Serial sevens

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Serial sevens, counting down from one hundred by sevens, is a clinical test used to test mental function; for example, to help assess mental status after possible head injury or in suspected cases of dementia. This well-known test, in active documented use since at least 1944, [1] was adopted as part of the mini-mental state examination. The test is also used in determining when a patient is becoming unconscious under anaesthetic, for example prior to major dental surgery.

7 (seven) is the natural number following 6 and preceding 8.

Head injury a very serious trauma to the cranium

A head injury is any injury that results in trauma to the skull or brain. The terms traumatic brain injury and head injury are often used interchangeably in the medical literature. Because head injuries cover such a broad scope of injuries, there are many causes—including accidents, falls, physical assault, or traffic accidents—that can cause head injuries.

Dementia long-term brain disorders causing impaired memory, reasoning, and normal function together with personality changes

Dementia is a broad category of brain diseases that cause a long-term and often gradual decrease in the ability to think and remember that is great enough to affect a person's daily functioning. Other common symptoms include emotional problems, difficulties with language, and a decrease in motivation. A person's consciousness is usually not affected. A dementia diagnosis requires a change from a person's usual mental functioning and a greater decline than one would expect due to aging. These diseases also have a significant effect on a person's caregivers.

On its own, the inability to perform 'serial sevens' is not diagnostic of any particular disorder or impairment, but is generally used as a quick and easy test of concentration and memory in any number of situations where clinicians suspect that these cognitive functions might be affected. Each subtraction is considered as a unit and calculations are made on the basis of the 14 possible correct subtractions, that is 93-86-79-72-65-58-51-44-37-30-23-16-9-2. [2]

In chemistry, concentration is the abundance of a constituent divided by the total volume of a mixture. Several types of mathematical description can be distinguished: mass concentration, molar concentration, number concentration, and volume concentration. A concentration can be any kind of chemical mixture, but most frequently solutes and solvents in solutions. The molar (amount) concentration has variants such as normal concentration and osmotic concentration.

Memory information stored in the mind, or the mental processes involved in receiving, storing, and retrieving this information

Memory is the faculty of the brain by which information is encoded, stored, and retrieved when needed.

Similar tests include serial threes where the counting downwards is done by threes, reciting the months of the year in reverse order, or spelling 'world' backwards.

A study involving uninjured high school athletes concluded that the serial sevens test is not appropriate when testing for concussion because it lacks specificity; the pass rate is too low to give any meaningful result. The ability to recite the months in reverse order was thought to be a more effective measure because the pass rate was higher for that test in uninjured athletes. [3]

Concussion type of traumatic brain injury

Concussion, also known as mild traumatic brain injury (mTBI), is typically defined as a head injury that temporarily affects brain functioning. Symptoms may include headaches, trouble with thinking, memory or concentration, nausea, blurry vision, sleep disturbances or mood changes. Some symptoms may begin immediately, while others may appear days after the injury. Fewer than 10% of sports-related concussions among children are associated with loss of consciousness. It is not unusual for symptoms to last up to four weeks.

Sensitivity and specificity statistical measures of the performance of a binary classification test

Sensitivity and specificity were developed by the American biostatistician Jacob Yerushalmy in 1947 as statistical measures of the performance of a binary classification test, also known in statistics as a classification function:

The numbers of the serial sevens test are a recurring motif in Sarah Kane's play 4.48 Psychosis .

4.48 Psychosis is a play by British playwright Sarah Kane. It was her last work, first staged at the Royal Court's Jerwood Theatre Upstairs on 23 June 2000, directed by James Macdonald, nearly one and a half years after Kane's death on 20 February 1999. The play has no explicit characters or stage directions; this continues the style of her previous production entitled Crave. Stage productions of the play vary greatly, therefore, with between one and several actors in performance; the original production featured three actors. According to Kane's friend and fellow-playwright David Greig, the title of the play derives from the time, 4:48 a.m., when Kane, in her depressed state, often woke.

