PRELIMS: Mental Status Examination Flashcards
Any part of pt’s status that can be objectively measure
-Consciousness requires a content . At any moment we are conscious of objects, the state of our bladder, the time of day, our feelings, etc . We call our awareness the sensorium.
SENSORIUM
ASSESSMENT OF SENSORIUM: Can the Pt attend to stimuli long enough to comprehend and respond to them, or attend to a task long enough to complete it?
For a simple, effective test, ask the Pt to recite the months backward or spell the word world backward
ATTENTION SPAN
ASSESSMENT OF SENSORIUM: ORIENTATION
Does the Pt comprehend who and where he or she is and when it is?
As to person: Does the Pt recognize him- or herself and his or her role, the other people present, and their roles?
As to place: Does the Pt recognize that he or she is in a clinic or hospital, its name, and the name of the city and state?
As to time: Can the Pt recite the time of day, day of the week, the month, and the year?
ASSESSMENT OF SENSORIUM: Awareness of self and environment.
Does the Pt make responses that prove awareness of self and environment?
CONSCIOUSNESS
ASSESSMENT OF SENSORIUM: CALCULATION
Test calculation by asking the patient to balance a checkbook, make change, do formal paper-and-pencil calculations, or subtract 7’s serially from 100.
ASSESMENT OF SENSORIUM: MEMORY
RECENT & REMOTE
Remote Memory: Assess recall of long-term events, e.g., asking about past presidents.
Recent Memory: Assess recall of recent events, e.g., what they had for breakfast.
Affective liability VS affective Blunting
Affective lability: Rapid, unpredictable changes in mood/emotions.
Affective blunting: Significant reduction in emotional expression intensity.
ASSESSMENT OF SENSORIUM: Insight, Judgment, and Planning
Ask about the patient’s plans and if their goals match their physical and mental abilities.
Does the patient recognize their illness and its implications?
Agraphognosia / Agraphesthesia Testing
Test: Trace numbers/letters on the patient’s palm or fingertips with their eyes closed.
Missed figures indicate agraphognosia (if sensory pathways intact) or graphanesthesia (if sensory pathways destroyed).
Measures levels of cognitive recovery post-brain injury, ranging from Level I (no response) to Level X (purposeful, appropriate response).
Rancho Los Amigos Levels of Cognitive Function
Agnosia is the inability to?
Inability to understand the significance of ordinary sensory stimuli, despite intact sensory pathways and cognition.
Assesses orientation to time, place, and memory functions, often used post-traumatic brain injury.
Galveston Orientation and Amnesia Test
This is the Gold standard for documenting consciousness in acute brain injury.
what functions does this examine (3)
Glasgow Coma Scale (GCS)
Examines three functions: eye opening (max 4), best motor response (max 6), and verbal response (max 5).
In the GCS what score would these indicate:
Severe injury/coma: ?
Moderate injury: ?
Mild injury: ?
Severe injury/coma: ≤ 8
Moderate injury: 9-12
Mild injury: 13-15
A commonly used cognitive screening tool that assesses orientation, attention, memory, language, and visuospatial skills.
Mini-Mental State Examination
Define:
Illusion: (?)
Hallucination: (?)
Delusion: (?)
Illusion: False perception based on actual sensory input.
Hallucination: False perception without sensory input.
Delusion: False belief, resistant to reason or contrary evidence.
Prosopagnosia
Inability to recognize faces, even familiar ones, despite intact vision.
Patients may recognize individuals by voice, but not by face.
Prosopagnosia is associated with lesions in the?
Lesion usually in the Inferomedial Temporooccipital region, often bilateral or right-sided.
