMN
AHC and out to muscle
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hemiparesis/paraparesis
UMN
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decreased or absent DTR, reduced tone
LMN
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fasciculations present
LMN
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inc DTR/ hypertonicity/spasticity
UMN
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Long term goals are ___ oriented
activity and participation
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Short term goals are ___ oriented
may be impairment oriented, but should be conected to long term functional goal
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