Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier...
-
Upload
beverly-cooper -
Category
Documents
-
view
218 -
download
1
Transcript of Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier...
![Page 1: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/1.jpg)
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Chapter 3: Cultural Competence: Cultural Care
Slide 3-1
The Neurologic System
J Carley MSN, MA, RN, CNEFall, 2009
The Spinning Woman Illusion --Nobuyuki Kayahara
JARVIS , C. (2008) Physical Examination & Health AssessmentChapter 23
![Page 2: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/2.jpg)
Unit Objectives
Slide 23-2
•1. Describe the anatomic structures of the central nervous system and brain.•2. Identify the 12 cranial nerves and their function•3. Complete the Glasgow Coma scale, the Rancho Los Amigos scale, and the mini mental state exam as appropriate for case studies.4. Explain how to prepare the client for a neurological examination5. Discuss the appropriate equipment necessary for examining the neurological system.
![Page 3: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/3.jpg)
Slide 23-3
![Page 4: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/4.jpg)
Slide 23-4
![Page 5: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/5.jpg)
Peripheral nerves go from spinal cord
to arms, hands, legs, and feet
Slide 23-5
![Page 6: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/6.jpg)
Autonomic nerves go to the stomach, intestines, and other parts of the digestive system
Slide 23-6
![Page 7: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/7.jpg)
Cranial nerves go from brain to eyes, mouth, ears, and other parts of head (and others…e.g., Vagus)
Slide 23-7
![Page 8: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/8.jpg)
Slide 23-8
![Page 9: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/9.jpg)
Slide 23-9
![Page 10: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/10.jpg)
Central Nervous System (CNS)
Cerebral cortex- Frontal lobe- Parietal lobe- Occipital lobe- Wernicke’s area- Broca’s area
Basal ganglia Thalamus
Hypothalamus Cerebellum Brainstem
- Midbrain- Pons- Medulla
Spinal cord
Slide 23-10
![Page 11: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/11.jpg)
Cerebral CortexSlide
23-11
![Page 12: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/12.jpg)
Slide 23-12
![Page 13: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/13.jpg)
Slide 23-13
![Page 14: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/14.jpg)
CNS
[PRODUCTION NOTE: Please insert Figure 23-2 (from Jarvis Physical Examination and Health Assessment, 5e, ISBN: 978-1-4160-3243-4)]
© Pat Thomas, 2006.
Slide 23-14
![Page 15: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/15.jpg)
CranialNerves
I Olfactory
II Optic
III Oculomotor
IV Trochlear,
VI Abducens
V Trigeminal
VII Facial
VIII Acoustic (vestibulocochlear)
IX Glossopharyngeal
X Vagus
XI Spinal accessory
XII HypoglossalSlide
23-15
![Page 16: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/16.jpg)
Olfactory I Optic II Oculomotor III Trochlear IV Trigeminal V Abducens VI Facial VII Auditory (vestibulocochlear) VIII Glossopharyngeal IX Vagus X Spinal Accessory XI Hypoglossal XII
Cranial Nerves - IntroductionInteractive quiz to identify the cranial nerve function.
