Astrocytoma physical examination: Difference between revisions
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The patients with astrocytoma usually appear alert and awake. The signs depend on the location of [[tumor]]. Physical examination of patients with astrocytoma is usually remarkable with signs of trunkal [[ataxia]], [[papilledema]], [[nystagmus]] and [[abducens nerve palsy]]. | The patients with astrocytoma usually appear alert and awake. The signs depend on the location of [[tumor]]. Physical examination of patients with astrocytoma is usually remarkable with signs of trunkal [[ataxia]], [[papilledema]], [[nystagmus]] and [[abducens nerve palsy]]. | ||
==Physical Examination== | ==Physical Examination== | ||
===Appearance of the Patient=== | |||
=== Appearance of the Patient === | |||
* Patients are usually well appearing and can have gait disturbances<ref name="pmid21721894">{{cite journal| author=Forbes JA, Mobley BC, O'Lynnger TM, Cooper CM, Ghiassi M, Hanif R et al.| title=Pediatric cerebellar pilomyxoid-spectrum astrocytomas. | journal=J Neurosurg Pediatr | year= 2011 | volume= 8 | issue= 1 | pages= 90-6 | pmid=21721894 | doi=10.3171/2011.4.PEDS1115 | pmc=PMC3779306 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21721894 }} </ref> | * Patients are usually well appearing and can have gait disturbances<ref name="pmid21721894">{{cite journal| author=Forbes JA, Mobley BC, O'Lynnger TM, Cooper CM, Ghiassi M, Hanif R et al.| title=Pediatric cerebellar pilomyxoid-spectrum astrocytomas. | journal=J Neurosurg Pediatr | year= 2011 | volume= 8 | issue= 1 | pages= 90-6 | pmid=21721894 | doi=10.3171/2011.4.PEDS1115 | pmc=PMC3779306 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21721894 }} </ref> | ||
=== | === Vital Signs === | ||
* High-grade / low-grade fever | |||
* [[Hypothermia]] / hyperthermia may be present | |||
*[[Bradycardia]] may be present | * [[Tachycardia]] with regular pulse or (ir)regularly irregular pulse | ||
* [[Bradycardia]] with regular pulse or (ir)regularly irregular pulse | |||
* Tachypnea / bradypnea | |||
* Kussmal respirations may be present in _____ (advanced disease state) | |||
* Weak/bounding pulse / pulsus alternans / paradoxical pulse / asymmetric pulse | |||
* High/low blood pressure with normal pulse pressure / [[wide pulse pressure]] / [[narrow pulse pressure]] | |||
=== | === Skin === | ||
*[[ | * Skin examination of patients with [disease name] is usually normal. | ||
OR | |||
* [[Cyanosis]] | |||
* [[Jaundice]] | |||
* [[Pallor]] | |||
* Bruises | |||
* UploadedImage-01.jpg Description (Adapted from Dermatology Atlas) | |||
* | * Description (Adapted from Dermatology Atlas) | ||
=== | === HEENT === | ||
* | * Hearing acuity may be reduced | ||
* [[Nystagmus]] may be present | * [[Nystagmus]] may be present | ||
* Extra-ocular movements may be abnormal | * Extra-ocular movements may be abnormal | ||
| Line 28: | Line 38: | ||
* Ophthalmoscopic exam may be abnormal with findings of [[papilledema]] such as swollen disc, [[blurry vision]], venous engorgement | * Ophthalmoscopic exam may be abnormal with findings of [[papilledema]] such as swollen disc, [[blurry vision]], venous engorgement | ||
=== | === Neck === | ||
* | * Head tilt may be present | ||
=== Lungs === | |||
* Pulmonary examination of patients with astrocytoma is usually normal. | |||
=== Heart === | |||
* Cardiovascular examination of patients with astrocytoma is usually normal. | |||
=== Abdomen === | |||
* Abdominal examination of patients with astrocytoma is usually normal. | |||
=== Back === | |||
* Back examination of patients with astrocytoma is usually normal. | |||
=== Genitourinary === | |||
* Genitourinary examination of patients with astrocytoma is usually normal. | |||
=== | === Neuromuscular === | ||
