Ch. 15 Flashcards
Cognitive behavioral functional competence
integrated process of cognitive sensory, and motor systems
systems manifested through motor network
behaviors that are appropriate to human activity
full comsiousness
state of awareness of oneself and appropriate responses to environment
consciousness components
-arousal
-awareness
awareness
content of thought
arousal
state of awareness
alterations of arousal
-structural alterations
-metabolic alterations
structural alterations
divided according to their location of dysfunction
-supratenorial disorders
-infratentorial disorders
supratenorial disorders
disorders (above tentorium cerebelli) produce changes in arousal
infratentorial disorders
(below tentorial cerebelli) produce decline in arousal by dysfunction of reticular activating system or brain stem
metabolic alterations
disorders produce a decline in arousal by alterations in delivery of energy substrates
alterations in arousal manifestations
-level of consiousness
-pupillary reaction
-pattern of breathing
-oculomotor responses
-motor responses
level of consousness
-most critical index of neuro function
-changes indicate improvement or deterioration
-highest level of consousness
-normal state-confusion-disorientation-coma
highest level of cosiousness
person is a/o to onself, others, place, and time
patterns of breathing
-normal breathing= rhythmic pattern
-consiousness deminishes
-cheyne-stokes
diminished consiousness
breathing resopondes to changes in PaCO2 levels
Cheyne-stokes
altered peroid of tachypnea and apnea directly related to PaCO2
pnea
breathing
other related patterns to reduced arousal
-apneusis
-ataxic breathing
apneusis
prolonged insporatory time and a pause before expiration
ataxic breathing
complete irrefularity of breathing with increasing peroids of apnea
pupillary reaction
-indicate presence/level of brainstem dysfunction
-brainstem area controlling arousal is adjacent to area controlling pupils
-iscchema
-hypothermia/opiates cause pinpoint pupils
ischemia
dialated/fixed pupils
occulomotor responses
resting, spontaneous, and reflexive eye movements change at various levels of brain dysfunction
-a,b,c
A- Normal response
eyes move together to side opposite from turn of head
B- abnormal response
eyes don’t turn together
C- Absent response
eyes move indirection of head movement
Caloric ice water test
ice is injected into ear canal
Ice water test normal response
eyes turn together to side of head where ice is injected
Ice water test abnormal response
eyes don’t move together
Ice water test absent response
no eye movement
motor responses
determon brain dysfunction and indicates most severly damaged side of the brain
patterns of response to motor responses
- purposful
- inappropriate, generalized movement
- not present
motor signs indicating loss of cotrical inhibition
-decreased consciousness
associated with the performane of primitive reflexes and rigidity (paratonia)