MMSE
- Mental and emotional measured through detailed interviews, screening tools ( cogntive impairments)
MocA aimed towards mild cognitive impairments
MMSE: assess orinetation, cognition, scored of 30 points.
Delirium vs dementia
Delrium- acute mental distiurbances, makred by reduced awareness, orientation, cognitive functioning
- Underlying damage, disorientation to person, place and can be resolved
Dementia ( long term proressive, awanress or function)
Mental Status Exam ABC
Assess alertness, cognition, orientation, language, consciouness, detailed history. Cerberal cortext cognition, intellectual, behaviors, assess for defects
- Mental exam begins with
1. Apperannce ( groomed,dressed, hygine, posture, movements, facial features for distress) *atkithesia excessive motor, catatonia
2. Behavior ( consciouness, mood/affect, speech and langauge, eye contact)
3. . Cogniton ( memory, axo, reasoning, judgement, thought clarity, behaviors, perception)
Glascow coma scale
- Assess patients risk for brain damage, stoke, possible coma scored best at 15
- objective tool record patient consciousness, used in acute care settings for inital and ongoing assessment.
- Aims to assess levels of consciouness for pt with risk for stroke ( reduced blood) head trama, chronic illnesses.
Assess LOC ( sound->touch->painful stimuli)
GCS Chart
- Eye opening: E (4) Spontaneous, (3) to sound, (2) pain, voice (1)
- Verbal responses: V (5) orientation, (4) confused, (3) inappropriate, (2) sounds, (1) none
- Motor responses M Obeys (6), localizes pain (5), withdrawl flexion (4), flex abnormal (3), extend abnormal (2), 1 none.
Normal (15), 12 or less possible coma or serious head trama
Apashia
- Trouble understanding language and producing it
Expressive influent: Broca’s aphasia refers to motor , slowed slured ability to produce speech. Poor word coordination, omitted slured vocab, influent, able to understand langaueg
Receptive fluent: Wrenike’s aphasia refers to the ability to produce clear sentences but does not understand commuication, inappropriate formed random thoughts. Meaningless speech.
Aphonina ( vocal loss) dysphonia ( horase)
Apperance
Hygine appropirate, groomed, dressed, body motions , facial features
Good hygine, appropriate dress and atttire, smooth, coorindated controled movements ( non excessive or not slow) Facial features, posture erect.
Behaviors
- Mood (climate)- long term emotional stability
Affect (weather) current expression - Speech ( fluency, tone, inflections in voice, understandable, word choice, smooth)
Expressive ( left frontal, broken, influent, able to understand comp)
Receptive ( left temporal fluent but meaningless, impaired)
Note abnormal speech
Cognition
Orientation ( person place time)
Attention ( distractions)
Remote, recent memory
Memorization of words
Percerption
Reasoning judement, thought processes clear , logical , behaviors clear ( any repetive thoughs, fears, voices)
MMSE
Screening tool to assess for cognitive functioning ( determine dementia, impairments) Quick screening tool, assess changes in mental status
1. Orientation 10pts: time , year, place
2. Registration of words
3. Attenttion
4. Recall
5. Language
30 points (normal) 20-30 (slight), less than 20 is impaired
Aphasia interventions
Expressive Broca’s influent: poor speech, unclear, misuse of sentences ( provide time for pt to answer, yes/no questions, viusal aids, speech patho)
Receptitve: formed meaningless sentences ( gestures, treat like adults,
