Consciousness

Question 1

What is consciousness defined as?

Answer 1

A state of being aware and responsive of one’s surroundings

Question 2

What is coma defined as, and what is there a complete loss of?

Answer 2

A state of unresponsiveness towards external stimuli with eyes closed.

Complete loss of wakefulness and reactivity

Question 3

What are some possible causes of coma?

Answer 3

• Anaesthesia
• Epilepsy
• Electrolyte or metabolic disturbance
• Thermoregulation disturbance
• Structural damage to the cortex, brainstem or thalamus

Question 4

What are the three possible outcomes after come?

Answer 4

• Reversal and recovery
• Survival into vegetative or minimally conscious state
• Irreversible loss of function of brainstem, cortex or body

Question 5

What is the possible range of scored in the Glasgow Coma Scale and what rating is needed for classification of coma?

Answer 5

3-15

Score of 8 or less indicates coma

Question 6

What are the different categories scored in the Glasgow Coma Scale, and how many points are given to each of them?

Answer 6

Eye opening (1-4 points)

Motor response (1-6 points)

Verbal response (1-5 points)

Question 7

How can vegetative state be caused by and what is the difference between a persistent and permanent vegetative state?

Answer 7

Caused by widespread damage to the cerebral cortex

Persistent: > 4 weeks
Permanent: > 6 months

Question 8

What is the difference between minimally conscious state and vegetative state?

Answer 8

Minimally conscious state is a slight improvement to a vegetative state

Question 9

What is locked in syndrome and what can it be cause by?

Answer 9

State of consciousness but inability to respond

Can be caused by:

• Severe Guillain Barre syndrome
• Ventral pontine damage

Question 10

What is brainstem death, and what are the legal requirements for it?

Answer 10

Irreversible cessation of the function of the brainstem, meaning consciousness can’t be regained.

Legal requirement is that there is an irreversible cause (e.g. damage or anoxia) and no reversible cause (e.g. drugs or hypothermia)

Question 11

What structure in the brain is thought to play a role in consciousness?

Answer 11

Anterior cingulate cortex

Question 12

What reflexes are lost in brainstem death?

Answer 12

Gag, pupillary, cough and pain reflexes