Slide 23-16
![Page 17: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/17.jpg)
CNS Pathways Sensory pathways
- Spinothalamic tract - Posterior (dorsal) column
Motor pathways - Corticospinal or pyramidal
tract - Extrapyramidal tracts - Cerebellar system
Upper motor neurons
Lower motor neuronsSlide
23-17
![Page 18: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/18.jpg)
Sensory Pathways © Pat Thomas, 2006. Slide 23-18
![Page 19: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/19.jpg)
Motor Pathways
© Pat Thomas, 2006. Slide 23-19
![Page 20: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/20.jpg)
Reflex Arc
Slide 23-20
![Page 21: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/21.jpg)
Subjective Data
Headache Head injury Dizziness or Vertigo Seizures Tremors Weakness
Slide 23-21
![Page 22: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/22.jpg)
Subjective Data
In-coordination / “uncoordinated” Numbness or tingling Difficulty swallowing Difficulty speaking (Dysphasia)
Environmental/occupational hazards
Slide 23-22
![Page 23: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/23.jpg)
Objective Data
Equipment needed - Penlight
- Tongue blade
- Toothpick
- Cotton swab / Cotton ball
- Tuning fork (128 or 256 Hz)
- Percussion hammer
- Familiar aromatic substance
Slide 23-23
![Page 24: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/24.jpg)
Motor System
Muscles - Size - Strength - Tone - Involuntary movements
Cerebellar function
- Balance tests - Coordination
- Skilled movements
Slide 23-24
![Page 25: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/25.jpg)
Romberg Test
Negative- ve
Normal
Positive+ ve
Abnormal Proprioceptive pathway Slide 23-25
![Page 26: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/26.jpg)
Ambulation
Slide 23-26
![Page 27: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/27.jpg)
Describe…
Slide 23-27
![Page 28: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/28.jpg)
Abnormal Ambulation
Asymmetrical Spastic DiplegiaSlide
23-28
![Page 29: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/29.jpg)
Neuro Check (Crani Check)
Level Of Consciousness (LOC)PersonPlaceTime
Motor function Pupillary response Vital signs Glasgow Coma Scale (GCS)
Oriented x 3
Slide 23-29
![Page 30: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/30.jpg)
IntraCranial Pressure = ICP
Slide 23-30
Pressure within the cranial cavity influenced by brain mass, the circulatory system, CSF dynamics, and skull rigidity
![Page 31: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/31.jpg)
Increased ICP (IICP)
Critical event / Life threatening
Slide 23-31
![Page 32: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/32.jpg)
Slide 23-32
CT scan showing intracranial hemorrhage with cerebral edema, midline shift, and
increased intracranial pressure
![Page 33: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/33.jpg)
Glasgow Coma Scale
Slide 23-33
![Page 34: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/34.jpg)
34
The GCS is the most widely used method of defining a patient's level of consciousness (LOC)
![Page 35: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/35.jpg)
35
![Page 36: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/36.jpg)
36
Expanded Neuro
Assessment Tool
![Page 37: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/37.jpg)
Mini-Mental Status ExamRancho Los Amigos Scale
Slide 23-37
![Page 38: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/38.jpg)
EARLY Signs of ↑ ICP
38
1. LOC changes ******MOST IMPORTANT****
2. Pupils sluggish / Impaired eye movement
3. Limb strength changes
4. Headache
The most important neurologic “vital sign”!!!!!!!!!!!!!!!!!!!!!!!!!
![Page 39: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/39.jpg)
LATE Signs of ICP
39
1. Further decreased LOC
2. Cushing’s Triad
3. Abnormal respiration patterns
4. Pupils asymmetrical / Dilated
5. Projectile vomiting
6. Hemiplegia / decorticate or decerebrate posturing
anisicoria
“fixed & dilated
“Call the neurosurgeon”
“Call the chaplain.”
Pupils . .
![Page 40: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/40.jpg)
Cushing’s “Triad”
Blood Pressure (Widening Pulse Pressure)
Temperature
Pulse
40
Late Sign of IICP
![Page 41: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/41.jpg)
Abnormal Postures
Flaccid quadriplegia Decorticate rigidity Decerebrate rigidity
Slide 23-41
![Page 42: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/42.jpg)
Slide 23-42
“Toward the Core”
![Page 43: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/43.jpg)
43
![Page 44: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/44.jpg)
Dilated ? Consenusal ? Shape ?
