Higher mental function examination is the initiation of the neurological examination and without proper assessment of these in detail examiner should not proceed forward to further examinations.
AVPU
A: Alert
V: Arousable with verbal command–> Drowsy
P: Arousable with painful stimulus –>Stupor
U: Not arousable
Other Higher mental function evaluations:
GLASGOW COMA SCALE (GCS)
A standard method used to document the level of consciousness in acute brain injury
<8: severe brain injury and coma
9-12: moderate brain injury
13-15: mild brain injury
ESSPN with VOCAIN by My OLD FriENd
EYE:
Spontaneous: 4
Sound/Speech: 3
Painful Stimulus: 2
No Response: 1
VERBAL COMMANDS:
Oriented: 5
Confused: 4
Inappropriate Word: 3
Incomprehensible Sound: 2
No response: 1
MOTOR RESPONSE:
Obeys commands: 6
Localize pain: 5
withDraws: 4
Flexion ( decorticate rigidity): 3
Extension (decerebrate rigidity): 2
No response: 1
Cognition
Mini-Mental Status Examination(MMSE) can do a screening examination of cognition
Mini-Mental Status Examination(MMSE)
- Orientation
- (1 point each=5)
- Time?
- Date?
- Day?
- Month?
- Year?
- 1 Point each = 5
- Ward?
- Hospital?
- District?
- Town?
- Country?
- (1 point each=5)
- Registration
- Name 3 objects, (1 sec to say each)
- Then ask the patient all after you have said them
- Give 1 point for each correct answer
- Attention and Calculation
- Serials 7’s. 1 point for each correct answer. Stop after 5 answers
- 5 correct= 5 points
- eg. subtract 7 from 100
- Recall
- Ask for the 3 objects repeated above in registration. Give 1 point for each correct answer
- Language
- Naming: show Pen and watch (name it)
- Repeat the following ” No ifs, and, or buts”
- 3-stage command:
- Take a piece of paper
- fold the paper
- place on the floor
- Reading: 1 point for each correct response; Close your eyes
- Writing a sentence
- Copy the design shown
See also: Cerebellar examination
See also: Cranial nerve examination
See also: Motor examination
See also: Sensory examination
