Mental Status Exam
1) General Appearance, Behavior & Atti-
tude
2) Level of Consciousness and Orienta-
tion
Components of Mental Status Exam 3) Speech and Language
(MSE) 4) Mood and Affect
5) Thought Process, Content, & Percep-
tions
6) Memory and Cognition
7) Judgment and Insight
This is your first impression of the pa-
tient:
- Pt. awake?
-Pt. clean, wearing appropriate clothing?
MSE: General Appearance, Behavior & - Pt. cooperative with staff?
Attitude -Pt. moving around too much, or com-
pletely still?
- Pt. appears roughly stated age?
- Pt. with appropriate verbal responses?
- Pt. angry, suspicious, guarded?
1) Alert - patient is able to open eyes,
look at you, responds fully and appropri-
ately
2) Lethargic - drowsy, but can open eyes,
look at examiner and respond. Falls back
to sleep easily
3) Obtunded - opens eyes when com-
MSE: Level of Consciousness manded to and looks at you, offers con-
fused responses, has lack of interest in
the environment
4) Stuporous - Wakens only with painful
stimuli. Verbal responses slow or absent.
Falls back into unresponsive state when
stimuli ceases
5) Comatose - unarousable to any stimuli
What is your name?
MSE: Orientation What is the day or date?
Where are we now?
1/5
, Mental Status Exam
If all normal, write "A and O x 3"
Quantity: talkative or silent? Does the pt
speak spontaneously or only when di-
rectly questioned?
Rate: Too fast, too slow, just right?
MSE: Speech & Lang.
Volume: too loud, too quiet, just right?
Articulation: can you understand what
the patient is saying physically? If not,
why not
1) receptive aphasia -
2) pts with fluent but non-sensical
speech, impaired word comprehension,
Wernicke's
repetition, naming, ability to read, ability
to write (location of lesion is posterior
superior temporal lobe)
1) expressive aphasia -
2) slow speech, hard to speak, but what
they get out makes sense. Word compre-
hension is intact and they may be able
Broca's aphasia
to nod or shake their head appropriately.
Repetition is impaired. Reading is fair to
good, writing is often impaired. Location
of lesion is posterior inferior frontal lobe.
Is the rate, flow, melody and content of
speech within normal limits? If not, sus-
pect an aphasia.
1) Word Comprehension: Ask pt to follow
one or two step command.
Fluency of Speech
2) Repetition: Ask the pt to repeat "No ifs,
ands or buts"
3) Naming: ask the patient to name the
parts of a watch
4) Reading: ask the pt. to read a para-
2/5
1) General Appearance, Behavior & Atti-
tude
2) Level of Consciousness and Orienta-
tion
Components of Mental Status Exam 3) Speech and Language
(MSE) 4) Mood and Affect
5) Thought Process, Content, & Percep-
tions
6) Memory and Cognition
7) Judgment and Insight
This is your first impression of the pa-
tient:
- Pt. awake?
-Pt. clean, wearing appropriate clothing?
MSE: General Appearance, Behavior & - Pt. cooperative with staff?
Attitude -Pt. moving around too much, or com-
pletely still?
- Pt. appears roughly stated age?
- Pt. with appropriate verbal responses?
- Pt. angry, suspicious, guarded?
1) Alert - patient is able to open eyes,
look at you, responds fully and appropri-
ately
2) Lethargic - drowsy, but can open eyes,
look at examiner and respond. Falls back
to sleep easily
3) Obtunded - opens eyes when com-
MSE: Level of Consciousness manded to and looks at you, offers con-
fused responses, has lack of interest in
the environment
4) Stuporous - Wakens only with painful
stimuli. Verbal responses slow or absent.
Falls back into unresponsive state when
stimuli ceases
5) Comatose - unarousable to any stimuli
What is your name?
MSE: Orientation What is the day or date?
Where are we now?
1/5
, Mental Status Exam
If all normal, write "A and O x 3"
Quantity: talkative or silent? Does the pt
speak spontaneously or only when di-
rectly questioned?
Rate: Too fast, too slow, just right?
MSE: Speech & Lang.
Volume: too loud, too quiet, just right?
Articulation: can you understand what
the patient is saying physically? If not,
why not
1) receptive aphasia -
2) pts with fluent but non-sensical
speech, impaired word comprehension,
Wernicke's
repetition, naming, ability to read, ability
to write (location of lesion is posterior
superior temporal lobe)
1) expressive aphasia -
2) slow speech, hard to speak, but what
they get out makes sense. Word compre-
hension is intact and they may be able
Broca's aphasia
to nod or shake their head appropriately.
Repetition is impaired. Reading is fair to
good, writing is often impaired. Location
of lesion is posterior inferior frontal lobe.
Is the rate, flow, melody and content of
speech within normal limits? If not, sus-
pect an aphasia.
1) Word Comprehension: Ask pt to follow
one or two step command.
Fluency of Speech
2) Repetition: Ask the pt to repeat "No ifs,
ands or buts"
3) Naming: ask the patient to name the
parts of a watch
4) Reading: ask the pt. to read a para-
2/5
