QUIZ 2 NSG 625: HIGH-YIELD QUESTIONS AND KEY
CONCEPTS
How is recent memory tested during MSE
Immediate Recall - say "ball", "flag", "tree" clearly and slowly, about 1 second for each. After you have
said all 3 words, ask him/her to repeat them
Delayed Verbal Recall - Ask the individual to recall the 3 words you previously asked him/her to
remember
agnosia
inability to interpret sensations and hence to recognize things, typically as a result of brain damage.
praxis
ability to perform a motor activity - ask patient to pour water from a bedside pitcher into a glass and
drink the water.
How to test for attention during an MSE
Ask the individual to begin with 100 and count backwards by 7
Ask the individual to spell the word "WORLD" backwards
mental status exam
Appearance and behavior
Sensorium and cognition
Mood and affect
Speech
Thought process
Thought content
Peceptual disturbances
Insight and judgment
Mini mental status exam
quick method of screening for signs of cognitive dysfunction and dementia
Orientation
,Attention
Memory
Language
Visual-spatial skills
Afferent nerves
Also called sensory nerves; nerves that carry information about the external environment to the brain
and spinal cord via sensory receptors.
Efferent nerves
Also called motor nerves; nerves that carry information out of the brain and spinal cord to other areas of
the body.
Acronym for cranial nerves
On Old Olympus's Towering Tops A Finn And German Viewed Some Hops
Cranial Nerves
1. Olfactory
2. Optic
3. Oculomotor
4. Trochlear
5. Trigeminal
6. Abducens
7. Facial
8. Acoustic
9. Glossopharyngeal
10. Vagus
11. Accessory
12. Hypoglossal
Describe techniques to assess mental status for speech
Tell the patient to recite short phrases such as "no ifs, ands or buts".
Assess for dysarthia, dysphonia, dysphasia, aphasia
Dysarthia
difficulty in articulation caused by lesions of the tongue and palate
Dysphonia
difficulty in phonation due to issues in the volume and tone of the voice caused by lesions of the palate
and vocal cords
Dysphasia
,speech difficulty resulting from brain injury
difficulty comprehending or speaking as a result of cerebral dysfunction
Aphasia
Motor aphasia occurs when patient knows what they want to say but cannot articulate properly (due to
a frontal lobe lesion). Sensory fluent aphasia present when patient articulates spontaneously but uses
words inappropriately. Cannot understand written and verbal commands due to temporal parietal
lesions
Syncope
loss of consciousness or almost passing out (presyncope)
vertigo
world spinning around as if just stepped off a merry-go-round
hallucination of movement and may be associated with N/V perspiration and sense of anxiety
Dysequilibrium
feeling dizziness in legs or trouble with balance
Dix-Hallpike maneuver
Benign paroxysmal positional vertigo - BPPV
Rapidly moving the pt from a sitting position to the supine position with the head turned 45 degrees to
the Right. After waiting apx. 20-30 sec, the pt is returned to the sitting position. If no Nystagmus is
observed, the procedure is then repeated on the Left side.
Neuromuscular (motor) weakness
unable to move their muscles at full strength despite maximum effort and optimization or modifiable
factors
Common causes: CNS disorders, motor neuron disease, radiculopathies (spine), peripheral neuropathies,
neuromuscular junction disorders, myopathies (disease of the muscle tissue- eyes, lungs, arms, difficulty
swallowing and breathing)
Functional Weakness
strength of muscles retained, due to a secondary cause such as pain infection, inflammatory disease,
psychiatric disorders, metabolic issues and cancer
common conditions affecting mental status in children/teens
ADHD, anxiety, learning and developmental disabilities, autism and substance use
common conditions affecting mental status in adults
depression, anxiety, bipolar disorder or schizophrenia
common conditions affecting mental status in older adults
, depression, dementia, alzheimer's disease, anxiety, bipolar disorder and schizophrenia, parkinsons
Common neuro findings related to aging
Pupillary reactivity is minimized, presbyopia (farsightedness), difficulty with ocular pursuit and up-gaze,
reduced/ absent distal reflexes, slower motor speed, reduced ability to tandem walk
Abnormal symptoms in older adults: cognitive difficulties, balance and gait disorders, tremors and
neuropathy
Lesion of CN 1
Olfactory - smell
Anosmia, or loss of smell
Unilateral loss of smell (anosmia). Is more important than bilat loss, because it indicates a lesion
affecting the olfactory nerve or tract on that side.
Lesion of CN 2
Optic - vision
amaruosis
results in same side blindness and no direct pupillary light reflex.
Afferent (Optic):If one of the 2nd cranial nerves (optic nerve) is damaged, vision in the affected eye may
be partially or completely lost
amaurosis
partial or total blindness without visible change in the eye, typically due to disease of the optic nerve,
spinal cord, or brain.
lesion of CN 3
Oculomotor - eye movements, pupillary constriction, accommodation
Diplopia, ptosis, mydriasis, loss of accommodation
paralysis of ocular muscles
loss of accommodation
Presbyopia is the irreversible loss of accommodative ability of the eye that occurs with aging
interferes with pupillary light reflex because of damage of parasympathetic fibers that mediate the
efferent limb
diplopia
double vision
ptosis
drooping of the upper eyelid
mydriasis
dilation of the pupil
presbyopia
CONCEPTS
How is recent memory tested during MSE
Immediate Recall - say "ball", "flag", "tree" clearly and slowly, about 1 second for each. After you have
said all 3 words, ask him/her to repeat them
Delayed Verbal Recall - Ask the individual to recall the 3 words you previously asked him/her to
remember
agnosia
inability to interpret sensations and hence to recognize things, typically as a result of brain damage.
praxis
ability to perform a motor activity - ask patient to pour water from a bedside pitcher into a glass and
drink the water.
