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4 DEM > 9 Sleep and Consciousness > Flashcards

9 Sleep and Consciousness Flashcards

1
Q

What is Gestalt Organisation?

A

perceptions interpreted into meaningful information

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2
Q

What is an illusion?

A

abnormal perception of external stimulus

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3
Q

What is a hallucination?

A

perception in absence of external stimulus without subjective control

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4
Q

What is affective illusion?

A

dependent on subject mood

fightened child at night mistakes towel hanging by wall for moving person

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5
Q

What is pareidolia?

A

images seen in abstract shapes due to fantasy thinking

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6
Q

Name some organic causes of hallucination

A 
brain pathology
tumour
CVA
ACS
seizure
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7
Q

Name some non-organic causes of hallucination

A

SCZ

affective disorders

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8
Q

What are the types of auditory hallucinations?

A

second person
third person
running commentary

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9
Q

What are the types of visual hallucinations?

A

simple (flashes of light)

complex (moving images)

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10
Q

What are passivity hallucinations?

A

sensory change

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11
Q

Which patients might get gustatory or olfactory hallucinations?

A

epilepsy patients

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12
Q

What are the 3 dimensions of unconsciousness?

A

Coma / vegetative state / MCS
Dissociative disorders
Sleep

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13
Q

What is consciousness?

A

A state of awareness of self and the environment

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14
Q

What are the features of clouding?

A

disorientation, agitation

impared attention, concentration, recognition, comprehesion, understanding, and judgement

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15
Q

What are the features of drowsiness?

A 
tendency to drift into sleep without sensory stimulation
slow actions
slurred speech
reduced reflexes
muscle tone
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16
Q

What does PDOC stand for?

A

Prolonged Disorders of Consciousness

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17
Q

What 2 states may people in PDOC be in?

A

Vegetative State

Minimally Conscious State (MCS)

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18
Q

What a vegetative state?

A

PDOC < 4 weeks
permanent <6 months (not TBI)
<12 months (TBI)

wakefulness with absent awareness

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19
Q

What is coma?

A

absent wakefulness, absent awareness

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20
Q

What is MCS?

A

wakefulness with minimal awareness

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21
Q

What are the compatible features of vegetative states?

A

spontaneous movements
reflexive movements
eyes may turn fleetingly, although don’t track movement

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22
Q

What are the incompatible features of vegetative state?

A

evidence of discriminative perception
localising or purposeful actions
anticipatory actions
communicative acts

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23
Q

What do those with MCS show clear evidence of?

A

awareness of self or environment

reproducible but inconsistent behaviours

24
Q

Which features are compatible with MCS?

A

following simple commands
Yes/no responses (gestural or verbal)
intelligible verbalisation
purposeful or discriminating behaviours

25
Q

what proportion of adults recover from VS/MCS?

A

TBI 50% adults 6/12 months

20% in 6/12 months

26
Q

What proportion of children with TBI VS/MSC recover?

A

60%

27
Q

What are dissociative disorders?

A

disruption in the usually integrated functions of consciousness, memory identity, and/or perception fo the environment

28
Q

What are the 3 types of dissociative disorders?

A

Depersonalisatin - derealisation disorder

Dissociative amnesia

Dissociative identity disorder

29
Q

What is depersonalisation-derealisation disorder?

A

depersonalisation (detachment from own thoughts and feelings)

derealisation (people, objects, events seem ‘lifeless’ or ‘foggy’)

30
Q

What is dissociative amnesia?

A

cannot remember information about themselves or events in their past life (episodic memory)

31
Q

What is dissociative identity disorder?

A

memory gaps about everyday events and personal information

32
Q

What is the behavioural definition of sleep?

A

recurrent regular reversible state characterised by quiescence and diminished responsiveness to external cues

33
Q

What structure drives wakefulness?

A

Suprachiasmatic nucleus

34
Q

What promotes sleep?

A

sleep homeostat

adenosine levels

35
Q

When during the day do we experience a drop in wake prosperity?

A

after lunch

36
Q

What happens to levels of adneosine during the day?

A

increases

37
Q

What in the base of the brain keeps us awake?

A

reticular activating system

uses ACh

38
Q

What in the lateral hypothalamus keeps us awake?

A

Orexin

39
Q

What causes Narcolepsy?

A

Orexin defficiency

40
Q

What are the relevant structures for non-REM sleep?

A

VLPO (GABA)

41
Q

What are the relevant structures for REM sleep?

A

LDT, PPT (midbrain)

ACh

42
Q

What is the role of the immune system in sleep?

A

IL-1 enhances sleep

Ab titres reduced with sleep

43
Q

What is the role of metabolism in sleep?

A

reduced calorie demand

NREM specific as metabolism demand increased in REM

44
Q

What is the role of glymphatic function in sleep?

A

enhanced connective flow from the brain to the circulation during sleep removing neurotoxins built up during wakefulness (B-amyloid)

45
Q

What is memory acquisition?

A

new information to the brain

46
Q

What is memory cosolidation?

A

processes by which a memory becomes stable

47
Q

What is memory recall?

A

ability to access the information after it has been stored

48
Q

What is declarative memory and its’ 2 types?

A

explicit recall of facts and knowledge

episodic / semantic

49
Q

What is procedural memory?

A

implicit-unconscous remembering how to do something

50
Q

When is procedural memory consolidated?

A

REM sleep

51
Q

When is declarative memory consolidated?

A

in SS if information simple and emotionally neutral

in REM if information complex and emotionally charged

52
Q

What is a Hypnogram?

A

graphical display of overnight sleep/wake cycle

53
Q

How long does each sleep cycle last, and how many do you get?

A

90 minutes

7 a night

54
Q

What sorts of waves do you get in REM sleep?

A

PGO waves and sore tooth waves

55
Q

What happens to frequency and amplitude of the EEG as you go deeper into sleep?

A

slows

56
Q

When is REM sleep usually?

A

second half of sleep, last couple of cycles

57
Q

How is obstructive sleep apnoea treated?

A

CPAP

4 DEM (10 decks)

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