HIGHER MENTAL FUNCTION
Examination of the higher mental function constitutes an integral part of the clinical evaluation of cortical function. However, a detailed assessment is time consuming and not routine performed. For all practical purposes, one needs to have a simple instrument for screening cognitive dysfunction. It is extremely unlikely that higher mental function assessment is assessed in the MRCPCH exam. In the section below, we have given modified mental assessment questions, which is suitable for children above four years and concentrates on five areas of cognitive functions i.e., orientation, attention-concentration, registration, recall and language. (Acronym – ROARS)
o Registration
• Can you identify three objects by name?
o Orientation (person, place and time)
• What is your name?
• Are you a boy or a girl?
• Where do you live?
• Where are you at present?
• How old are you?
• What time is it?
o Attention-concentration
• Can you count from 1, 2, 3…?
• Can count backwards from 20 to 1?
o Recall (Immediate)
• Show them three common objects and ask them to recollect them
o Speech (Language)
• Look at fluency and articulation of normal speech
• Name parts of the Body
• Simple command “take the toy from my hand and put it on the table”
• Repeat simple sentence (with a verb and a noun)
• Reading – “can you reads your name”
• Writing – “Write down your name”
• Copy a simple design
MOTOR EXAMINATION OF THE UPPER LIMB
• Inspection
o Posture - Note the resting posture. Look for abnormal flexion, unusual rotation or clawing of the hand. Always compare with the other side for symmetry. In a child with hemiplegia, the upper limb is flexed at shoulder and elbow with adduction and pronation of the a...
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...defects or sensory impairment). In order to assess the functional capacity of upper extremity and performance, the following tests can be done
o Give an object and see how he receives it
o Ask to write in paper or draw a figure
o Ask about ‘combing the hair’
• Back Examination
o Motor examination of the upper limb is only complete after performing the examination of the upper back.
o Inspection – Look for muscle wasting, winging of scapula and surgical scars.
o Power (in addition to muscles of the shoulder girdle – refer above)
Serratus anterior (C5, C6, C7): ‘Stand in front of the wall and push it with your hands’. Look at the back for winging of the lower scapula.
Infraspinatus (C5, C6): ‘with the arms at the sides, bend both elbows to 90º, and rotate the arms outwards (externally rotate)’, while you provide the resistance against external rotation.
In 13 patients a significant difference between verbal and performance IQ was found. In 10 of them the performance IQ was higher than the verbal. The results of subtest analysis indicate that cognitive strengths are more visible than cognitive weaknesses.
When performing manual muscle testing for shoulder flexion and abduction, PTA’s typically place their hand at the wrist verses the mid-extremity because placing their hands at the wrist increases the length of the lever thus testing the muscles ability to resist externally applied force overtime and across the bone-joint lever arm system. Shorter lever arms will provide higher testing scores when compared to using longer lever arms, thus changing the point of force application affects the length of the lever arm and therefore the muscle torque.
Two types of assessment procedures that are currently being used are the Luria-Nebraska Neuropsychological Battery (LNNB), and the Halstead Russell Neuropsychological Evaluation System (HRNES-R). The LNNB is used to diagnose cognitive deficits, while the HRNES-R indicates both the presence and degree of impairment. Both procedures involve tasks that require the patient to complete a series of functions that test abilities and/or perceptions. Such tasks would include, but are not limited to, problem solving, memory, sensorimotor functioning, and psychological/emotional status.
“Keith Currier” an Occupational therapist at Fawcett Memorial stated that the main goal for in OT is improving hand strength. Patients with physical issue use Theraputty which is putty that hardens and is used to exercise the joints in the hand. Theraputty is used by certified hand therapist. “A Certified Hand Therapist (CHT) is an occupational therapist or physical therapist who has a minimum of five years of clinical experience. Including 4,000 hours or more in direct practice in hand therapy” (“Who is a Certified Hand Therapist?”). OT’s use different tests to identify a patient’s weakness and strengths which allows them to develop a care plan. A 9- hole peg test is an indication of fine motor coordination. It’s used to show the grip strength of how hard the muscles work. This helps Ot’s create home program exercises such as washing, showering and anything that’s included in their daily
McCarthy, R., Warrington, E. (1990), Cognitive Neuropsychology: A Clinical Introduction. San Diego: Academic Press Ltd.