How to test for attention during an MSE
Ask the individual to begin with 100 and count backwards by 7
Ask the individual to spell the word "WORLD" backwards
mental status exam
Appearance and behavior
Sensorium and cognition
Mood and affect
Speech
Thought process
Thought content
Peceptual disturbances
Insight and judgment
Mini mental status exam
quick method of screening for signs of cognitive dysfunction and dementia
Orientation
,Attention
Memory
Language
Visual-spatial skills
Afferent nerves
Also called sensory nerves; nerves that carry information about the external environment to the brain
and spinal cord via sensory receptors.
Efferent nerves
Also called motor nerves; nerves that carry information out of the brain and spinal cord to other areas of
the body.
Acronym for cranial nerves
On Old Olympus's Towering Tops A Finn And German Viewed Some Hops
Cranial Nerves
1. Olfactory
2. Optic
3. Oculomotor
4. Trochlear
5. Trigeminal
6. Abducens
7. Facial
8. Acoustic
9. Glossopharyngeal
10. Vagus
11. Accessory
12. Hypoglossal
Describe techniques to assess mental status for speech
Tell the patient to recite short phrases such as "no ifs, ands or buts".
Assess for dysarthia, dysphonia, dysphasia, aphasia
Dysarthia
difficulty in articulation caused by lesions of the tongue and palate
Dysphonia
difficulty in phonation due to issues in the volume and tone of the voice caused by lesions of the palate
and vocal cords
Dysphasia
,speech difficulty resulting from brain injury
difficulty comprehending or speaking as a result of cerebral dysfunction
Aphasia
Motor aphasia occurs when patient knows what they want to say but cannot articulate properly (due to
a frontal lobe lesion). Sensory fluent aphasia present when patient articulates spontaneously but uses
words inappropriately. Cannot understand written and verbal commands due to temporal parietal
lesions
Syncope
loss of consciousness or almost passing out (presyncope)
vertigo
world spinning around as if just stepped off a merry-go-round
hallucination of movement and may be associated with N/V perspiration and sense of anxiety
Dysequilibrium
feeling dizziness in legs or trouble with balance
Dix-Hallpike maneuver
Benign paroxysmal positional vertigo - BPPV
Rapidly moving the pt from a sitting position to the supine position with the head turned 45 degrees to
the Right. After waiting apx. 20-30 sec, the pt is returned to the sitting position. If no Nystagmus is
observed, the procedure is then repeated on the Left side.
Neuromuscular (motor) weakness
unable to move their muscles at full strength despite maximum effort and optimization or modifiable
factors
Common causes: CNS disorders, motor neuron disease, radiculopathies (spine), peripheral neuropathies,
neuromuscular junction disorders, myopathies (disease of the muscle tissue- eyes, lungs, arms, difficulty
swallowing and breathing)
Functional Weakness
strength of muscles retained, due to a secondary cause such as pain infection, inflammatory disease,
psychiatric disorders, metabolic issues and cancer
common conditions affecting mental status in children/teens
ADHD, anxiety, learning and developmental disabilities, autism and substance use
common conditions affecting mental status in adults
depression, anxiety, bipolar disorder or schizophrenia
common conditions affecting mental status in older adults
, depression, dementia, alzheimer's disease, anxiety, bipolar disorder and schizophrenia, parkinsons
Common neuro findings related to aging
Pupillary reactivity is minimized, presbyopia (farsightedness), difficulty with ocular pursuit and up-gaze,
reduced/ absent distal reflexes, slower motor speed, reduced ability to tandem walk
Abnormal symptoms in older adults: cognitive difficulties, balance and gait disorders, tremors and
neuropathy
Lesion of CN 1
Olfactory - smell
Anosmia, or loss of smell
Unilateral loss of smell (anosmia). Is more important than bilat loss, because it indicates a lesion
affecting the olfactory nerve or tract on that side.
Lesion of CN 2
Optic - vision
amaruosis
results in same side blindness and no direct pupillary light reflex.
Afferent (Optic):If one of the 2nd cranial nerves (optic nerve) is damaged, vision in the affected eye may
be partially or completely lost
amaurosis
partial or total blindness without visible change in the eye, typically due to disease of the optic nerve,
spinal cord, or brain.
lesion of CN 3
Oculomotor - eye movements, pupillary constriction, accommodation
Diplopia, ptosis, mydriasis, loss of accommodation
paralysis of ocular muscles
loss of accommodation
Presbyopia is the irreversible loss of accommodative ability of the eye that occurs with aging
interferes with pupillary light reflex because of damage of parasympathetic fibers that mediate the
efferent limb
diplopia
double vision
ptosis
drooping of the upper eyelid
mydriasis
dilation of the pupil
presbyopia
