Serial Sevens
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Serial Sevens
Serial sevens (or, more generally, the descending subtraction task; DST), where a patient counts down from one hundred by 7, sevens, is a clinical test used to test cognition; for example, to help assess mental status after possible head injury, in suspected cases of dementia or to show sleep inertia. This well-known test, in active documented use since at least 1944, was adopted as part of the mini-mental state examination. The test is also used in determining when a patient is becoming unconscious under anaesthetic, for example prior to major dental surgery. On its own, the inability to perform 'serial sevens' is not diagnostic of any particular disorder or impairment, but is generally used as a quick and easy test of Attentional control, concentration and memory in any number of situations where clinicians suspect that these cognitive functions might be affected. Each subtraction is considered as a unit and calculations are made on the basis of the 14 possible correct subtraction ...
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Mental Status
The mental status examination (MSE) is an important part of the clinical assessment process in neurological and psychiatric practice. It is a structured way of observing and describing a patient's psychological functioning at a given point in time, under the domains of appearance, attitude, behavior, mood and affect, speech, thought process, thought content, perception, cognition, insight, and judgment. There are some minor variations in the subdivision of the MSE and the sequence and names of MSE domains. The purpose of the MSE is to obtain a comprehensive cross-sectional description of the patient's mental state, which, when combined with the biographical and historical information of the psychiatric history, allows the clinician to make an accurate diagnosis and formulation, which are required for coherent treatment planning. The data are collected through a combination of direct and indirect means: unstructured observation while obtaining the biographical and social inform ...
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Head Injury
A head injury is any injury that results in trauma to the skull or brain. The terms ''traumatic brain injury'' and ''head injury'' are often used interchangeably in the medical literature. Because head injuries cover such a broad scope of injuries, there are many causes—including accidents, falls, physical assault, or traffic accidents—that can cause head injuries. The number of new cases is 1.7 million in the United States each year, with about 3% of these incidents leading to death. Adults have head injuries more frequently than any age group resulting from falls, motor vehicle crashes, colliding or being struck by an object, or assaults. Children, however, may experience head injuries from accidental falls or intentional causes (such as being struck or shaken) leading to hospitalization. Acquired brain injury (ABI) is a term used to differentiate brain injuries occurring after birth from injury, from a genetic disorder, or from a congenital disorder. Unlike a broken bon ...
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Dementia
Dementia is a disorder which manifests as a set of related symptoms, which usually surfaces when the brain is damaged by injury or disease. The symptoms involve progressive impairments in memory, thinking, and behavior, which negatively affects a person's ability to function and carry out everyday activities. Aside from memory impairment and a disruption in thought patterns, the most common symptoms include emotional problems, difficulties with language, and decreased motivation. The symptoms may be described as occurring in a continuum over several stages. Consciousness is not affected. Dementia ultimately has a significant effect on the individual, caregivers, and on social relationships in general. A diagnosis of dementia requires the observation of a change from a person's usual mental functioning, and a greater cognitive decline than what is caused by normal aging. Several diseases and injuries to the brain, such as a stroke, can give rise to dementia. However, th ...
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Sleep Inertia
Sleep inertia is a physiological state of impaired cognitive and sensory-motor performance that is present immediately after awakening. It persists during the transition of sleep to wakefulness, where an individual will experience feelings of drowsiness, disorientation and a decline in motor dexterity. Impairment from sleep inertia may take several hours to dissipate. In the majority of cases, morning sleep inertia is experienced for 15 to 30 minutes after waking. Sleep inertia is of concern with decision-making abilities, safety-critical tasks and the ability to operate efficiently soon after awakening. In these situations, it poses an occupational hazard due to the cognitive and motor deficits that may be present. Symptoms * "Grogginess", as defined by a drowsy or disoriented state in which there is a dampening of sensory acuity and mental processing. * Impaired motor dexterity and decrease in cognitive ability. These gross impairments may be responsible for the associated incre ...
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Attentional Control
Attentional control, colloquially referred to as concentration, refers to an individual's capacity to choose what they pay attention to and what they ignore. It is also known as endogenous attention or executive attention. In lay terms, attentional control can be described as an individual's ability to concentrate. Primarily mediated by the frontal areas of the brain including the anterior cingulate cortex, attentional control is thought to be closely related to other executive functions such as working memory. General overview of research Sources of attention in our brain create a system of three networks: alertness (maintaining awareness), orientation (information from sensory input), and executive control (resolving conflict). These three networks have been studied using experimental designs involving adults, children, and monkeys, with and without abnormalities of attention. Research designs include the Stroop task and flanker task, which study executive control with analy ...
