Arousal functions include wakefulness and basic eyes-open alerting functions. Anatomically, neurons responsible for these arousal functions reside in the reticular activating system, a collection of neurons scattered through the midbrain, pons, and medulla. The neuronal structures responsible for the content of consciousness reside in the cerebral cortex. Content of consciousness includes self-awareness, language, reasoning, spatial relationship integration, emotions, and the myriad complex integration functions that we regard basic to being human. Following this model, disorders of consciousness may be divided into processes that affect either arousal functions, content of consciousness functions, or combinations of both functions.
Mental status is the clinical state of emotional and intellectual functioning of the individual.
Emergency physicians seldom perform the same aspects of mental status examination as general psychiatrists. Testing the mental status is done both formally and informally during patient evaluation. Currently no standardized testing is done in most emergency departments. Alerting functions are working, perhaps overworking. The patient may have difficulty in focusing, shifting, or sustaining attention.