Pupil Responses
Slide 23-44
![Page 45: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/45.jpg)
Rapidly Alternating Movement (RAM) Evaluation
Slide 23-45
![Page 46: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/46.jpg)
Finger to Nose Test
Slide 23-46
![Page 47: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/47.jpg)
Heel to Shin Coordination Test
Slide 23-47
![Page 48: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/48.jpg)
Test Deep Tendon ReflexesTechniqueGradingBabinski’s signBiceps reflexTriceps reflexBrachioradialis reflexQuadriceps reflexAchilles reflex (“ankle jerk”)Abdominal reflexes
Slide 23-48
![Page 49: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/49.jpg)
Reflexes
Slide 23-49
![Page 50: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/50.jpg)
Babinski Reflex
A normal response, B Babinski reflex
Positive+ ve
Abnormal
Negative- ve
Normal
Slide 23-50
![Page 51: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/51.jpg)
Testing the DTR’s provides data about the INTACTNESS of the REFLEX ARC at specific levels in the spinal cord.
Slide 23-51
![Page 52: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/52.jpg)
Abnormalities in Muscle Movement
Paralysis Fasciculations Flaccidity Ataxia
Rest tremor Intention
tremor Paresthesia Coma
Slide 23-52
![Page 53: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/53.jpg)
Sensory System
Spinothalamic tract - Pain - Temperature - Light touch
Posterior column tract - Vibration - Position (kinesthesia) - Tactile discrimination
(stereognosis, graphesthesia)
Alert, cooperative, and comfortable
Slide 23-53
![Page 54: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/54.jpg)
Aged – “Less” is Normal
- Walk slower- More careful walking- Decreased tactile sensation- Lose ability to feel vibration
at ankles- Decreased ability to smell
Slide 23-54
![Page 55: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/55.jpg)
Cultural Considerations “Epilepsy”
Uganda: contagious, untreatable
Greece: source of family shame
Mexican-American: evidence of physical imbalance
Hutterites: having endured a trial by God
Slide 23-55
![Page 56: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/56.jpg)
Narrative Charting
Slide 23-56
Denies any of the following: frequent or severe headaches; history of head injury, dizziness, or vertigo. Denies weakness, numbness, or tingling; no difficulty swallowing or speaking. No past history of stroke, meningitis, spinal cord injury, or alcoholism.
![Page 57: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/57.jpg)
Slide 23-57
Narrative Charting
![Page 58: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/58.jpg)
Slide 23-58
![Page 59: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/59.jpg)
Slide 23-59
Jarvis Page 679
![Page 60: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/60.jpg)
Neuro Assessments
Neuro Assessment Practice:http://icarus.med.utoronto.ca/NeuroExam/
Slide 23-60
![Page 61: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/61.jpg)
Which area of the brain is most likely affected if the patient is having trouble with the finger-to-nose test?
A. CerebellumB. CerebrumC. HypothalmusD. Brain stem
Slide 23-61
![Page 62: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/62.jpg)
Vibratory sense is most frequently affected in cases of?
A. Heart diseaseB. Crohns’ diseaseC. Lung CancerD. Diabetes
Slide 23-62
![Page 63: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/63.jpg)
Brain Teasers
Slide 23-63
http://brainconnection.positscience.com/teasers/
![Page 64: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/64.jpg)
The Hermann Grid IllusionThis phenomena demonstrates a very important principle of perception: we don't always see what's really there. Our perceptions depend upon how our visual system responds to environmental stimuli and how our brain then interprets this information.1 Slide
23-64
1 Bach, M. (n.d.). Grid illusions. http://www.michaelbach.de/ot/lum_herGrid/index.html
![Page 65: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/65.jpg)
The Zollner IllusionThis illusion presents a series of oblique lines crossed with overlapping short lines. The oblique lines look as if they are crooked and will diverge. In reality, all of the oblique lines are parallel.This optical illusion demonstrates how the background of an image can distort the appearance of straight lines. Slide
23-65
![Page 66: Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 3: Cultural Competence: Cultural Care.](https://reader035.fdocuments.us/reader035/viewer/2022062407/56649d1f5503460f949f3aa8/html5/thumbnails/66.jpg)
Slide 23-66
The End