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Sports injury

Sports injuries are injuries that occur during sport, athletic activities, or exercising. In the United States, there are approximately 30 million teenagers and children combined who participate in some form of organized sport. Of those, about three million athletes age 14 years and under experience a sports injury annually. According to a study performed at Stanford University, 21 percent of the injuries observed in elite college athletes caused the athlete to miss at least one day of sport, and approximately 77 percent of these injuries involved the lower leg, ankle, or foot. In addition to those sport injuries, the leading cause of death related to sports injuries is traumatic head or neck occurrences. When an athlete complains of pain or an injury, the key to a diagnosis is to obtain a detailed history and examination. An example of a format used to guide an examination and treatment plan is a S.O.A.P note or, subjective, objective, assessment, plan. Another important aspect of sport injury is prevention, which helps to reduce potential sport injuries. It is important to establish sport-specific dynamic warm-ups, stretching, and exercises that can help prevent injuries common to each individual sport. Creating an injury prevention program also includes education on hydration, nutrition, monitoring team members “at risk”, monitoring at-risk behaviors, and improving technique. Season analysis reviews, preseason screenings, and pre-participation examinations are also essential in recognizing pre-existing conditions or previous injuries that could cause further illness or injury. One technique that can be used in the process of preseason screening is the functional movement screen. The functional movement screen can assess movement patterns in athletes in order to find players who are at risk of certain injuries. In addition, prevention for adolescent athletes should be considered and may need to be applied differently than adult athletes. Lastly, following various research about sport injury, it is shown that levels of anxiety, stress, and depression are elevated when an athlete experiences an injury depending on the type and severity of the injury.

Delirium, also known as acute confusional state, is an organically caused decline from a previously baseline level of mental function. It often varies in severity over a short period of time, and includes attentional deficits, and disorganization of behavior. It typically involves other cognitive deficits, changes in arousal, perceptual deficits, altered sleep-wake cycle, and psychotic features such as hallucinations and delusions. Delirium itself is not a disease, but rather a set of symptoms.

Rhabdomyolysis condition in which damaged skeletal muscle breaks down rapidly

Rhabdomyolysis is a condition in which damaged skeletal muscle breaks down rapidly. Symptoms may include muscle pains, weakness, vomiting, and confusion. There may be tea-colored urine or an irregular heartbeat. Some of the muscle breakdown products, such as the protein myoglobin, are harmful to the kidneys and may lead to kidney failure.

Septic arthritis arthritis that involves infection by a pathogen located in joint

Septic arthritis, also known as joint infection or infectious arthritis, is the invasion of a joint by an infectious agent resulting in joint inflammation. Symptoms typically include redness, heat, and pain in a single joint associated with a decreased ability to move the joint. Onset is usually rapid. Other symptoms may include fever, weakness, and headache. Occasionally, more than one joint may be involved.

Mental status examination way of observing and describing a patients current state of mind

The mental status examination or mental state examination (MSE) is an important part of the clinical assessment process in psychiatric practice. It is a structured way of observing and describing a patient's psychological functioning at a given point in time, under the domains of appearance, attitude, behavior, mood, and affect, speech, thought process, thought content, perception, cognition, insight, and judgment. There are some minor variations in the subdivision of the MSE and the sequence and names of MSE domains.

Acute liver failure rapid deterioration of liver function causing encephalopathy and coagulopathy

Acute liver failure is the appearance of severe complications rapidly after the first signs of liver disease, and indicates that the liver has sustained severe damage. The complications are hepatic encephalopathy and impaired protein synthesis. The 1993 classification defines hyperacute as within 1 week, acute as 8–28 days, and subacute as 4–12 weeks. It reflects the fact that the pace of disease evolution strongly influences prognosis. Underlying cause is the other significant determinant of outcome.

The Mini-Mental State Examination (MMSE) or Folstein test is a 30-point questionnaire that is used extensively in clinical and research settings to measure cognitive impairment. It is commonly used in medicine and allied health to screen for dementia. It is also used to estimate the severity and progression of cognitive impairment and to follow the course of cognitive changes in an individual over time; thus making it an effective way to document an individual's response to treatment. The MMSE's purpose has been not, on its own, to provide a diagnosis for any particular nosological entity.

Post-concussion syndrome, also known as postconcussive syndrome or PCS, is a set of symptoms that may continue for weeks, months, or a year or more after a concussion – a mild form of traumatic brain injury (TBI). The rates of PCS vary, but most studies report that about 15% of individuals with a history of a single concussion develop persistent symptoms associated with the injury. A diagnosis may be made when symptoms resulting from concussion last for more than three months after the injury. Loss of consciousness is not required for a diagnosis of concussion or post-concussion syndrome.

Radioisotope renography form of kidney imaging involving radioisotopes

Radioisotope renography is a form of medical imaging of the kidneys that uses radiolabelling. A renogram, which may also be known as a MAG3 scan, allows a nuclear medicine physician or a radiologist to visualize the kidneys and learn more about how they are functioning. MAG3 is an acronym for mercapto acetyl tri glycine, a compound that is chelated with a radioactive element – technetium-99m.

