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12 Cards in this Set

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What are the two primary components of consciousness?
AROUSAL & CONTENT
AROUSAL: brainstem function that governs wakefulness particularly in the reticular activating system
CONTENT: the sum of cerebral hemisphere functions (thought, behavior, language, expression)
What are the two primary components of consciousness?
Define each one.
AROUSAL & CONTENT
AROUSAL: brainstem function that governs wakefulness particularly in the reticular activating system
CONTENT: the sum of cerebral hemisphere functions (thought, behavior, language, expression)
A & C
What do disruptions in either/both arousal and content cause?
Altered level of consciousness.
Name some structural problems that cause altered level of consciousness.
Tumors
Cerebral Edema
Brain Trauma
Cerebral Emboli
Name some metabolic problems that cause altered level of consciousness.
Hypoglycemia
Hypoxia
Diabetic Keto Acidosis
Hyponatermia
Opioids
Lead Toxicity
Hypothermia
Seizures
Define a "persistent vegetative state".
When does it develop?
What functions are intact?
What function are not intact?
Condition where patient demonstrates eye opening and sleepwake cycles that indicate arousal, but don't exhibit cognitive function. Develops after sever bain trauma.
Functions of the brainstem (respirator drive, brain stem reflexes, Some RAS) are intact.
Cognition that allow them to interact with there environment are not intact.
Define "locked-in syndrome".
What can and can't they do?
Condition where motor pathways in brainstem are destroyed but RAS & highter cognitive functions intact.
Can move eyes, think, sensory perception
Can't: move, speak
What are the criteria for being brain dead (4 total).
1)Coma has know cause and is unreversible.
2)Unresposive to external stimuli.
3)Absent brainstem function.
4)Absent respiratory effort and presence of hypercapnea.
What can you use to assess LOC?
Mental Status Exams
Motor Exam (strength, coordination, stimulus)
Symmetry of Facial Expression
Sensory
Cranial Nerve Exam
Glasgow Coma Scale
Explain the negative pathophysiology for increased intracranial pressure.
As pressure increases arterial perfusion decreases due to compression leading to ischemia then hypoxia then necrosis. CO2 increases resulting in dilation of cerebral arteries resulting in increased ICP.
^pressure>perfusion decreases
CO2
What are the 3 places that brain herniation occurs.
Falx cerebri
Uncal
Transforaminal
T.U.F.
What are the early and late signs of increased intracranial pressure.
Early: Decresed LOC (best) and headache.
Late: Decline in LOC, elevated SBP, decreased DBP, heat rate < 60, shallow slow respirations/apnea/irregular respirations, decorticate or decerebrate posturing, dilation of one or both pupils, fever.