Conciousness Flashcards

1
Q

What is conciouness?

A

Very hard to define:

  1. experience and awareness of the self and world around us
  2. Something that is like a “first-person narrative”
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2
Q

What are the different elements of conciousnes?

A
  1. Level of conciouness
    • awake?
    • Asleep
  2. Content of conciousness
    • Happens when eyes are open
    • can be nothing
    • but can also be highly intlectual content
  3. Self
    • seperate experience from external world
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3
Q

What is the differenc between brain death, coma and persistent vegitative state?

A

All three have no levels of awareness but

  1. Brain death
    • total absence of brain function
    • absent relflexes etc.
  2. Coma
    • eyes-closed, depressed consciousness from which they cannot be aroused
    • but brain stem reflexes are present, spontaneous breathing + motor function possible
  3. Vegetative state (e.g. end state dementia)
    • eyes might be open
    • non-purposeful movements might be present
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4
Q

What are the main structural components of the Reticular formation (RF)?

A

Mainy located in the

  • Ventral tegmental area (dopaminergic neurones) (midbrain)
  • Locus coeruleus (noradrenergic neurones) (pons)

but projects into

  • RF projects to the hypothalamus, thalamus and the cortex –> basically everywhere
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5
Q

What is the main function of the Reticular formation?

A

The degree of activity in the reticular system is associated with alertness/levels of consciousness

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6
Q

What is the neurological mechanism of conciousness?

A
  • There is no single brain region for conciousness
  • the interaction of many regions determines the level of conciouness

–> normally way the neurons are interactiong and interaction of neurons over time

Need a mixutre of integration of different regiona but also Differentiation in brain regions (if everything the same–> seizure)

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7
Q

What is TMS?

A

Transcranial magnetic stimmulation

–> stimmulates different regions of the brain externally

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8
Q

How is TMS used in determination of level of conciousness?

A
  1. TMS stimulus is induced
  2. Measuring brain activity straight after stimmulation
  3. The more complex–> the more concious the person is

–> Compexity measures variation (not seizrous) and is used as diversity of brain activity = high conciousness

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9
Q

What is PCI?

A

Pertubational complexity index–> Quantifyingbrain complexity using transcranial magnetic stimulation and EEG

  1. The more complex the EEG response after a stimmulation (TMS) is, the more concious is the person
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10
Q

What is coma?

A

absent wakefulness and absent awareness

–> unarousable unresponsiveness

failure to respond normally to light, pain, or sound stimmuli

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11
Q

What is the vegetative stateß

A

State of wakefullness without awareness with

  • spontaneous stimmulus induced arousal
  • sleep-wake cycle
  • reflexive and spontaneous behaviours
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12
Q

What is the minimally concious state?

A

State of wakefullness with minimally but clear evidence of awareness (destruction of cortex and heminspheres)

  • inconsistend but reproducibel responses to stimmuli above reflex behavior
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13
Q

What is the Neural correlates of consciousness (NCC)?

A

Neural pathways that indicate/ are responsible for conciousness

  • The minimum neuronal mechanisms jointly sufficient for any one specific conscious experience.
  • Primarily localized to a posterior cortical hot zone that includes sensory areas

–> not known yet

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14
Q

Inwhich states of wakefullness can you see which EEG waves?

A
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15
Q

What are delta EEG waves?

When are teex seen?

A

slow EEG waves (up to 4Hz) seen in sleep

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16
Q

What are Theta EEG waves?

When can they be oserved?

A

WAves 4-8Hz

–> slowing is bad

17
Q

What is a EEG alpha rythym

A

Syncronised waves in, conciousness when relaxed and eyes are closed –> healthy (mainly in posterior electrodes)

18
Q

What is a EEG beta rythm?

When is it observed?

A

Normally observed in normal wakefulness with eyes open 13-30Hz

19
Q

Sort the following EEG waves from slow to fast

  • Alpha
  • beta
  • delta
  • theta
A
  1. Beta
  2. Alpha
  3. Theta
  4. Delta
20
Q

What are the metabolic causes of coma?

A
  • Drug overdose
  • hypoglycaemia
  • diabetes
  • “the failures” (liver, kidney etc.)
  • hypercalcaemia
21
Q

What is non-metabolic coma?

What are possible reasons?

A

Not linked to metabolic disfunction, mostly traumatic or injury

  • epilepsy, hypoxia, meningitis, stroke, infections, haemorrhages, tumors etc.
22
Q

What is the typicall presentation of tan eytradural haemorrhage

A

Trauma to head

concussion –> loss of conciousness (often fracture+ rupture of middle meningeal artery)

lucit interval (awake+ concious)

loose conciousness again

23
Q

What are diffuse axonal injuries?

A

White matter tract injury

–> When brain moves in trauma –> interruption + damage to tracts can occuer (e.g. in corpus calossum) (dificult to image)

24
Q

What is the problem with posterior fossa lesions?

A

They can compress the brainstem –> bad

25
Q

What is a bilateral medial thalamic infarct?

What are the consequences?

A

Stroke causing damage to the thalamo-cortical system –> loss of conciousness