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Cognitive Alteration
Cognitive Alterations
| Question | Answer |
|---|---|
| Consciousness | State of awareness-”Oriented x3” Person, Place, Time Arousal and wakefulness rely on an intact Reticular Activating System (RAS), a cluster of primitive cells in the central brainstem |
| Consciousness cont'd | Content and cognitive aspects of consciousness dependent on cerebral hemispheres For any deficit in level of consciousness, either the RAS or BOTH cerebral hemispheres concurrently must be injured |
| Reticular Activating System | been around for billions of years, most primitive creature– in Central brain stem– any problem with brain stem, problem with RAS |
| Altered Mental States | Structural: brain tumor, physical pressure Metabolic: glucose levels too low, other electrolytes out of whack Psychogenic: doesn’t mean it’s any less real or treatable |
| Confused | Unable to think clearly or engage in effective problem solving; orientation to time, place, person impaired; easily aroused by verbal stimuli |
| Delirious | Restless and disoriented, may have hallucinations; easily aroused, but may have difficulty with attention |
| Lethargic | Uninterested in surroundings or events; sluggish in thought and motor activities; does not engage spontaneously in activities |
| Obtunded | Falls asleep unless stimulated; arousable with voice or touch, but quickly returns to sleep |
| Stuporous | In a deep state of sleep; vigorous stimulation is required to arouse and a wakeful state is not maintained |
| Comatose | Unable to be aroused, even with vigorous painful stimuli; motor responses, such as withdrawl or posturing, may occur |
| Altered Breathing Patterns: Cheyne-Stokes and Central Neurogenic Hyperventilation | Cheyne-Stokes Respirations: Gradual increase and decrease in rate and depth. Deep cerebral or diencephalic structures Central Neurogenic Hyperventilation: rapid and regular. Midbrain or upper pons Can be reversible if remove the problem, dependin |
| ALtered Breathing Patterns: Apneusis and Cluster breathing | Apneusis: Prolonged pause at full inspiration. Pons Cluster Breathing: irregular clusters. Lower pons and upper medulla Can be reversible if remove the problem, depending |
| Altered Breathing Patterns: Ataxic and Agonal gasps | Ataxic breathing: completely irregular, dysfunction of medullary breathing center Agonal gasps: complete failure of medullary respiratory center |
| Pupillary Changes | Metabolic Imbalance: small, reactive, regular Diencephalic Dysfunction: small and reactive Metabolic: regularly reactive– still be brisk investigate further between metabolic and diencephalic– reaction are the same Met: chemistries Di: phys & hx |
| Pupillary Changes | Pontine Dysfunction: pinpoint Midbrain: midposition and fixed Severe Hypoxia and Ischemia: fixed and dilated |
| Positioning/Posturing | Decorticate: corticospinal tract– coming down from motor cortex. Both arms are flexed and wrists are dorsiflexed and legs extended Decerebrate: arms go from against chest to sides: Cerebral brain stem Usually progressive, Could be one sided |
Created by:
Marissagostanian
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