Mental Status (Chapter 7) Flashcards
Cerebrum
The brain. Two hemisphere. 4 lobes.
Limbic system
1. What are its major structures and their functions?
Mediates certain patterns of behavior that determine survival (mating, aggression, fear, affection). Reactions to emotions originate here but are expressed with the help of the frontal lobe.
1. Hippocampus - seahorse shaped organ that lies above the brainstem. Plays a role in episodic memory, longterm storage, and connecting memories with sensations. New neurons are made here from stem cells.
2. Amygdala - located similarly as the hippocampus. Attaches emotions to memories, particularly fear. Helps process emotions like fear, pleasure, anger and anxiety.
Reticular Activating System (RAS)
Located in the brainstem. Regulates the level of wakefulness or arousal. Also helps control the HR and RR.
Where is the Broca area? What is it’s main function?
Located in the frontal lobe. Controls expressive aspects of language (speech and writing).
This lobe is responsible for decision making, problem solving, concentrating, and short-term memory.
Frontal lobe - motor cortex is also here
This lobe’s primary purpose is receiving and processing data
Parietal lobe
Wernicke speech area
Located in the temporal lobe. Allows the understanding of speech and written word.
This lobe allows integration of behavior, emotion, and personality. Also controls long-term memory.
Temporal lobe - primary function is hearing
How many neurons are children born with?
Children are born with all the neurons they will ever have at birth. As the child ages, these neurons develop.
What cognitive changes are seen with adolescents?
Abstract thinking - develop theories, reason, make plans, generalize
Judgement
Mini-Mental State Examination
Standardized exam. Used to assess cognitive impairment. Asks a series of questions:
- Orientation (What is the year? Season? Date? Day? Month?) Where are you?
- Registration - names some objects, have the patient repeat those objects back to you. Record the number of trails it takes to remember all three.
- Attention and calculation - count by 7s
- Recall - have them repeat the 3 above objects
- Language - have the patient repeat and say various things. Includes writing.
Maximum score - 30. If scored 20 or less could be dementia related.
Mini-Cognitive test
A quick assessment of cognitive abilities. 3 steps.
1. Word registration (say three words, have patient repeat these three words until they get all the words correct)
2. Clock drawing - have the patient number a redrawn circle. Have the patient point the hands to 10 past 11.
3. Recall - what were the three words from above
How could the following be used to assess a patient’s cognitive abilities?
1. Analogies
2. Abstract reasoning
3. Calculation
4. Writing
5.Execution of motor skills
6. Memory
7. Attention span
8. Judgement
- Analogies - can you tell me what a lake and an ocean have in common? What about a car and a bus?
- What does “a rolling stone gathers no moss” mean?
- Math
- Writing something familiar
- Have the patient unbutton a button or comb their hair
- Immediate, short-term, and long-term
- Follow a short set of commands
- Ask long term questions that they have to use judgement on
Neologisms
Made up word
This type of aphasia is characterized by slow speech flow, labored. Know what they want to say, but cant find the right words. Telegraphic speech.
Broca’s aphasia - the damage is done to the frontal lobe where motor activities (act of speaking and writing) are controlled.
This type of aphasia is characterized by fluent speech but inappropriate words, neologisms, word substitutions, or incomprehensible speech
Wernicke aphasia - damage to the temporal lobe
What is the pathophysiology behind depression?
Neurochemical imbalance where there are decreased monoamines or increased plasma cortisol
Genetic predisposition. Associated with stressful or traumatic life events
