Introduction
The examination and evaluation of somatosensory function requires a systematic and comprehensive approach in order to accurately interpret the impact of somatosensory deficits on an individual’s ability to perform specific activities and to participate in activities of daily living. The first step in preparing to administer tests and measures of somatosensation is to ensure that the patient has the mental ability to participate in the tests and measures. For example, the patient needs to be able to attend to the task, remember instructions, and understand how to respond to instructions, stimuli, and questions. Prior to testing somatosensation, the health care practitioner should assess the patient’s level of arousal, orientation to person, place ,and time, attention, and general cognitive abilities. The following section will present fundamental definitions, identify important considerations, and present two methods for mental status examination. The mental status examination methods used as examples presented in this section of the study guide are not a substitute for a complete and systematic mental status examination.
Definitions
Arousal is the physiological readiness of the human system for activity (APTA Guide to Physical Therapist Practice). Common clinical terms used to describe level of arousal include alert, lethargic, stupor, semi-comatose, and comatose.
Orientation is the patient’s awareness to person, place, time, and situation. Asking questions such as “What day is it?", “What season is it?", “What is your name?", and “Where are you?" can give you an understanding of a person’s orientation.
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