These tests indicated problems with coordination and impulse control. These results were supported with PET scans that indicated subtle and non-symmetrical activity in the prefrontal areas. The results of the PET scan, though initially deemed normal, were later deemed significant enough to warrant the observed
Recently, I found myself drawn to Woody Allen’s essay, “Random Reflections of a Second-Rate Mind.” I liked the title; I can relate to random thoughts, but I hated the idea of relating to Allen himself. I dislike him on a personal level. I have trouble condoning the behavior of a grown man who refuses to ignore his animalistic urges and sleeps with his teenage step-child. But perhaps Allen had some clue as to what he was doing considering that the latest Hollywood tabloid reports that he and his step-daughter/wife have just had a child together, and are doing well. I won’t speculate, but I have put aside my issues with his personal life, and have found common ground. I too, have random thoughts, and often take the “free association” approach in my writing. But what really got me with Allen’s essay is that all the random thoughts he includes, were all inspired by one chance meeting with a Holocaust survivor in a trendy New York Restaurant. Allen’s analysis of this man began, and I was hooked: As I eavesdropped, I wondered: If an angel had come to see him [in the concentration camp], when he was scheming desperately not to be among those chosen for annihilation, and told him that one day he’d be sitting on Second Avenue in Manhattan in a trendy Italian restaurant amongst lovely young women in designer jeans, and he’d be wearing a fine suit and ordering lobster salad and baked salmon, would he have grabbed the angel around the throat and throttled him in a sudden fit of insanity? Talk about cognitive dissonance! (22). This little passage did two things to my mind. First, I recalled countless times when I could not have even tried to predict a positive outcome to a given situation, much less a fu...
Vasconcelos, O., Rodrigues, P., Barreiros, J. & Jacobsohn, L. (2009). Laterality, developmental coordination disorders and posture. In L. P. Rodrigues, L. Saraiva, J. Barreiros & O. Vasconcelos (Eds.) Estudos em desenvolvimento motor da criança II (pp.19-26). Escola Superior de Educação, Instituto Politécnico de Viana do Castelo.
Caramazza, A., & Coltheart, M. (2006). Cognitive Neuropsychology twenty years on. Cognitive Neuropsychology, Vol. 23, pp. 3-12.
Describe what evolutionary psychologists mean when they employ the term ‘theory of mind’. Use examples and research studies from Book 1, Chapter 2 to show why this theory is important in evolutionary psychology.
In this paper, the researchers are interested in expanding the understanding of executive function. This is the process that is used to guide goal oriented behavior. It includes the ability to prioritize behavior, to resist information that is irrelevant to the situation, and to switch between different goals. Like many other concepts in psychology, executive function has many different dimensions and there are many differing viewpoint about its basic structure. Because executive function involves an individual guiding their own behavior often in novel situations, it by nature is difficult to measure in a laboratory setting. The laboratory setting is structured which that may cause problems with proper testing measures especially when the participant is given rules or instructions.
Obvious signs include crooked spine while bending over, fatigue, shortness of breath, uneven hemline on shirts, and an asymmetrical waistline. Less obvious signs must be detected by health professionals through early screening, or diagnosed by your physician during a comprehensive physical exam.
Hemiparesis that affects the peroneal nerve preventing dorsiflexors muscles from lifting the toes up when walking causes the toes to drag, impairing gait. Hemiparesis can also affect the knee flexor and extensor muscles which are important for “shock absorption, assisting with foot clearance and balance control” (Sadeghi, H. et al., 2002, p. 51). Physical therapists know that poor gait can affect the pelvis, lower back, spine and neck as the body tries to compensate for unilateral weakness of the lower limbs. The sooner a patient can achieve normal gait the less likely they are to suffer permanent damage and the quicker they can return to their normal lives and activity levels.
tips of my fingers and my thumbs form a W shape), bending my knees as