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NSB Extra Lecture Cards > Consciousness > Flashcards

Consciousness Flashcards

1
Q

What is consciousness?

A

State of wakefulness & awareness of self + environment

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2
Q

What is it called when you have a aroused from sleep cycle, have eyes open and motor activity?

A

Wakefulness

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3
Q

What is the feeling of “I am” and subjective experience called?

A

Awareness

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4
Q

What is a state of unrousable responsiveness?

A

Coma

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5
Q

What is a coma-like state that has some but very little responsiveness?

A

Stupor

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6
Q

What is acute, cyclical pattern of confusion called?

A

Delirium

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7
Q

What is abnormally slowed thinking called?

A

Obtundation

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8
Q

What four things constitutes consciousness?

A

Brain arousal / activation
Connected thought patterns
Ability to sense sensory inputs
Ability to effect controlled outputs

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9
Q

What is the sense of the internal state of the body called?

A

Interoception

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10
Q

Where is the interoception sense located in the brain?

A

Anterior Insular Cortex

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11
Q

Which neurons facilitate interoception?

A

von Economo neurons

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12
Q

What is the definition of a coma?

A

A depressed level of consciousness resulting in an unresponsive P who cannot be awakened with pain - that lasts for MORE THAN 6 HOURS

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13
Q

Do Ps have a normal sleep-wake cycle in a coma?

A

No

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14
Q

Do Ps respond to painful stimuli, light or sound in a coma?

A

No

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15
Q

How are the P’s eyes in a coma

A

May get blink response to visual threat & pupillary reactions

When moving P’s head, eyes may stay fixed on a stationary object (Doll’s head manoeuvre positive).

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16
Q

Which two groups commonly cause impaired consciousness?

A

Neurological causes
Metabolic causes

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17
Q

What are the commonest neurological causes of impaired consciousness?

A

Trauma
Cerebrovascular
Infection (esp meningitis)

18
Q

What are the commonest metabolic causes of impaired consciousness?

A

Hypoglycaemia
Hypoxia
Drugs & toxins

19
Q

Which test of consciousness is often used with dementia Ps?

A

4A’s Test (4AT)

20
Q

What is the GCS?

A

Glasgow Coma Scale

21
Q

What is the AVPU and how does it work?

A

Alert
Visual
Pain
Unresponsive

Which response on this scale that Ps respond to

22
Q

What is the RASS?

A

Richmond Agitation Sedation Scale

23
Q

What do we look at when assessing a P’s consciousness?

A

Sensori-motor stimulus and responses inc
- Eyes
- Verbal
- Protective movements and postures
- Spontaneous and voluntary movements
- Voice

24
Q

Which three things are assessed by the GCS?

A

Eye Opening (1 none, 4 spontaneous)
Best verbal response (1 none, 5 - orientated)
Best motor response (1 no movement, 6 - obeys commands)

25
Q

What is the lowest score a P can have on the GCS?

A

3

26
Q

What is localising pain in a P?

A

Patient can recognise where the pain is, localise and try to push you away from the pain

27
Q

When Ps move their limb in an abnormal way - by rotating or extending in response to pain - what does this indicate?

A

That the higher parts of the brain are not functioning

28
Q

Why do we use these tools?

A

To determine which Ps may need protection of airway & determine which are at risk of complications

29
Q

What is the score on the GCS at which Ps cannot protect their airway?

A

< 8

30
Q

How is GCS correlated to outcome in brain injury?

A

Score on GCS can be linked to the successfulness of an outcome for Ps with a brain injury,

31
Q

Name 3 questionnaires used to measure cognitive impairment

A

Mini Mental State Examination (MMSE)
Confusion Assessment Method (CAM)
4 A’s Test (4AT)

32
Q

Name three types of confusion

A

Hyperactive
Hypoactive
Mixed

33
Q

How can you determine delirium from dementia?

A

Delirium - acute & fluctuates
Demential - chronic, steady progression

34
Q

What is a transient loss of consciousness called?

A

Blackout (or syncope)

35
Q

What is syncope usually caused by?

A

Cardiovascular causes

36
Q

What are the three causes of blackout?

A

Syncope
Epilepsy
Hypoglycaemia

37
Q

What is it important to treat blackouts caused by hypoglycaemia?

A

The brain has no store of glycogen = therefore important to treat this.

38
Q

What is it important to ask in the history about what happened prior to the blackout episode?

A
  • Did it follow a change in posture / position
  • Did it follow an activity
  • Did they have an aura
  • Did they have chest symptoms
  • Do they remember falling? (Yes - blackout can be due to head injury, no - unconscious before they hit the floor)
39
Q

What symptoms are important during a blackout?

A

Duration
Seizures?
Urinary incontinence?
Tongue biting?
Pale?
Flushing?
Pulse?
BP? BG?

40
Q

What are risk factors for blackout?

A

Past medical history
Drugs

NSB Extra Lecture Cards (7 decks)

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