Frontal lobe disorder

Frontal lobe disorder is an impairment of the frontal lobe that occurs due to disease or head trauma. The frontal lobe of the brain plays a key role in higher mental functions such as motivation, planning, social behaviour, and speech production. A frontal lobe syndrome can be caused by a range of conditions including head trauma, tumours, degenerative diseases, neurosurgery and cerebrovascular disease. Frontal lobe impairment can be detected by recognition of typical clinical signs, use of simple screening tests, and specialist neurological testing.

An organic brain syndrome (OBS), also known as an organic brain disease/disorder (OBD), an organic mental syndrome (OMS), or an organic mental disorder (OMD), is a syndrome or disorder of mental function whose cause is alleged to be known as organic (physiologic) rather than purely of the mind. These names are older and nearly obsolete general terms from psychiatry, referring to many physical disorders that cause impaired mental function. They are meant to exclude psychiatric disorders. Originally, the term was created to distinguish physical causes of mental impairment from psychiatric disorders, but during the era when this distinction was drawn, not enough was known about brain science for this cause-based classification to be more than educated guesswork labeled with misplaced certainty, which is why it has been deemphasized in current medicine.

Anterior cruciate ligament injury ligament injury near the knee

Anterior cruciate ligament injury is when the anterior cruciate ligament (ACL) is either stretched, partially torn, or completely torn. The most common injury is a complete tear. Symptoms include pain, a popping sound during injury, instability of the knee, and joint swelling. Swelling generally appears within a couple of hours. In approximately 50% of cases, other structures of the knee such as surrounding ligaments, cartilage, or meniscus are damaged.

Clouding of consciousness, also known as brain fog or mental fog, is a term used in medicine denoting an abnormality in the regulation of the overall level of consciousness that is mild and less severe than a delirium. The sufferer experiences a subjective sensation of mental clouding described as feeling "foggy".

Radiculopathy Human disease

Radiculopathy, also commonly referred to as pinched nerve, refers to a set of conditions in which one or more nerves are affected and do not work properly. This can result in pain, weakness, numbness, or difficulty controlling specific muscles.

Neurointensive care branch of medicine that deals with life-threatening diseases of the nervous system

Neurocritical care is a medical field that treats life-threatening diseases of the nervous system and identifies, prevents/treats secondary brain injury.

Alzheimers disease progressive, neurodegenerative disease characterized by memory loss

Alzheimer's disease (AD), also referred to simply as Alzheimer's, is a chronic neurodegenerative disease that usually starts slowly and gradually worsens over time. It is the cause of 60–70% of cases of dementia. The most common early symptom is difficulty in remembering recent events. As the disease advances, symptoms can include problems with language, disorientation, mood swings, loss of motivation, not managing self care, and behavioural issues. As a person's condition declines, they often withdraw from family and society. Gradually, bodily functions are lost, ultimately leading to death. Although the speed of progression can vary, the typical life expectancy following diagnosis is three to nine years.

Elastic therapeutic tape, also called kinesiology tape, Kinesio tape, k-tape, or KT, is an elastic cotton strip with an acrylic adhesive that is used with the intent of treating pain and disability from athletic injuries and a variety of other physical disorders. In individuals with chronic musculoskeletal pain, research suggests that elastic taping may help relieve pain, but not more than other treatment approaches, and there is no evidence that it can reduce disability in chronic pain cases.

The Montreal Cognitive Assessment (MoCA) is a widely used screening assessment for detecting cognitive impairment. It was created in 1996 by Ziad Nasreddine in Montreal, Quebec. It was validated in the setting of mild cognitive impairment, and has subsequently been adopted in numerous other settings clinically.

A sports-related traumatic brain injury is a serious accident which may lead to significant morbidity or mortality. Traumatic brain injury (TBI) in sports are usually a result of physical contact with another person or stationary object, these sports may include boxing, football, field/ice hockey, lacrosse, martial arts, rugby, soccer, wrestling, auto racing, cycling, equestrian, roller blading, skateboarding, skiing, or snowboarding.

References

  1. Jurgen Ruesch (1944). "Intellectual Impairment in Head Injuries". The American Journal of Psychiatry. 100: 480–496. doi:10.1176/ajp.100.4.480.
  2. The Serial Sevens Test by Robert Thomas Manning, Arch Intern Med. 1982;142(6):1192. doi:10.1001/archinte.1982.00340190148022
  3. Young, Cc; Jacobs, Ba; Clavette, K; Mark, Dh; Guse, Ce (Jul 1997). "Serial sevens: not the most effective test of mental status in high school athletes". Clinical Journal of Sport Medicine. 7 (3): 196–8. doi:10.1097/00042752-199707000-00008. ISSN   1050-642X. PMID   9262887.