Objective Assessment

Question 1

In what order should you conduct an objective assessment

Answer 1

1. general observations
2. alertness
3. cognition/ orientation
4. memory
5. vision
6. hearing
7. speech
8. sensation
9. range of movement
10. muscle tone & power
11. mobility
12. funcitonal Ax
13. balance

Question 2

how can you assess alertness of a patient

Answer 2

using GCS score or AVPU

Question 3

how can you assess cognition/orientation of a patient

Answer 3

use your initiative to see whether they are orientated to person, place, time and situation etc.

Question 4

how can you assess the memory of a petient

Answer 4

see if their memory is:
- Immediate
- Recent
- Remote
- Verbal
- Visual

Question 5

how can you assess the vision of a patient

Answer 5

• can patient track finger
• check periferal vision at eye level and from below with each eye
• has their sight changed since their latest epsiode etc.
• any diplopia?
• blurred?
• if any abnormalities refer on to specialist

Question 6

how can you assess the hearing of a patient

Answer 6

• do they have a hearing aid
• can they audibly hear your

Question 7

ho can you assess the speech of a patient

Answer 7

• see if they have dysphasia (receptive - wernicke’s area/ expressive - Broca’s area)
• dysarthria? form having weak muscles

Question 8

how can you assess sensation of a patient

Answer 8

• ability to detect touch using cotton whool ball for soft touch or a neurotip for blunt or sharp
• pain - using neurotips
• vibtration using the vibrating tongues and patient should be able to differentiate when the vibrations end
• temperature can be tested using two tubes, one with cold and one with hot water and see if patient can differentiate
• one and 2 point discrimination : paper clip, two point discriminator, or calipers and apply pressure at certain points
• proprioception: wiggle thumbs or toes ith patients eyes closed, ask them if it is up or down without looking. OR touch nose to your finger

Question 9

how can you assess patients range of moevement and power

Answer 9

• start by seeing if patient can demonstrate active range of movement?
• if so then they are automatically a 3 on oxford scale, but provie resistance through range and see if they can move against you
• if not then facilitate the limb to counteract gravity. do they have any signs of activty?

Question 10

what are the stages of the oxford scale

Answer 10

0 - no contraction
1 - visible/ palpable muscle contraction but no movement
2 - movemnt with gravity eliminated
3 - movement against gravity only
4 - movement against gravity with some resistance
5 - movement against gravity with full resistance

Question 11

how do you assess muscle tone

Answer 11

use the modified ashworth scale with passive range of movement with variable speed applied to the action

Question 12

stages of modifies ashworth scale

Answer 12

0 - no increase in muscle tone
1 - slight increase in muscle tone, with a catch and release or minimal resistance at the end of the range of motion when affected part is moved in flexion or extension
1+ - slight increase in muscle tone, manifested as a catch, followed by minimal rsistance through the remainder of the range of motion
2 - a marked increase in muscle tone throughout most of the range of motion, but affected parts are still easily moved
3 - considerable increase in tone, passive moevement difficult
4 - affected parts rigid in flexion or extension

Question 13

how can you assess a patients movement and function in lying to sitting

Answer 13

• ability ro process the task
• ability to perform the task independently
• movement analysis

Question 14

how can you assess a patients moveemnt and function in sitting balance

Answer 14

• static posture
• posture/ alignment
• dynamic balance
• movement outside base of support
• consideration of seating

Question 15

how can you assess a patients moveemnt and function in sit to stand

Answer 15

• ability to process the task
• ability to perform the task independently
• movement analysis
• consideration of equipment

Question 16

how can you assess a patients moveemnt and function in standing balance

Answer 16

• static balance
• posture/ alignment
• dynamic balance
• mmovement outside base of support
• consideration of equipment

Question 17

how can you assess a patients moveemnt and function in gait

Answer 17

• abiltiy to process the task
• ability to perform the task independently
• movement analysis
• consideration of equipment