Mental Status Flashcards
importance of checking cognition
- informed consent
- collaboration
- screenings (sys rev)
- Diff DX
- Plan of care (education)
Indications for mental status exam
- brain lesion
- febrile (fever)
- headaches
- seizures
- vague bx complaints
- significant bx changes
ABCT
Appearance
Behavior
Cognition
Thought processes
Appearance examine…
- General appearance
- Personal cleanliness
- Habits of dress
- Motor activity
Behavior
levels of consciousness
Alert
awake and fully aware of normal external and internal stimuli
Lethargy
decreased spontaneous movements and responses; easy arousal with normal sounds or touch
Obtundation
Difficult to arouse; inconsistent and poor response to normal sound and touch
Stupor
Responds to only vigorous and persistent stimulus (when stop will go back into coma like state)
Semi-coma
Coma
complete non-responsive state
May have some non-purposeful motion associated with light coma
Purposeful movement
in response to a stimulus
None of this in coma
Describing level of consciousness
- stimulus needed to arouse patient
- Patient’s highest level of response (what did they do)
- What occurs when stimulus is withdrawn
Glasgow Coma Scale
Formal test for evaluating coma - gives quantitative data Best eye opening (1-4) Best verbal response (1-5) Best motor response (1-6) 15 is normal, 7 or less - coma
Cognitive Functions
Attention
Concentration
Orientation
Memory
Attention
Ability to attend to a specific stimulus without being distracted by other things
Concentration
Ability to sustain attention over an extended period of time
Orientation
Person (3rd)
Place (2nd)
Time (1st)
Memory
Stored experiences and emotions
Long term vs. Recent
Higher order cognitive functions
- Abstract thought
- Judgment
- Problem Solving
- Calculations
- Interpretation of visual information
Thought Processes Concerns
- Obsession
- Delusion
- Confabulation
- Loosening Associations
Thought Processes
Integration of sensory information into meaningful interpretation
Mood
Subjective
Range - Depressed to Elated
Labile - quickly changing, unstable
Affect
Observable
Full/broad to blunted/flat
Congruent vs incongruent
Mini Mental Exam
Screening tool only
Reliability/validity issues
Max of 30
score
