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Neuroscience > disorders of consciousness and death > Flashcards

disorders of consciousness and death Flashcards

exam 1

1
Q

arousal (wakefulness) requires the

A

ascending reticular activating system

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2
Q

awareness (content) requires

A

cerebral cortex and its connections to the subcortical structures

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3
Q

An active process often defined as the state of awareness of the self and the environment

A

consciouseness

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4
Q

loss consciousness is always pathological

A

nope; it can be normal as part of the sleep-wake cycle

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5
Q

state of drowsiness or near-sleep

A

somnolence

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6
Q

extreme fatigue or drowsiness

A

lethargy

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7
Q

syndrome of global brain dysfunction

A

encephalopathy

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8
Q

encephalopathy Caused by damage or suppression of the

A

brainstem ARAS or of both cerebral hemispheres

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9
Q

is the sleep-wake cycle absent in people on a coma?

A

yep

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10
Q

unarouseable unresponsiveness

A

coma

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11
Q

apallic syndrome

A

persistent vegetative state

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12
Q

State of complete unawareness in which the patient may open eyes spontaneously or to verbal stimuli, but without recognition of the environment

A

PVS

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13
Q

lights on but no one is home

A

PVS

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14
Q

PVS unlike coma is associated with sleep-wake cycles

A

yep

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15
Q

when to dx. PVS?

A

not before one month for non-traumatic and before 1 yr after traumatic

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16
Q

prognosis for PVS poor?

A

yea; generally adults have a 50% of recovery while children have a 60% from PVS w/in 6 months

17
Q

Minimally conscious state is between

A

PVS and normal

18
Q

MCS have a better prognosis than PVS

A

yea

19
Q

Locked in syndrome typically caused by a

A

pontine infarction

can also be caused by:

  • ALS
  • Guillain Barre
  • MS
  • snake bites
20
Q

intact occulomot system but otherwise complete paralysis

A

locked in syndrome

21
Q

central pontine myelinolysis is caused

A

by a dymyealination in the pons

  • can cause Locked in syndrome
22
Q

what chemoreceptors are spared in locked in syndrome leading to intact respiratory function

A

ventral medulla

23
Q

what other features are left intact with locked in syndrome

A

RAS and Hearing

24
Q

Directly compressing the ascending arousal system or distorting brain tissue (shift) so it secondarily compresses components of the ascending arousal system.

A

compressive lesions

25
Q

Directly cause damage to the ascending arousal system through tumor, hemorrhage, stroke, trauma and infection

A

destructive lesions

26
Q

multifocal, diffuse disease causing coma (just name a few)

A
  • ischemia, hypoxia

- glucose disorders

27
Q

Doll’s eyes afferent and efferent

A

afferent: CN 8
Efferent: CN 6 and 3

28
Q

Caloric reflex afferent and effect

what relfex is this?

A

afferent: CN 8
efferent: CN 3, 6, 4

cold water in ear and to see if head/eyes turns to the ipsilateral

29
Q

nystagmus in contralateral in caloric reflex?

A

normal

30
Q

hypertension and Bradycardia should be setting off warning bells for

A

intracranial hypertension

31
Q

FOUR

A

dull outline of unresponsivenss

score of 16

32
Q

Poor prognostic signs in post-anoxic coma

Absent pupillary responses = _____
Absent corneal respons= ____
Absent motor responses= ____
Absent Somatosensory Evoked Potentia= ____

A

Absent pupillary responses, Day 1

Absent corneal responses, Day 1

Absent motor responses, Day 3

Absent Somatosensory Evoked Potentials within the first week

33
Q

sepsite sophisticated techniques is TIME still the most uselful tool to prognosticate?

A

yes

34
Q

determination of Death by

A

neurologic criteria

35
Q

Brain death determined by what criteria?

A
  1. total cessation of hemispheric and brainstem neuronal functioning
  2. irreversible brain injury
36
Q

cardinal features of brain death

A
  1. unresponsive
  2. no brainstem reflexes
  3. apnea test; absence of respiratory reflex
37
Q

brain death ancillary testing

A
  1. cerebral blood flow
  2. EEG
  3. ultrasound
  4. nuclear flow study SPECT- no uptake of isotope in the brain

Neuroscience (35 decks)

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