Term
| What are the seven components of the MSE? |
|
Definition
I. General Appearance, Behavior & Attitude
II. Level of Consciousness and Orientation
III. Speech and Language
IV. Mood and Affect
V. Thought Process, Content, & Perceptions
VI. Memory and Cognition
VII. Judgment and Insight |
|
|
Term
| Level of consciousness: Alert |
|
Definition
patient is able to open eyes, look at
you, responds fully and appropriately |
|
|
Term
| Level of consciousness: lethargic |
|
Definition
drowsy, but can open eyes,
look at examiner and respond. Falls back
to sleep easily |
|
|
Term
| level of consciousness: obtunded |
|
Definition
opens eyes and looks at you,
offers confused responses, has lack of
interest in the environment |
|
|
Term
| Level of consciousness: stuporous |
|
Definition
Wakens
only with painful stimuli.
Verbal responses slow
or absent. Falls back
into unresponsive state
when stimuli ceases |
|
|
Term
|
Definition
unarousable to any
stimuli |
|
|
Term
| speech and language: quantity |
|
Definition
talkative or silent? Does the pt
speak spontaneously or only when directly
questioned? |
|
|
Term
| speech and language: rate |
|
Definition
| Too fast, too slow, just right? |
|
|
Term
| speech and language: volume |
|
Definition
| too loud, too quiet, just right? |
|
|
Term
| speech and language: articulation |
|
Definition
can you understand what the
patient is saying physically? If not, why not? |
|
|
Term
| speech and language: fluency |
|
Definition
Is the rate, flow, melody and
content of speech within normal limits? If
not, suspect an aphasia. |
|
|
Term
|
Definition
| the external expression of emotion visible to the clinician. |
|
|
Term
| Thought process - derailment or loose associations |
|
Definition
speech shifts
from one topic to another that is not clearly
related to the first topic without the patient realizing that the topics are unrelated. |
|
|
Term
| Thought process - tangentiality |
|
Definition
| only partially relevant or irrelevant responses to questioning |
|
|
Term
| thought process - pressured speech |
|
Definition
Patient speaks more and
more quickly than would be ordinarily expected.
Patient gives long answers to brief questions and may not finish one thought before starting another. |
|
|
Term
| thought process - incoherence |
|
Definition
| speech makes no sense at all (aka “word salad”) |
|
|
Term
| thought process - circumstantiality |
|
Definition
speech is
delayed in reaching goal because
of unnecessary detail, however
components are properly related |
|
|
Term
| thought process - distractable speech |
|
Definition
During the course of a
discussion, pt changes subject in response to
something unrelated in the environment. |
|
|
Term
| thought process - perseveration |
|
Definition
| persistent repetition of specific words |
|
|
Term
| thought process - clanging |
|
Definition
| word choice doesn't make any sense because words are chosen based on the sound they make (often rhyming), not their meaning |
|
|
Term
| thought process - confabulation |
|
Definition
Fabrication of facts to fill in gaps
of memory |
|
|
Term
| thought content - obsessions |
|
Definition
Recurrent, uncontrollable
thoughts or images that are unwanted and
unpleasant to the pt. |
|
|
Term
| thought content - compulsions |
|
Definition
Repetitive behaviors or mental
acts that the pt. feels driven to perform to
produce relief or to prevent some future
consequence (although that
consequence is unlikely) |
|
|
Term
| thought content - delusions |
|
Definition
| false, fixed personal beliefs that are not shared by other is the pt's community: persecution, grandiosity, delusion of being controlled externally, somatic delusions, jealously |
|
|
Term
|
Definition
Persistent,irrational fears accompanied
by desire to avoid the stimulus |
|
|
Term
| thought content - feelings of unreality |
|
Definition
A sense that things in the
environment are unreal, strange or remote |
|
|
Term
| thought content - feelings of depersonalization |
|
Definition
A sense that the
inner self has become detached from the mind
or body |
|
|
Term
| perceptions - hallucinations |
|
Definition
false perceptions. Pt
hears, sees, smells or feels something
others cannot.
or body |
|
|
Term
|
Definition
misperception of real external
stimuli
or body |
|
|
Term
| thought content - anxiety |
|
Definition
Fears, tensions, or uneasiness that
may be focused or free-floating |
|
|
Term
|
Definition
Can pt. learn something new
and repeat it back? |
|
|
Term
|
Definition
Can the patient correctly
remember things that happened today? |
|
|
Term
|
Definition
Can the patient correctly
remember things that happened or
information from long ago? |
|
|
Term
|
Definition
| digit span: serial 7s or 3s; "world" spelled backwards |
|
|
Term
| cognition - information and vocabulary |
|
Definition
Assess
patient’s apparent intelligence by assessing
the degree to which they are informed and
the complexity of their vocabulary |
|
|
Term
| cognition - abstract thinking |
|
Definition
| proverbs and/or similarities |
|
|
Term
| What are other ways to test cognition? |
|
Definition
| calculations, reading/writing, and visuospacial (face of a clock) |
|
|
Term
|
Definition
| Ask pt to propose a solution to their current problem or ask pt to propose a solution to a hypothetical problem. |
|
|
Term
| Do I need to test my pt's insight? |
|
Definition
| Yes, because some patients do not have the ability or desire to acknowledge their illness or situation. |
|
|
