Examination of Higher Mental Function

Examination of Higher Mental FunctionCreated OnJune 1, 2020Last Updated OnJune 1, 2020byadmin You are here: Main Clinical Examination Examination of Higher Mental Function < All Topics Table of Contents Component Examination Level of Consciousness Note whether patient is awake and alert. If not, describe what level of stimulation is needed to arouse and keep patient awake. (Eg. Opens eyes to _stimuli, falls back asleep if not continuously stimulated) Assess Glasgow Coma Scale (can perform those by simply conversing) Glasgow Coma Scale Behavior Response Score Eye opening response Spontaneously 4 To speech 3 To pain 2 No response 1 Best verbal response Oriented to time, place, person 5 Confused 4 Inappropriate words 3 Incomprehensive sounds 2 No response 1 Best motor response Obeys commands 6 Moves to localized pain 5 Flexion withdrawal from pain 4 Abnormal flexion (decorticate) 3 Abnormal extension (decerebrate) 2 No response 1 Total score Best response 15 Comatose client ≤8 Totally unresponsive 3 Component Examination Attentiveness See whether patient is attentive if able to attend to you and the examination without getting distracted easily To assess for selective attention: Ask the patient to repeat a short list of numbers forwards or back ward (digit span test). Normally, the individual can recall forward and five backward numbers. To assess for sustained attention: Assess how long the patient is able to maintain attention on a particular task. To assess for alternating attention: Request the patient to alternate back and forth between two different tasks. For example, add the first two pairs of numbers, then subtract the next two pairs of numbers. To assess for divided attention: Request the patient to perform two tasks simultaneously. For example, talk while walking (Walkie-Talkie test. Orientation To test if the patient is orientated to time, place and person: Time: Ask the patient to tell the year, season, date, day and month. Place: Ask for the state, country, town, hospital and floor in which he is admitted. Person: Ask for the identity of his nearby relatives or neighbors. Self: Ask the patient’s name, age, address and qualifications. Speech and Language Listen to patient’s spontaneous speech, articulation, fluency, paraphasias, grammar, syntax, naming objects, concepts, comprehension of spoken command, repetition of spoken phrases, reading aloud, handwriting: Fluency is normal if patient speaks in complete sentences without hesistancy between words Comprehension is normal if patient is able to understand your question and answer them appropriately and follow instructions “Do what I say: look at the table then look to the door. “ If not done properly, give simpler command: “Show me your thumb” Naming Points to one object and ask patient to name the object Reading Let patient to read and follow a...

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