Sos- Consciousness Controlled Flashcards
a capacity to direct attention and manipulate abstract ideas
Consciousness
wakefulness
arousal
how cortex responds to brainstem which controls arousal
awareness
keeps us at homeostasis of consciousness
brainstem
Anatomy of consciousness requires a network of _______
reticular formation + subcortical nuclei + cortex
route of info of ascending reticular activating system (ARAS)
reticular formation in the midbrain to thalamus to cortex
3D network of neurons (not a nucleus you can identify)
reticular formation
rostral pontine-caudal midbrain RF
MRF
regulates sleep, wakefulness, and arousal
reticular formation
Collect information about multiple sensory modalities – for example: pain, head snap
midbrain reticular formation (MRF) neurons
main pathway when dealing with arousal
midbrain to intralaminar/reticular thalamic nuclei to cortex
important nuclei for Alzheimer’s and reticular formation
Ach nuclei (cholinergic nucleus basalis of Meynert)
unconscious state that is arousable
asleep
unconscious state that is not arousable
coma
GCS < __ for coma/intubation
8
GCS of 13-14
mild impairment
GCS 9-12
moderate impairment
GCS of 3-8
severe impairment
____requires bilateral CNS damage
Coma
punch to the face what two main things can happen
quick interruption of reticular formation (recovery)
diffuse axonal injury/coup/contrecoup
GCS 3-8
everything slowed down
can’t breath on their own
>/= an hour
no voluntary movement
coma
bilateral damage that affects the brain
ex. uncal/central herniation
coma
2 main spots for coma lesions in brainstem
reticular formation
caudal midbrain- upper pons
see corneas under eye lid going back and forth (normal during sleeping) abnormal in vegetative state
Roving eye movements
normal arousal to an awake state but unaware of self or environment
vegetative state
can breathe on their own
brainstem reflexes intact
reflexes present (but only in response to stimulation)
present >/= 1 month (persistent ____)
vegetative state
Most things gone but can still do reflexes b/c spinal loops are still intact—just a reaction to the exam, they can’t elicit it
EEG: flat line
No activity on neuroimaging
brain death
brain death
vegetative state
What neurotransmitter is involved in ARAS or coma states or Alzheimers
Ach
most important nuclei of wakefuleness and found in nucleus basalis of meynert and important for alzheimers
cholinergic nuclei (Ach)
serotonin associated nuclei for wakefulness
rostral raphe n.
what inhibits ARAS (arousal system)
adenosine
what stimulates ARAS and blocks adenosine binding to receptor
caffeine
a normal suspension of ARAS activity
sleep
normal sleep decline with ____
age
good for repair, homeostasis
get rid of breakdown products
new memory formation
deep sleep
slow wave sleep and wide to narrow and not as deep as you progress in the sleep cycle
stages 3 and 4
awake and then right into REM sleep
well-controlled with meds
narcolepsy
abnormal movements, sleep walking, talking, restless leg syndrome, sleep terrors (don’t remember)
stress and lack of sleep can bring this out
non-REM parasomnias
sleep paralysis; hypnagogic hallucinations (right when you start to fall asleep—thought you saw mouse run across room)
REM parasomnia
can be from prion disease (destroys cells), normal to cognitive loss in 3 yrs
happens in a short period of time (can happen with hunters eating raw meat)
fatal familial insomnia
trypanosomes (parasite); lives in blood; causes anemia and patient is sleepy all the time
African sleeping sickness
how does eating regulate sleep and arousal
ghrelin-orexin effects (brain shuts down while body is digesting food)
how does retina regulate arousal
light input that goes to suprachiasmatic nucleus (clock is set here) and then through sympathetics to pineal gland (melatonin)
increase in _______ will start you in sleep pattern and will continue increasing until cycle is over and you wake back up
melatonin
