Confusion physical examination: Difference between revisions
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===General Examination=== | ===General Examination=== | ||
A comprehensive examination may be tough due to an [[altered mental status]] of the patient. | A comprehensive examination may be tough due to an [[altered mental status]] of the patient. | ||
* Alertness | |||
* General behavior | |||
* Language or speech defects | |||
* Level of arousal | |||
* Presence of [[agitation]], restlessness, [[hyperactivity]], [[anxiety]] | |||
===Vital Signs=== | ===Vital Signs=== | ||
* Temperature : increase in temperature is significant for some infective foci. | * Temperature: An increase in temperature is significant for some infective foci. | ||
* Blood pressure : | * Blood pressure: If the blood pressure is decreased, it can be indicative of [[shock]] and [[hypoperfusion]]. | ||
* Pulse : | * Pulse: If the pulse is increased, it may be correlated to a raise in temperature. | ||
* Respiratory rate : | * Respiratory rate: There may be [[hyperventilation]] in a few conditions due to [[anxiety]], but in severe cases leading to a [[coma]], the respiratory rate may be compromised. | ||
===Neurologic=== | ===Neurologic=== | ||
* Cranial nerve examination : | * Cranial nerve examination : This is limited by uncooperative patients. Funduscopic examination helps in checking for [[papilledema]] or [[hemorrhage]]s. Checking for a [[gag reflex]] to ensure safe oral feeds and medications. | ||
* Motor examination : underlying brain disease | * Motor examination : This can help in diagnosing an underlying brain disease. | ||
* Gait evaluation : check for cerebellar lesion | * Gait evaluation : This can be used to check for a cerebellar lesion. | ||
===Other=== | ===Other=== | ||
* Skull fracture - | * [[Skull fracture]] - [[Trauma]] | ||
* Neck stiffness - | * Neck stiffness - [[Meningitis]] | ||
* Lip erosions - | * Lip erosions - Ingestion of [[poison]]s | ||
* Indwelling catheters - | * Indwelling catheters - [[Sepsis]] | ||
* Tongue bites - | * Tongue bites - [[Seizure]]s | ||
* Neck swelling - | * Neck swelling - Thyroid disease | ||
* Signs of liver failure | * Signs of [[liver failure]] | ||
* Excessive sweating - | * Excessive sweating - [[Dehydration]], [[hypoglycemia]] | ||
==References== | ==References== | ||
| Line 41: | Line 42: | ||
{{WS}} | {{WS}} | ||
[[Category:Neurology]] | [[Category:Neurology]] | ||
[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
[[Category:Psychiatry]] | [[Category:Psychiatry]] | ||
[[Category:Endocrinology]] | [[Category:Endocrinology]] | ||
[[Category:Intensive care medicine]] | [[Category:Intensive care medicine]] | ||
Latest revision as of 19:55, 2 June 2015
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Confusion Microchapters |
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Confusion physical examination On the Web |
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American Roentgen Ray Society Images of Confusion physical examination |
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Risk calculators and risk factors for Confusion physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2]
Overview
In cases of confusion, a physical examination helps in localizing the lesion if the cause is from the brain. It also gives clues to the underlying cause of the disease. A complete neurological examination may not be done due to a limitation of the patient's condition.
Physical Examination
General Examination
A comprehensive examination may be tough due to an altered mental status of the patient.
- Alertness
- General behavior
- Language or speech defects
- Level of arousal
- Presence of agitation, restlessness, hyperactivity, anxiety
Vital Signs
- Temperature: An increase in temperature is significant for some infective foci.
- Blood pressure: If the blood pressure is decreased, it can be indicative of shock and hypoperfusion.
- Pulse: If the pulse is increased, it may be correlated to a raise in temperature.
- Respiratory rate: There may be hyperventilation in a few conditions due to anxiety, but in severe cases leading to a coma, the respiratory rate may be compromised.
Neurologic
- Cranial nerve examination : This is limited by uncooperative patients. Funduscopic examination helps in checking for papilledema or hemorrhages. Checking for a gag reflex to ensure safe oral feeds and medications.
- Motor examination : This can help in diagnosing an underlying brain disease.
- Gait evaluation : This can be used to check for a cerebellar lesion.
Other
- Skull fracture - Trauma
- Neck stiffness - Meningitis
- Lip erosions - Ingestion of poisons
- Indwelling catheters - Sepsis
- Tongue bites - Seizures
- Neck swelling - Thyroid disease
- Signs of liver failure
- Excessive sweating - Dehydration, hypoglycemia