heMentalStatusExamination(MSE)-PalmerCollegeof精神状态检查(MSE)-帕大学VIP专享VIP免费

TheMentalStatusExamination(MSE)MentalStatusMentalstatusisthetotalexpressionofaperson’semotionalresponses,mood,cognitivefunction,andpersonalityItiscloselylinkedtotheindividual’sexecutivefunctioning,i.e.motivation,initiative,goalformation,planningandperforming,self-monitoring,andintegrationoffeedbackQuickNeurologyReviewFrontallobeSpeechformation(Brocaarea)Emotions/affectDriveAwarenessofselfShort-termmemoryGoal-orientedbehaviorQuickNeurologyReviewParietallobeSensoryperceptionSpatialsenseandnavigationQuickNeurologyReviewTemporallobePerceptionandinterpretationofsoundsWernicke’sareaIntegrationofbehavior,emotion,andpersonalityLong-termmemoryQuickNeurologyReviewLimbicsystemSurvivalbehaviors(mating,aggression,fear,affection)Reactionstoemotions,andexpressionofaffectismediatedbyconnectionsofthelimbicsystemandthefrontallobeDementiaDementiaisaclinicalsyndrome,characterizedbydeterioratingcognition,behavior,andfunctionalindependenceItisusuallyrelatedtoobviousstructuraldiseaseofthebrain(mostcommonlyatrophy)Dementiaaffects3-11%ofadultsolderthan65MnemonicforcausesofdementiaD:drugsandtoxinsE:endocrineM:metabolicandmechanicalE:epilepsyN:nutritionalandnervoussystemT:tumorandtraumaI:infectionA:arterialDeliriumDeliriumisdifferentthandementiaItisanacuteconfusionalstateaccompaniedbyadisorderofperceptionSymptomsincludealterationsinmentalstatus(disorientation),attentionspan,sleeppatterns,andaffectSuddenandfluctuatingUsuallyreversibleMentalStatusExaminationTheMSEisonecomponentofanexamandmaybeviewedasthepsychologicalequivalentofthephysicalexamItisanimportantcomponenttoaneurologicalevaluationFactorsaffectingtheMSECultureandeducationalbackgroundofthepatientWhatisabnormalforapersonwithhighintellectualabilitymaybenormalforapersonoflesseducationPatientswithESLmayhavedifficultywithsomecomponentsoftheexamMajorComponentsoftheMSE1.Appearance2.Motor3.Speech4.Affect&mood5.ThoughtContent6.ThoughtProcess7.Perception8.Intellect9.InsightAppearanceAgeGenderRaceBodybuildPostureEyecontactDressGroomingMannerAttentivenesstoexaminerEmotionalfacialexpressionAlertnessMotorBehavior:Pleasant?Cooperative?Appropriatefortheparticularsituation?HesitancyAgitationAbnormalmovementsGaitCatatoniaSpeechRateRhythmVolumeAmountArticulationSpontaneityAffectandMoodAffect:Howdotheyappeartoyou?StabilityRangeAppropriatenessIntensityMood:Dr.asksthepatientdirectlyhowhe/shefeelsThoughtContentSuicidalideationDeathwishesHomicidalideationDepressivecognitionObsessionsRuminationsPhobiasParanoidideationMagicalideationDelusionsOvervaluedideasDescriptionofwhatthepatientisthinkingaboutThoughtProcessAssociationsCoherenceLogicStreamClangassociationsPerseverationNeologismThoughtblockingAttentionDescriptionofthewayinwhichthepatientthinksPerceptionHallucinationsIllusionsDepersonalizationDerealizationdéjàvujamaisvuIntellectGlobalimpression:average,aboveaverage,belowaverageInsightAwarenessofillnessMSEThefullMSEisalengthyexamYouassessmanycomponentsoftheMSEinyournormalworkupofapatientWhenyouneedtodoashorterneurologicalscreeningexam,youmayshortentheMSEtotheMiniMentalStatusExam(MMSE)MMSETakesapproximately10minutesTheMMSEtests:OrientationImmediateands...