Neurological alterations pt 1 Flashcards
A person achieve cognitive and behavioral functional competence by integrated process of the following systems: __, ___ & ___ systems.
Cognitive; sensory; motor
The neuronal systems that are essential to the function of cognitive systems: (1)__ system (create arousal and maintain attention), (2) __ and __ systems (create communication, making speech) (3) __ or __ systems which mediate mood, emotion and intention
Attention; memory language; affective emotive
Consciousness has two components: __ (level of awakeness) & ___ (content of thought)
- Arousal; awareness
Which term refers to a state of awareness both of oneself and of the environment, and a set of responses to that environment, where the individual initiates spontaneous, purposeful activity independently to a perceived stimulus?
Any decrease in this state of awareness and varied responses is a decrease in consciousness, which measuring it is called the level of consciousness or LOC
Full consciousness
Which term refers to the most critical clinical index of nervous system function, with changes indicating either improvement or deterioration of the individual’s condition, and it diminish in stages from confusion and disorientation (which can occur simultaneously) to coma?
Tested with a Glasgow coma scale, to assess if they are opening their eyes, oriented, follow commands
Level of consciousness
(Alterations in the cognitive systems)
Alterations in level of arousal may be caused by 3 categories: __, ___, or ___
Structural, metabolic, or psychogenic (functional) disorders.
(Alterations in the cognitive systems)
___ alterations in arousal are divided according to the original location of the pathological condition.
Causes include infection, vascular alterations (hemorrhage), neoplasms, traumatic injury, congenital alterations, degenerative changes (dementia), polygenic traits, & metabolic disorders
Structural
(Alterations in the cognitive systems)
___ ___ produce a decline in arousal by alterations in delivery of energy substrates as occurs with hypoxia, electrolyte disturbances, or hypoglycemia.
__ ___ caused by liver or renal failure cause alterations in neuronal excitability because of failure to metabolize or eliminate medications and toxins.
Metabolic disorders
(Alterations in the cognitive systems)
___ alterations in arousal (___), although uncommon, may signal general __ disorders.
Despite apparent unconsciousness, the person actually is physiologically awake and the neurological examination reflects normal responses
Psychogenic; unresponsiveness; psychiatric
(Terms describing altered level of consciousness)
Which term refers to the loss of ability to think rapidly and clearly; impaired judgement and decision making?
Which term refers to the person may exhibit restlessness, anxiety, and irritation; ___ to time occurs first, followed by ___ to place and familiar others (family members) and impaired memory; recognition of self is lost last?
Which term refers to limited spontaneous movement or speech; easy arousal with normal speech or touch; may or may not be oriented to time, place, or person?
Which term refers to mild to moderate reduction in arousal (awakeness) with limited response to environment; falls asleep unless stimulated verbally or tactilely; answers questions with minimal response?
Which term refers to a condition of deep sleep or unresponsiveness from which person may be aroused or caused to open eyes only by vigorous and repeated stimulation; response is often withdrawal or grabbing at stimulus?
Which term refers to no motor response to the external environment or to any stimuli, even deep pain or suctioning; there is no arousal to any stimulus, and reflexes may be present, abnormal movement (posturing) to pain may be present?
- Confusion
- Disorientation
- Lethargy
- Obtundation
- Stupor or stuporous
- Coma or comatose
(Alterations in arousal)
With normal breathing, which area of the brain produces rhythmic pattern
When consciousness decreases, which area of the brain regulates the breathing pattern by responding only to changes in partial pressure of carbon dioxide in arterial blood (PaCO2) levels?
Increases in PaCO2 levels lead to ___. The PaCO2 level then decreases to below normal and breathing stops (___) until the carbon dioxide reaccumulates and again stimulates ___. This phenomenon is called ____ ___
- Forebrain (cerebrum)
- Lower brainstem centres
- Tachypnea; apnea; achypnea; Cheyne-Stokes respiration
(Alterations in arousal)
Which term indicates the presence and level of brainstem dysfunction because brainstem areas that control arousal are adjacent to areas that control the pupils, where some medications will also affect the pupils, such as anticholinergic medicatio?
Pupillary changes
(Alterations in arousal)
Which term refers to abnormal eye movements, including nystagmus which indicates alterations in brainstem function, where the eyes should move together, and are not dysconjugate in their movements? Also, no eye movement is indication of brain injury
Oculomotor responses
(Alterations in arousal)
Which term can be classified as (1) purposeful, (2) inappropriate, or (3) not present, where patients are asked to “squeeze my fingers” to determine their ___ ___?
Which term refers to flexion of arms, wrists, and fingers with adduction in upper extremities Bilateral extension, internal rotation, and plantar flexion in lower extremities (bringing into the core) associated with hemispheric damage above the midbrain?
Which term refers to all four extremities in rigid extension with hyperpronation of forearms and plantar extension of feet, associated with sever damage involving the midbrain and upper pons?
Motor responses
- Decorticate posturing/response
- Decerebrate posture/response
(Alterations in arousal)
The size of the pupil is under control by the ___ cranial nerve
A bilateral dilated, unreactive pupil may be due to …?
A unilateral dilated pupil may be due to…?
Other causes for puppillary changes includes..?
- 3rd
- Brainstem injury
- Inter-cranial pressure
- Hypothermia, anoxia, drugs, & ocular trauma
(Alterations in awareness - LOC)
Which term refers to the ability to select specific information to be processed from available, competing environmental and internal stimuli, and to focus on that stimulus (i.e., to concentrate on a specific task without being distracted)?
Selective attention (orienting)
(Alterations in awareness - LOC)
Which term can be temporary, permanent, or progressive, where disorders associated with ___ ____ ___ can be caused by seizures, ___ in brain structure, subdural __, stroke neoplasms, ___ disease, dementia
Selective attention deficits; contusions; hematomas; Alzheimer’s
(Alterations in awareness - LOC)
Which term refers to alterations in the recording, retention, & retrieval of information?
Alterations in memory
(Alterations in awareness - LOC)
Which term refers to mild or severe loss in memory and can be put into 2 categories?
Which category of amnesia refers to when a person has difficulty retrieving past personal history memories or past factual memories?
Which category of amnesia refers to the inability to form new personal or factual memories but memories of the distant past are retained and retrieved?
Memory disorders can be…?
Amnesia
- Retrograde amnesia
- Anterograde amnesia
- Temporary (e.g., after a seizure) or permanent (e.g., after severe head injury or in Alzheimer’s disease).
(Alterations in awareness - LOC)
Executive attention deficits include alterations in …?
An obvious example is..?
- Abstract reasoning, planning, decision-making, judgement, error correction, & self-control
- Attention- deficit/hyperactivity disorder (ADHD)