Higher mental function

The following are points in a neurological examination that relate to higher mental function:

• right or left handedness
  
  
• level of arousal:
  • awake and alert
  • drowsy
  • stuporous
  • comatose
  • the Glasgow coma score may be used
    
    
• orientation: in person, place, date
  
  
• commands:
  • one step midline - "stick out your tongue"
  • one step limb - "show three fingers"
  • two step - "point to the ceiling and floor"
  • three step - "take paper, fold, put on floor"
  • crossing the midline - "touch left ear with right finger"
    
    
• memory:
  • 3 objects - immediate recall, e.g. Birmingham, Winston Churchill, shoe.
    
    
• cognitive functioning- spell WORLD forwards and backwards, proverb interpretation, digit span, maths.
  
  
• language & free speech:
  • name some objects, e.g. finger, watch
  • repetition "no ifs ands or buts" - tests Broca's area
    
    
• memory - recall the three objects