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Memory
Memory is the faculty of the mind by which data or information is encoded, stored, and retrieved when needed. It is the retention of information over time for the purpose of influencing future action. If past events could not be remembered, it would be impossible for language, relationships, or personal identity to develop. Memory loss is usually described as forgetfulness or amnesia. Memory is often understood as an informational processing system with explicit and implicit functioning that is made up of a sensory processor, short-term (or working) memory, and long-term memory. This can be related to the neuron. The sensory processor allows information from the outside world to be sensed in the form of chemical and physical stimuli and attended to various levels of focus and intent. Working memory serves as an encoding and retrieval processor. Information in the form of stimuli is encoded in accordance with explicit or implicit functions by the working memory processor. ...
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Concussion
A concussion, also known as a mild traumatic brain injury (mTBI), is a head injury that temporarily affects brain functioning. Symptoms may include loss of consciousness (LOC); memory loss; headaches; difficulty with thinking, concentration, or balance; nausea; blurred vision; sleep disturbances; and mood changes. Any of these symptoms may begin immediately, or appear days after the injury. Concussion should be suspected if a person indirectly or directly hits their head and experiences any of the symptoms of concussion. It is not unusual for symptoms to last 2 weeks in adults and 4 weeks in children. Fewer than 10% of sports-related concussions among children are associated with loss of consciousness. Common causes include motor vehicle collisions, falls, sports injuries, and bicycle accidents. Risk factors include drinking alcohol and a prior history of concussion. The mechanism of injury involves either a direct blow to the head or forces elsewhere on the body that a ...
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Sensitivity And Specificity
''Sensitivity'' and ''specificity'' mathematically describe the accuracy of a test which reports the presence or absence of a condition. Individuals for which the condition is satisfied are considered "positive" and those for which it is not are considered "negative". *Sensitivity (true positive rate) refers to the probability of a positive test, conditioned on truly being positive. *Specificity (true negative rate) refers to the probability of a negative test, conditioned on truly being negative. If the true condition can not be known, a " gold standard test" is assumed to be correct. In a diagnostic test, sensitivity is a measure of how well a test can identify true positives and specificity is a measure of how well a test can identify true negatives. For all testing, both diagnostic and screening, there is usually a trade-off between sensitivity and specificity, such that higher sensitivities will mean lower specificities and vice versa. If the goal is to return the ratio at w ...
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Cognitive Impairment And Dementia Screening And Assessment Tools
Cognition refers to "the mental action or process of acquiring knowledge and understanding through thought, experience, and the senses". It encompasses all aspects of intellectual functions and processes such as: perception, attention, thought, intelligence, the formation of knowledge, memory and working memory, judgment and evaluation, reasoning and computation, problem solving and decision making, comprehension and production of language. Imagination is also a cognitive process, it is considered as such because it involves thinking about possibilities. Cognitive processes use existing knowledge and discover new knowledge. Cognitive processes are analyzed from different perspectives within different contexts, notably in the fields of linguistics, musicology, anesthesia, neuroscience, psychiatry, psychology, education, philosophy, anthropology, biology, systemics, logic, and computer science. These and other approaches to the analysis of cognition (such as embodied c ...
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Cognitive Tests
Cognitive tests are assessments of the cognitive capabilities of humans and other animals. Tests administered to humans include various forms of IQ tests; those administered to animals include the mirror test (a test of visual self-awareness) and the T maze test (which tests learning ability). Such study is important to research concerning the philosophy of mind and psychology, as well as determination of human and animal intelligence. Modern cognitive tests originated through the work of James McKeen Cattell who coined the term "mental tests". They followed Francis Galton's development of physical and physiological tests. For example, Galton measured strength of grip and height and weight. He established an "Anthropometric Laboratory" in the 1880s where patrons paid to have physical and physiological attributes measured. Galton's measurements had an enormous influence on psychology. Cattell continued the measurement approach with simple measurements of perception. Cattell's t ...
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