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HLSC 222 > Ch. 15 > Flashcards

Ch. 15 Flashcards

1
Q

Cognitive behavioral functional competence

A

integrated process of cognitive sensory, and motor systems

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2
Q

systems manifested through motor network

A

behaviors that are appropriate to human activity

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3
Q

full comsiousness

A

state of awareness of oneself and appropriate responses to environment

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4
Q

consciousness components

A

-arousal
-awareness

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5
Q

awareness

A

content of thought

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6
Q

arousal

A

state of awareness

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7
Q

alterations of arousal

A

-structural alterations
-metabolic alterations

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8
Q

structural alterations

A

divided according to their location of dysfunction
-supratenorial disorders
-infratentorial disorders

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9
Q

supratenorial disorders

A

disorders (above tentorium cerebelli) produce changes in arousal

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10
Q

infratentorial disorders

A

(below tentorial cerebelli) produce decline in arousal by dysfunction of reticular activating system or brain stem

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11
Q

metabolic alterations

A

disorders produce a decline in arousal by alterations in delivery of energy substrates

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12
Q

alterations in arousal manifestations

A

-level of consiousness
-pupillary reaction
-pattern of breathing
-oculomotor responses
-motor responses

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13
Q

level of consousness

A

-most critical index of neuro function
-changes indicate improvement or deterioration
-highest level of consousness
-normal state-confusion-disorientation-coma

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14
Q

highest level of cosiousness

A

person is a/o to onself, others, place, and time

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15
Q

patterns of breathing

A

-normal breathing= rhythmic pattern
-consiousness deminishes
-cheyne-stokes

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16
Q

diminished consiousness

A

breathing resopondes to changes in PaCO2 levels

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17
Q

Cheyne-stokes

A

altered peroid of tachypnea and apnea directly related to PaCO2

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18
Q

pnea

A

breathing

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19
Q

other related patterns to reduced arousal

A

-apneusis
-ataxic breathing

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20
Q

apneusis

A

prolonged insporatory time and a pause before expiration

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21
Q

ataxic breathing

A

complete irrefularity of breathing with increasing peroids of apnea

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22
Q

pupillary reaction

A

-indicate presence/level of brainstem dysfunction
-brainstem area controlling arousal is adjacent to area controlling pupils
-iscchema
-hypothermia/opiates cause pinpoint pupils

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23
Q

ischemia

A

dialated/fixed pupils

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24
Q

occulomotor responses

A

resting, spontaneous, and reflexive eye movements change at various levels of brain dysfunction
-a,b,c

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25
Q

A- Normal response

A

eyes move together to side opposite from turn of head

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26
Q

B- abnormal response

A

eyes don’t turn together

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27
Q

C- Absent response

A

eyes move indirection of head movement

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28
Q

Caloric ice water test

A

ice is injected into ear canal

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29
Q

Ice water test normal response

A

eyes turn together to side of head where ice is injected

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30
Q

Ice water test abnormal response

A

eyes don’t move together

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31
Q

Ice water test absent response

A

no eye movement

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32
Q

motor responses

A

determon brain dysfunction and indicates most severly damaged side of the brain

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33
Q

patterns of response to motor responses

A
  1. purposful
  2. inappropriate, generalized movement
  3. not present
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34
Q

motor signs indicating loss of cotrical inhibition

A

-decreased consciousness
associated with the performane of primitive reflexes and rigidity (paratonia)

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35
Q

vomiting, yawning, and hiccups

A

complex refles-like motor reaponse integrated in brainstem (medulla oblongotta)

36
Q

dysfunction of the medulla oblongata

A

compulsive/repetitive production of these responses

37
Q

outcomes of alterations in arousal

A

-disability (morbitity) + mortality

38
Q

disability + mortality

A

-outcomes depend on cause and duration of coma
-some individuals never retain consiousness (neurological death)

39
Q

two forms of neurological death

A

-brain death
-cerebral death

40
Q

Brain death (total brain)

A

-neurological determonation of death (NDD)
-brain damage/can’t recover/cant maintain homeostasis

41
Q

Canadian criteria for NDD

A

-unresponsive coma
-no brainstem functions
-no spontaneous respiration (apnea)

42
Q

cerebral death (irreversable coma)

A

-death of cerebral hemispheres except brainstem and cerebellum
-perminant brain damage/individual doesn’t respond a certain way
-brain may continue to maintain homeostasis

43
Q

cerebral death states

A

-persistant vegitative state
-minimally consious state
-locked in syndrome

44
Q

Persistant vegitative state

A

-complete unawareness of self or environment/no speaking/ sleep wake cycle/cerebral function is absent

