Confusion physical examination: Difference between revisions
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__NOTOC__ | |||
{{Confusion}} | {{Confusion}} | ||
{{CMG}} | {{CMG}} ; {{AE}} {{ADI}} | ||
==Overview== | ==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 | ==Physical Examination== | ||
===General Examination=== | |||
A comprehensive examination may be tough due to an [[altered mental status]] of the patient. | |||
* General | * 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 [[hemorrhage]]s. 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 [[poison]]s | |||
* Indwelling catheters - [[Sepsis]] | |||
* Tongue bites - [[Seizure]]s | |||
* Neck swelling - Thyroid disease | |||
* Signs of [[liver failure]] | |||
* Excessive sweating - [[Dehydration]], [[hypoglycemia]] | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
[[Category:Neurology]] | |||
[[Category:Emergency medicine]] | |||
[[Category:Psychiatry]] | |||
[[Category:Endocrinology]] | |||
[[Category:Intensive care medicine]] | |||
Latest revision as of 19:55, 2 June 2015
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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