* | * Patient is usually oriented to persons, place, and time | ||
* Altered mental status | |||
* Glasgow coma scale is 15 / 15 | |||
* Clonus may be present | |||
* Hyperreflexia may be present | |||
* Muscle rigidity | |||
* Proximal/distal muscle weakness unilaterally/bilaterally | |||
* Cranial nerve involvement may be present. | |||
* Unilateral/bilateral upper/lower extremity weakness | |||
* Unilateral/bilateral sensory loss in the upper/lower extremity | |||
* Abnormal gait may be present (trunkal ataxia) | |||
* Positive/negative Trendelenburg sign | |||
* Unilateral/bilateral tremor (describe tremor, e.g. at rest, pill-rolling) | |||
* Normal finger-to-nose test / Dysmetria | |||
* Absent/present dysdiadochokinesia (palm tapping test) | |||
=== | === Extremities === | ||
* | * Extremities examination of patients with astrocytoma is usually normal. | ||
==References== | ==References== | ||
Revision as of 20:53, 2 January 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [2]
Overview
The patients with astrocytoma usually appear alert and awake. The signs depend on the location of tumor. Physical examination of patients with astrocytoma is usually remarkable with signs of trunkal ataxia, papilledema, nystagmus and abducens nerve palsy.
Physical Examination
Appearance of the Patient
- Patients are usually well appearing and can have gait disturbances[1]
Vital Signs
- High-grade / low-grade fever
- Hypothermia / hyperthermia may be present
- Tachycardia with regular pulse or (ir)regularly irregular pulse
- Bradycardia with regular pulse or (ir)regularly irregular pulse
- Tachypnea / bradypnea
- Kussmal respirations may be present in _____ (advanced disease state)
- Weak/bounding pulse / pulsus alternans / paradoxical pulse / asymmetric pulse
- High/low blood pressure with normal pulse pressure / wide pulse pressure / narrow pulse pressure
Skin
- Skin examination of patients with [disease name] is usually normal.
OR
- UploadedImage-01.jpg Description (Adapted from Dermatology Atlas)
- Description (Adapted from Dermatology Atlas)
HEENT
- Hearing acuity may be reduced
- Nystagmus may be present
- Extra-ocular movements may be abnormal
- Pupils may not react to light
- Ophthalmoscopic exam may be abnormal with findings of papilledema such as swollen disc, blurry vision, venous engorgement
Neck
- Head tilt may be present
Lungs
- Pulmonary examination of patients with astrocytoma is usually normal.
Heart
- Cardiovascular examination of patients with astrocytoma is usually normal.
Abdomen
- Abdominal examination of patients with astrocytoma is usually normal.
Back
- Back examination of patients with astrocytoma is usually normal.
Genitourinary
- Genitourinary examination of patients with astrocytoma is usually normal.
Neuromuscular
- Patient is usually oriented to persons, place, and time
- Altered mental status
- Glasgow coma scale is 15 / 15
- Clonus may be present
- Hyperreflexia may be present
- Muscle rigidity
- Proximal/distal muscle weakness unilaterally/bilaterally
- Cranial nerve involvement may be present.
- Unilateral/bilateral upper/lower extremity weakness
- Unilateral/bilateral sensory loss in the upper/lower extremity
- Abnormal gait may be present (trunkal ataxia)
- Positive/negative Trendelenburg sign
- Unilateral/bilateral tremor (describe tremor, e.g. at rest, pill-rolling)
- Normal finger-to-nose test / Dysmetria
- Absent/present dysdiadochokinesia (palm tapping test)
Extremities
- Extremities examination of patients with astrocytoma is usually normal.
References
- ↑ Forbes JA, Mobley BC, O'Lynnger TM, Cooper CM, Ghiassi M, Hanif R; et al. (2011). "Pediatric cerebellar pilomyxoid-spectrum astrocytomas". J Neurosurg Pediatr. 8 (1): 90–6. doi:10.3171/2011.4.PEDS1115. PMC 3779306. PMID 21721894.