Introduction to Consciousness Flashcards
What is consciousness?
Processes that enable us to experience the world around us
This is distinct from automatic behaviours that occur in a rather unconscious manner
What structure within the brain is heavily involved in regulatingalertness?
Reticular Activating System (this is part of reticular formation)
What is the reticular formation?
A core of grey matter passing through the midbrain, pons and uppermedulla – it is a polysynaptic network that regulates the activity of the cerebral cortex
What are the sensory inputs to the reticular formation?
Sensory and pain from ascending pathways
Vestibular information from medial vestibular nucleus
Visual from superior colliculus
Auditory from inferior colliculus
Olfactory via the median forebrain bundle
The RF modulates cerebral activity via various projections. Where do these projections go to?
Which 2 other areas in the brain work in close relation with the RAS?
thalamus, hypothalamus and cortex
Ventral tegmental area (dopaminergic neurones) (in midbrain)
• Locus coeruleus (noradrenergic neurones) (in pons)
Which of these projections is most important in regulating the level of arousal?
Cholinergic projections
What are the three mechanisms by which these projections regulate the level of arousal?
Excitation of individual thalamic relay nuclei –> activation of cortex
Projections to intralaminar nuclei –> project to all areas of cortex
Projections to reticular nucleus– regulates flow of information through other thalamic nuclei to the cortex
What are the different waveforms seen on an EEG and what levels of arousal do they represent?
Delta (< 4 Hz) – seen in sleep
Theta (4-8 Hz) – drowsiness
Alpha (8-13 Hz) – subject relaxed with eyes closed
Beta (13-30 Hz) – normal waking consciousness
Gamma range (~40 Hz) – creation of conscious contents in the focus of the mind’s
Do The ABGs
What is a cerebral contusion?
Localised bleeding in the brain (bruise in the brain)
What is a concussion?
Diffuse, widespread, homogenous impairment of brain tissue due tobrain trauma
What is acute confusion/delirium and stupor?
Acute confusion and delirium– sustained disturbance of consciousness where mental processes are slowed. Subject may be inattentive, disorientated and having difficulty carrying out simple commands or speaking
Stupor– lack of critical cognitive function and consciousness – only responsive to pain
Damage to the reticular formation can lead to coma. What is a coma?
State of unconsciousness in which the subject cannot be roused even by strong sensory stimuli
Different from sleep – metabolic activity of the brain is depressed and there is total amnesia for this period
State some causes of coma.
Metabolic alteration e.g. hypoglycaemia, hypoxia, intoxication
Bilateral lesions in the cerebral hemispheres
Lesions in the thalamus or brainstem
Describe how the Glasgow Coma Scale is structured.
Eye opening = 4
Verbal responses = 5
Motor responses = 6
What causes a persistent vegetative state?
Disconnection of the brainstem from the cortex or widespread cortical damage
Brainstem is still functioning so reflexes, postural movements and sleep-wake cycle may still be present
