Mental Status Examination Flashcards
What are the components of a Mental Status Examination?
- Level of consciousness
- Cognition
- Attention
- Orientation
- Memory
- Language
- Perception
What is the definition of alert in levels of consciousness?
Awake and attending; responds and is awake to conversations
What does lethargic mean in levels of consciousness?
Lethargic:
- Drowsy, may fall asleep if not stimulated, difficulty focusing, loud voice needed.
What is delirium often characterized by?
Confusion of the circumstances, may hallucinate or act as if in dream state; conversation may not make sense
Define obtunded in levels of consciousness.
Confused, difficult to arouse, interactions with therapist highly unproductive
What does stupor indicate?
Semi-coma, responds only to strong/noxious stimuli, unable to interact with the therapist
What are the characteristics of a coma?
Deep coma, cannot be aroused by any stimulation, GCS score of less than 8
What is a coma?
Complete loss of the arousal system, unable to be awakened with reflex and postural response motor function, no sleep/wake cycles.
Define a vegetative state.
Loss of awareness to self and environment, sleep/wake cycles with motor function response to noxious stimuli only.
What is a minimally conscious state?
Minimally Conscious State:
- Partial preservation of conscious awareness including inconsistent localized responses to noxious stimulation or sound, verbalization, purposeful behavior such as holding objects and visual pursuit.
What is the Glasgow Coma Scale used for?
- To monitor level of consciousness and coma in patients with brain injury, especially in acute care and trauma setting.
What is the scoring ranges of the Glasgow Coma Scale?
minor, moderate, severe
Between 3-15
- Minor Brain injury = 13-15 points
- Moderate Brain injury 9-12 points
- Severe Brain injury = 3-8 points
What does an initial GCS score of 3 indicate?
- Severe brain injury
- Mortality between 65-99%
What does the Ranchos Los Amigos Levels of Cognitive Functioning (RLOCF) describe?
The cognitive and emotional behaviors of patients emerging from coma or minimally conscious state.
What assistance is required for levels I-III III in RLOCF?
Total assistance
What does levels IV-V in RLOCF require?
Maximal assistance
What is required for level VI in RLOCF?
Moderate assistance
What is needed for level VII in RLOCF?
Minimal assistance for routine tasks
What does level VIII in RLOCF require?
Stand-by assistance
What does A&O x4 stand for?
Alert and Oriented to…
- Person
- Place
- Time
- Situation
What is selective attention?
Selective Attention:
- The ability to select important/relevant information while ignoring other sources of information.
- Ability of a patient to follow the therapist’s verbal cues while ignoring nearby conversation.
What is divided attention?
Divided Attention:
- The ability to process more than one source of information or to perform more than one task at a time.
- Ability to talk while walking or to take money out of a wallet while walking.
What is attention switching or alternating attention?
Attention Switching or Alternating Attention:
- The ability to switch attention between two tasks or sources of information as needed for the task and environment.
- Patient stops conversing to perform a difficult task, then resumes talking once complete.
Give an example of attention switching.
Patient stops conversing to perform a difficult task, then resumes talking once complete.
What is sustained attention also called?
Vigilance
Where is sustained attention believed to be a function of?
The right hemisphere
How is sustained attention tested?
By asking the patient to repeat numbers or tap a hand when a specific letter is heard.
What is the Walking While Talking Test (WWTT)?
A test where the patient walks 20 feet, turns, and returns 20 feet while performing a simple talking task, then repeats with a more complex task.
What does the WWTT test predict?
Falls in older adults
What is the cut score for the simple talking test in WWTT?
20+ seconds
What is the cut score for the complex talking test in WWTT?
33+ seconds
What is the Mini Mental Status Examination (MMSE)?
Mini Mental Status Examination (MMSE):
- A standardized test for assessing cognitive function.
What is the Montreal Cognitive Assessment (MoCA) ?
- Cutoff score = ?
Montreal Cognitive Assessment (MoCA):
- A cognitive test used to assess various cognitive abilities.
- Cutoff score < 26
What is the cutoff score for the MoCA?
<26
What are the two types of memory associated with memory and learning ?
I) Explicit memory (declarative memory):
- Explicit memory include remembering a specific fact, a specific event, or the steps required to complete a task.
II) Implicit memory (Procedural or Nondeclarative memory)
- Memory for tasks or information performed without conscious thought, such as tying shoes.
- Learning and memory can be of two types.
What is short-term memory (STM)?
Short-term memory (STM / Recent Memory):
- The capability to remember current day-to-day events and retrieve material after minutes, hours, or days.
What is long-term memory (LTM)?
Long-term memory (LTM / Remote Memory):
- The recall of facts or events that occurred years before.
What are the standardized tests for screening depression?
I) Geriatric Depression Scale:
- Scores of 0-4 are considered normal
- 5-8 indicate mild depressive symptoms
- 8-11 indicate moderate depressive symptoms
- 12-15 indicate severe depressive symptoms
II) Beck Depression Inventory:
- “Feeling sad or depressed can cause you to think or even move differently This questionnaire looks at your overall mood and feelings.
- Please answer YES or NO to each question even if the answer varies day to day.
- Try to give the answer that BEST describes how you feel most of the time.
- If you need help reading the questions, I can read them for you.”
