mentPHYSICAL ASSESSMENT Last September 16, 2011 at exactly 9 o’clock in the morning, we conducted a physical assessment to Patient X who is 12 years old. He was admitted last September 15, 2011 at 12:30 am due to edema on the right ankle. He is under Dr. Uy. Patient X was admitted per wheelchair with watcher.
General Survey Patient X was lying on bed. He was awake and coherent and responsive to any kind of stimulus. He had an IVF of PNSS 1 liter at KVO rate infusing well at his left metacarpal vein. Elastic bandage was well attached at his right ankle. Vital Signs | 12:00 nn | Normal Range | Blood Pressure | 90/60 mmHg | 110/70- 130/90 mmHg | Cardiac Rate | 95 bpm | 70-80 bpm | Pulse Rate | 93 bpm | 70-80 bpm |
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He was able to guess the smell of soup and meal served. | II | Optic | He was able to read the readings from the students jot down notebook. | III | Oculomotor | In this test, we ask the patient to look straight and follow the direction of the finger were it was heading. Patient X was able to move his eyes in six ocular directions. | IV | Trochlear | In this test, we ask him to look straight and follow the direction of the finger were it was heading. Patient X was able to move his eyes in six ocular directions. | V | Trigeminal a. Opthalmic b. Maxillary c. Mandibular | When we lightly touched the lateral sclera of the eye, the patient blinked. As the he closed his eyes, we wiped a wisp of cotton over his forehead and paranasal sinuses and when asked, he was able to feel it. We used the blunt and sharp ends of a pin to test for deep sensation over the same area and the patient was still able to feel it, as verbalized. | VI |
|(with the patient or guardian, if necessary) to see if the | | | | | | | | | | |
This result shows that he bad with he’s coordination as he only reached the average result because this was he’s best result after trying this test 3 times.
Another visual condition that has intrigued the neurologist for over a century is a condition called visual neglect. After having a stroke in her parietal lobes in her brain, Peggy Palmer had normal vision, which should allow her to draw a copy an image without difficulty. When Peggy was asked to draw a copy of a daisy, they found that she only would draw the right half of the daisies image. She didn’t realize this until the it was told to her, then she could see that she in fact was missing the entire left half of the daisy. Dr. Ramachandran explains that as we see an object, the visual input will split into two different pathways. One is the “how?” and the other is the “what?”. The “how” deals with the area of the brain that mainly controls
I instructed Ellison to imagine a straight line from his toes about 20 feet out. Ellison advised he could see the line. I asked Ellison to place his left foot on that line and place his right foot in front of his left foot heel-to-toe. I demonstrated the instruction to Ellison. I advised Ellison to then take 9 heel-to-toe steps forward keeping the lead foot on the line, taking a series of small steps and then take 9 heel-to-toe steps back. I asked Ellison if he understood and he then began the test. Ellison couldn't maintain heel-to-toe steps taking 3 steps forward and 3 steps back. I instructed Ellison to perform the test taking 9 heel-to-toe steps forward and 9 heel-to-toe steps back that I performed and explained to him. Ellison failed to maintain heel-to-toe through out the steps 2,3,4,5,6,7,8,9. Ellison stepped off line on the 3rd step Ellison failed to take a series of smalls steps as instructed. Ellison failed to maintain heel-to- toe steps 1,2,3,4,5,6 and stopped at the 6th step turning around thinking the test was done. I advised Ellison to nine and he only counted to six. Ellison finished the test without maintaining heel-to-toe on step 7-8-9. Ellison stepped off line on the 9th step Ellison performed the incorrect number of steps and used his arms as balance throughout the test raising his arms more than 6
I have to agree the autobiographic an experimental lenses are the easiest lenses to reflect on the situation. However, I think the patient's eyes would be the most difficult. I believe it is really hard to put yourself in another's shoes. I am sure we all have experienced situations where we are completely sure the patient understood the instructions and shortly after you figure out they don't understand. I think nervousness, and anxiety play a large role in patients only interpreting some of what is
3. Repeat for a total of six times and squeeze eyes tightly closed for 10 seconds to finish.
I advised Monique I was going to place my finger 12" in front of her face and move in a circular motion. After I completed a few rotations, I was going to move my finger towards the bridge of her nose and that she needed to follow my finger at all times. Monique advised she understood this test. I then began by placing my finger approximately 12" in front of her face and rotating in a clockwise motion. As I moving my finger, Monique failed to follow my finger. Monique was advised a total of three (3) times on how to follow my finger but each time she failed to do so. I then terminated the test. The next test I administered was the Modified Romberg
Visual acuity is a measure of an observer’s ability to see fine spatial detail (Cavonius & Schumacher, 1966). There are a number of factors that affect visual acuity, such as illumination and contrast, and various ways to measure it (Kalloniatis & Luu, 2005). One way to measure visual acuity is through target detection which requires the perception of the orientation of a stimulus such as a Landolt C or a Snellen E (Kalloniatis & Luu, 2005). The participant in the current experiment was referred to have their acuity tested. Target detection of a stimulus was used to measure the participant’s visual acuity as a function of retinal eccentricity of the target.
For the first condition, the patient should identify the target, the second condition the subject should respond to 2 similar letters and for the third condition the subject should respond when two similar letter separate with a different letter. All the responses to the conditions should be recorded.
The dilemma is that the patient is experiencing some tingling and then he says that he could not feel his arms or hands. The doctor tells me to finish the exam even though I tell him the situation. Also, the patient’s friends are not cooperative. I worried that since the patient could not feel his arms or hands, it could change to critical.
“Rebalancing binocular vision in amblyopia” by Jian Ding and Dennis M Levi is an important article on how to help correct asymmetric vision in people. Ding and Levi do an extraordinary job of describing the technical science behind amblyopia and introduce a new and innovative technique of an old concept to improve the effectiveness. When humans look at something, they are seeing the image with each eye separately and then those images are sent through signals to the brain where the brain forms them into one cohesive picture that is then interpreted. Each eye sees a slightly different image than the other but then in turn each eye suppresses the other a certain amount in order to see the picture as one whole picture. This type of vision of seeing
Use a handheld card such as Rosenbaum Pocket Vision Screener. He could read card by left eye, but he could not read card accurately by right eye because he has severe pain and aching in his right eye.
Some researchers classify eye dominance as one of two types: motor dominance and sensory dominance. Motor dominance usually is identified through pointing and sighting tests and involves cases where a person has to choose between the two eyes. These include the triangle test described above, or the pointing test to determine which eye sees a distant target. Sensory dominance, on the other hand, involves a different process where both eyes are competing to process information. The tests that are used to judge sensory dominance include, for example, where an image associated with either the right or left eye is presented or the subject sees a combined perception of the two. Sometimes images are presented repeatedly to see which eye is
side to side" he does this to see what is before him on either side,
The monocular cue, Linear perspective, is the cue that shows a convergence of lines to a single point, which can also be the