45
Q

Minimally consious state (MSC)

A

-follow simple commanda, manipulate objects, give Y/n responses

46
Q

Locked in syndrome

A

-complete paralysis of voluntary muscles except eye movement
-content of thought and level of arousal are intact/fully consous
-blinking as communication

47
Q

awareness is

A

-all cognitive function
-mediated by attention networks (EAN)

48
Q

Exective attention networks

A

networks include selective attention and memory involve abstract reasoning, planning, decisionmaking, judgement, and self-control

49
Q

selective attention (orienting)

A

-ability to select specific information and focus on related specific task
-also includes selective visual and auditory attention

50
Q

Executive attention deficits

A

-intial detection
-mild deficit
-severe deficit

51
Q

initial detection

A

person fails to stay alert and oriented to stimuli

52
Q

mild deficit

A

grooming and social graces are lacking

53
Q

severe deficit

A

motionless/lack of respose/ doesn’t react to surroundings

54
Q

characteristics of executive attention deficits

A

inability to maintain sustained attention and ability to set goals and recognize when goal is achieved

55
Q

memory

A

recording, retention and retrieval of information

56
Q

amnisa

A

loss of memory

57
Q

retrograde amnsia

A

difficulty rerieving past memories

58
Q

anterograde amnesia

A

inability to form new memories

59
Q

Data processing deficits

A

-problems associated with recognizing and processing sensory information
-5 stages

60
Q

5 stages of data processing deficits

A
  1. agnosia
  2. Dysphasia
  3. Acute confusional states and delirium
  4. dementia
  5. frontotemporal dementia
61
Q

Angosia

A

-defect of pattern recognition
-failure to recognize form and nature of objects
-usually only one sense effected
-associated with cerebrovascular accidents ot specific brain areas

62
Q

dysphasia

A

impairment of comprehensionor production of language

63
Q

types of dysphasia

A

-expressive dysphasia
-receptive dysphasia

64
Q

expressive dysphasia (broca dysphasia)

A

-loss of ability to produce spoken or written language
-can comprehend verbal

65
Q

receptive dysphasia (wernicke dysphasia)

A

-inability to understand written or spoken language
-speech is fluent, but no words and phrases have meaning

66
Q

dysphasia cause

A

occlusion of middle cerebral artery

67
Q

middle cerebral artery

A

1/3 major arteries supplying blood to brain

68
Q

Acute confusional states and delirium

A

-transient disorders of awareness and may have sudden or gradual onset

69
Q

causes of acute confusional states and delirium

A

drug intoxication, alcohom withdrawl, post anesthesia, electrolyte imblalnce

70
Q

pathophysiology of acute confusional states and delerium

A

-disruption of reticular system, thalamus, cortex,and limbic system

71
Q

delirium

A

-hyperactive acute confusional state
-common in critical care unity >2-3 days causes sisruption of neurotransmitters Acetylcholine and dopamine

72
Q

excited delerium syndrome

A

-hyperkineric delerium that can lead to sudden death
-rapid breathing,high tolerance to pain, superhuman strength

73
Q

manifestations of acute confusional states and delierium

A

-terrifying dreams
-hallucinations
-gross alteration of perception
-individual can’t sleep

74
Q

evaluation of acute confusional states and delierium

A

-CAM-ICU

75
Q

CAM-ICU

A

confusion assesment method for intensive care unit

76
Q

Dementia

A

deterioration/progressive failure of many cerebral functions

77
Q

causes of dementia

A

-cerebral neuron degeneration
-atherosclerosis
-genetics

78
Q

manifestations of dementia

A

-no specific cure
-maximix remaning capacities
-helping family to understand

79
Q

Alzhemiers disease

A

leading cause of severe cognitive dysfunction in older adults
-unknown cause

80
Q

forms of alzheimers

A

-Nonheditary sporadic late onset AD
-early onset familial AD
-early onset AD

81
Q

Nonheriditary sporadic late onset AD

A

-most common form
- no specific genetic association

82
Q

early onset familial AD

A

linked to chromosome 21 mutations

83
Q

early onset AD

A

-rare
-inked to chromosomal 19 mutations

84
Q

pathophysiology of AD

A

-all alterations for types of AD are the same
-accumulation of toxic fragments of amyloid plagues
-loss of acetylcholine in forbrain choliergic neurons = death of neurons

85
Q

key components of alzheimers disease

A

HLSC 222 (9 decks)

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