mental status assessment Flashcards
mental disorder
person’s response is much greater than expected reaction to traumatic life event
- significant behavioral or psychological pattern associated with distress
organic disorder
due to brain disease
- delerium, dimentia, alcohold, drug intoxication
psychiatric mental illness
anxiety disorder, schizophrenia
mental status exam
inferred through assessment of an individual’s behaviors
- consciousness: aware of one’s own existence, feelings, and thoughts and aware of environment.
- language: voice used to communicate thoughts and feelings.
- mood and affect: temporary expression of feelings and durable, prolonged display of feelings
- orientation: awareness of objective world in relation to self
- attention: concentration, ability to focus
- memory: ability to lay down and store experiences
- abstract reasoning: pondering a deeper meaning
- thought process: way a person thinks, logical train of thought
- preceptions: awareness of objects through 5 senses
children MSE
by school age most children can sit and concentrate for a period of time
- age 7 - thinking becomes more logical and systematic and child is able to reason and understand
- age 12-15 = abstract thinking and thinking of hypothetical situations
Behavior Checklist: used for kids 7-11 who have outgrown developmental checklist
DENVER II: detects developmental delays in infants and preschoolers for: gross motor, language, fine motor, social skills
aging adult MSE
takes longer for brain to process info
- recent memory decreases, remote memory does not
- age related changes in sensory can affect perception
- always check sensory status first, this can cause misdiagnosis if not checked 1st
GLASGOW COMA SCALE: useful for testing consciousness
- general orientation is good
MINI COG: 3 item recall test and clock drawing
- grief can interfere with MSE
Components of MSE
APPEARANCE: posture, body movements, dress, hygiene
BEHAVIOR: facial expression, speech, mood and affect
COGNITION: orientation, attention span, recent and remote memory, new learning
THOUGHT PROCESSES: thought process, thought content, perceptions, anxiety disorders, depression, suicidal thoughts,
MMSE
mini mental status exam
- used to demonstrate worsening or improvement over time.
- concentrates on cognitive functioning, not mood or process
levels of consciousness
- Alert: awake or readily aroused, oriented, fully aware of external and internal stimuli
- lethargic, somnolent: not fully alert, drifts to sleep, arounsed by name or but looks drowsy, thinking seems slow and fuzzy
- obtunded: sleeps most of time, difficult to arouse, monosylabus, mumbled speech
- stupor or semi-coma: spontaneously unconscious, responds to only persistent or various shaking,
- Coma: completely unconscious, no response to pain or to external or internal stimuli
* Delirium: clouding of consciousness, inattentive, incoherent convos, impaired recent memory,
full mental exam is needed when:
- initial screening suggests anxiety or depression
- family members are concerned
- known brain lesions
- aphasia
- symptoms psychiatric illness
ABCT
Appearance, behavior, cognition, thought process
additional tests for patients with apasia
- word comprehension - point and identify
- reading - read and then do what it says
- writing - write subject and verb
delirium vs. dimentia
delirium: acute, reversible, identifiable factor for change in mental status (alcohol, drugs, oxygenation,
dimentia: progressive, not sudden, alzheimers. can result in death
Speech Disorders
- dysphonia: voice; difficulty talking with normal pitch and volume, due to laryngeal disease, voice horse or whispered but in tact
- dysarthria: ariculation; distorted speech sounds, unintelligible, basic language in tact
- Apasia: language comprehension and production; secondary to brain damage. true language disturbance.
mood and affect abnormalities
- flat affect: lack of emotion, no expression or feelings, voice monotonous
- depresson: sad, gloomy, dejected
- depersonalization: loss of identity, feels estranged, “i don’t feel real”
- elation: joy and optomism, overconfidence,
- euphoria: excessive well being
- anxiety: worried, uneasy unknown anticipation of unknown danger
- fear: worried, uneasy, apprehensive
- irritability: annoyed, easily provoked, impatient
- rage: furious, loss of control
- ambivalence: love and hate towards self or other
- lability: rapid shift of emotions
