Confusion physical examination: Difference between revisions
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==Physical examination== | ==Physical examination== | ||
'''<u> | * '''<u>Vital signs</u>''' | ||
** Temperature : increase in temperature is significant for some infective foci. | ** Temperature : increase in temperature is significant for some infective foci. | ||
** Blood pressure : if decreased indicative of shock and hypoperfusion. | ** Blood pressure : if decreased indicative of shock and hypoperfusion. | ||
| Line 11: | Line 11: | ||
** Respiratory rate : there may be hyperventilation in few conditions due to anxiety, but in severe cases leading to coma respiratory rate may be compromised. | ** Respiratory rate : there may be hyperventilation in few conditions due to anxiety, but in severe cases leading to coma respiratory rate may be compromised. | ||
'''<u> | * '''<u>General examination</u>''' : A comprehensive examination may be tough due to altered mental status of the patient. | ||
** General behavior | ** General behavior | ||
** Level of arousal | ** Level of arousal | ||
| Line 17: | Line 17: | ||
** Language or speech defects | ** Language or speech defects | ||
** Presence of agitation, restlessness, hyperactivity, anxiety | ** Presence of agitation, restlessness, hyperactivity, anxiety | ||
'''<u> | |||
* '''<u>Focused examination of Nervous system</u>''' | |||
** Cranial nerve examination : this is limited by uncooperative patients. Funduscopic examination helps in checking for papilledema or hemorrhages. Checking for gag reflex to ensure safe oral feeds and medications. | ** Cranial nerve examination : this is limited by uncooperative patients. Funduscopic examination helps in checking for papilledema or hemorrhages. Checking for gag reflex to ensure safe oral feeds and medications. | ||
** Motor examination : underlying brain disease | ** Motor examination : underlying brain disease | ||
** Gait evaluation : check for cerebellar lesion | ** Gait evaluation : check for cerebellar lesion | ||
'''<u> | * '''<u>Other signs suggesting underlying causes</u>''' | ||
** Skull fracture - trauma | ** Skull fracture - trauma | ||
** Neck stiffness - meningitits | ** Neck stiffness - meningitits | ||
Revision as of 20:29, 17 July 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Physical examination
- Vital signs
- Temperature : increase in temperature is significant for some infective foci.
- Blood pressure : if decreased indicative of shock and hypoperfusion.
- Pulse : if its increase it has to be correlated to raise in temperature.
- Respiratory rate : there may be hyperventilation in few conditions due to anxiety, but in severe cases leading to coma respiratory rate may be compromised.
- General examination : A comprehensive examination may be tough due to altered mental status of the patient.
- General behavior
- Level of arousal
- Alertness
- Language or speech defects
- Presence of agitation, restlessness, hyperactivity, anxiety
- Focused examination of Nervous system
- Cranial nerve examination : this is limited by uncooperative patients. Funduscopic examination helps in checking for papilledema or hemorrhages. Checking for gag reflex to ensure safe oral feeds and medications.
- Motor examination : underlying brain disease
- Gait evaluation : check for cerebellar lesion
- Other signs suggesting underlying causes
- Skull fracture - trauma
- Neck stiffness - meningitits
- Lip erosions - ingestion of poisons
- Indwelling catheters - sepsis
- Tongue bites - seizures
- Neck swelling - thyroid disease
- Signs of liver failure
- Excessive sweating - dehydration, hypoglycemia