Confusion physical examination: Difference between revisions
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===Vital Signs=== | ===Vital Signs=== | ||
* 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 it can be indicative of [[shock]] and [[hypoperfusion]]. | ||
* Pulse : if | * Pulse : if it is increased, it may be correlated to a 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. | * Respiratory rate : there may be hyperventilation in few conditions due to [[anxiety]], but in severe cases leading to [[coma]], the respiratory rate may be compromised. | ||
===Neurologic=== | ===Neurologic=== | ||
Revision as of 15:29, 8 February 2013
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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 : increase in temperature is significant for some infective foci.
- Blood pressure : if decreased it can be indicative of shock and hypoperfusion.
- Pulse : if it is increased, it may be correlated to a raise in temperature.
- Respiratory rate : there may be hyperventilation in few conditions due to anxiety, but in severe cases leading to 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 gag reflex to ensure safe oral feeds and medications.
- Motor examination : underlying brain disease
- Gait evaluation : check for 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