MENTALSTATUSEXAMINATION:精神状态检查课件.ppt
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- MENTALSTATUSEXAMINATION 精神状态 检查 课件
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1、MENTAL STATUS EXAMINATIONOutline Operational definition Purposes Components Behavior Cognition Emotion Cognitive examination Mini Mental StatusMENTAL STATUS EXAMINATION:What is it?ASSESSMENT of the:Behavior(see it all)Emotion(see some of it)Cognition(see none of it)Exhibited by the patient during th
2、e entire medical encounterPURPOSES Detect Describe Neuroanatomical localization Assess functional implications ofAbnormalities/deficits in:Behavior Emotion CognitionABNORMALITIES&DEFICITSRequire diagnostic explanationMay compromise capacity to coherently and reliably describe medical state to give i
3、nformed consent to adhere to a therapeutic planMEDICALENCOUNTERComprehensiveglobal assessmentBEHAVIORAppearanceAttitudeActivitySpeechDressGroomingHygieneBEHAVIORAppearanceAttitudeActivitySpeechDressGroomingHygieneCOGNITIONThought contentThought progressionInsight/judgmentBEHAVIORAppearanceAttitudeAc
4、tivitySpeechDressGroomingHygieneCOGNITIONThought contentCoherenceGoal directednessInsight/judgmentOperationsArousalAttentionMemoryEmotionLanguageReasoningBEHAVIORAppearanceAttitudeActivitySpeechDressGroomingHygieneEMOTIONAffectMoodSuicideHomicideCOGNITIONThought contentCoherenceGoal directednessInsi
5、ght/judgmentOperationsArousalAttentionMemoryEmotionLanguageReasoningBEHAVIORAppearanceappears stated age,uses a cane to walkAttitudecooperative,hostile,detachedActivitynormal,increased,agitated,subduedSpeechnormal rate/rhythm,dysarthricDresscasual,provocative,dirtyGroomingdisheveled,meticulousHygien
6、eclean,malodorousCOGNITIVE EXAM (“Mental status”)REASONINGLANGUAGEMEMORYATTENTIONAROUSALCOGNITIVE EXAM (“Mental status”)REASONINGLANGUAGEMEMORYATTENTIONAROUSALMust know educationCan thepatienthear?MEMORYImmediate memory=attentionRecent memory(episodic)Recall of three words at 5 minutesEnsure that pt
7、 has registered the items“Repeat these words after me,I want you to remember them.”Remote memory(semantic&episodic)Tends to overlap with knowledge,most of what we ask is overlearnedPresidents,date of W.W.II,etc.REASONING(Higher cognitive fx)Tests problem solving,abstract thinkingFund of knowledge-ov
8、erlaps with remote memoryHow many weeks in a year?Name four presidents since 1940?What causes rust?CalculationsAdd,subtract,multiple,divideSequences1,2,3,.1,4,9,16,.2,3,5,7,11,.REASONING(continued)SimilaritiesApple-orangeCar-airplanePoem-novelProverbsDont cry over spilt milkA stitch in time saves ni
9、nePeople who live in glass houses shouldnt throw stonesBEHAVIORAppearanceAttitudeActivitySpeechDressGroomingHygieneCOGNITIONThought contentThought progressionInsight/judgmentArousalAttentionMemoryLanguageReasoningEMOTIONAffectMoodSuicideHomicideEMOTIONAFFECT “Affect is to weather as mood is to clima
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