MENTAL STATUS EXAM: NORMAL EXAM
Asking questions about month, date, day of week and place tests orientation, which involves not only memory but also attention and language. Three-word recall tests recent memory for which the temporal lobe is important. Remote memory tasks such as naming Presidents, tests not only the temporal lobes but also heteromodal association cortices.
Digit span, spelling backwards and naming months of the year backward test attention and working memory which are frontal lobe functions.
These frontal lobe functions can be tested by using problem solving, verbal similarities and proverbs.
This is a test of verbal fluency and the ability to generate a set of items which are frontal lobe functions. Most individuals can give 10 or more words in a minute.
Asking the patient to follow commands demonstrates that they understand the meaning of what they have heard or read. It is important to test reception of both spoken and written language.
In assessing expressive language it is important to note fluency and correctness of content and grammar. This can be accomplished by tasks that require spontaneous speech and writing, naming objects, repetition of sentences, and reading comprehension.
The patient is asked to perform skilled motor tasks without any nonverbal prompting. Skills tested for should involve the face then the limbs. In order to test for praxis the patient must have normal comprehension and intact voluntary movement. Apraxia is typically seen in lesions of the dominant inferior parietal lobe.
Gnosis is the ability to recognize objects perceived by the senses especially somatosensory sensation. Having the patient (with their eyes closed) identify objects placed in their hand (stereognosis) and numbers written on their hand (graphesthesia) tests parietal lobe sensory perception.
Dominant Parietal Lobe Function
Tests for dominant inferior parietal lobe function includes right-left orientation, naming fingers, and calculations.
Non-Dominant Parietal Lobe Function
The non-dominant parietal lobe is important for visual spatial sensory tasks such as attending to the contralateral side of the body and space as well as constructional tasks such as drawing a face, clock or geometric figures.
Recognition of colors and faces tests visual association cortex (inferior occiptotemporal area). Achromatopsia (inability to distinguish colors), visual agnosia (inability to name or point to a color) and prosopagnosia (inability to identify a familiar faces) result from lesions in this area.