Arousal and Consciousness questions

Nystagmus response refers to ___

involuntary rapid eye movements either side to side or up and down

Which of the following is incorrect? Executive function is important for __

sustained attention.

An abnormal breathing pattern characterized by halting respiration at the peak of inspiration and then resuming is known as __

apneusis.

What is the purpose of the ascending arousal pathways?

To increase / improve wakefulness and vigilance

Which structures in the determine the level of arousal/responsiveness of cortex to stimuli?

Thalamic Relay Neurons

What does an EEG measure?

Activity in the thalamocortical systems

De-synchronized EEG __ voltage and ___ frequency indicates ___or lesion to ___.

LOW voltage, HIGH frequency, indicates wakefulness or lesion to lower medulla

Synchronized EEG ___ voltage and ___ frequency indicates ___ or lesion of the ___; with a ____ pattern

HIGH voltage, LOW frequency, indicates sleep or lesion to inferior colliculi of midbrain; has burst/relax pattern

T/F lesion to the lower medulla will not impact the AAP.

True

Which structure regardless of the EEG type determines the mode?

Thalamic Relay Neurons

To determine the lesion location that impacts the ascending arousal pathway slash our ability to maintain consciousness we should observe and assess what?

Respiratory patterns, motor responses, people area reflexes, and eye movements

Decerebrate posturing refers to ___

UE Extension and IR and LE Extension and IR

Decorticate posturing refers to __

UE flexion and IR and LE extension IR

Where is the most severe area to have a lesion that disrupts the AAP / ability to maintain wakefulness?

Midbrain rostral to inferior colliculi

Hyperventilation and upper extremity flexion and IR or lower extremity extension and IR may indicate a lesion where?

Midbrain

Irregular or variable breathing and inability to track eyes in opposite direction of head turn may indicate a lesion to which part of the brain?

Rostral medulla

VOR requires the patient to ___

Maintain eyes on stationary target while moving head or body (eyes move in opposite direction of body)

You should use __ reflex to test VOR in a comatose patient.

Doll's Eyes

Caloric stimulation is best used to test __ response

Nystagmus

A patient described as lethargic means that arousal is ___ and the patient can ___ to wakefulness

Mildly depressed, easily brought

A patient described as a obtunded is likely to be ___ and have ____ responses

Sleepy, slowed

A patient described as stuperous may have a ___ state, and is likely to have _____ wakefulness given ____ stimulation

Sleep-like, momentary / brief, rigorous

An encephalopathy is a ___ state of complete alertness with poor quality not attributable to another cause

acute

Dementia is a __ state of complete alertness with poor quality not attributable to another cause

chronic

Cognition is the ability to __ information

know and process

Damage to which cranial nerve would result in loss of pupilary light responses?

CN III

Selective attention refers to focusing on a task continuously for ___

Minutes

Working memory refers to __ memory

short-term

Doing mental math and is an example of what kind of executive functioning?

Working memory

The Stroop color task is an example of what kind of executive functioning?

Supervisory control

The ability to inhibit habitual responses utilizes which type of executive functioning?

Supervisory control

 The ventromedian frontal cortex plays a significant role in which type of executive functioning?

Supervisory control

Agnosia refers to difficulty with ___

Recognizing or identifying objects people or geometric features

A pt with appreciative visual agnosia likely has trouble ___

Drawing representations of concept / words

A pt with associative visual agnosia likely has trouble with ___

Naming objects/ people

A lesion in the parietal cortical region may be indicative of which component of cognition?

Perceptual motor function

A patient with apraxia may have trouble with __

Dressing, brushing hair, imitating gestures based off of verbal commands

A patient with Left sided spatial neglect likely has an injury to the ___ side /hemisphere

Right

You decide to test your patient's gait with a 6MWT post-stroke. During the course of the walk, you notice that when they turn left to follow the course, their left arm tends to hit the chairs in the hallway and grazes the doorway on the left hand side. Based on this information, where do you expect an brain lesion to be located?

Right hemisphere, inferior parietal lobe

When thalamic relay neurons are in burst mode ___

the patient may be asleep.

Hemispatial neglect ___

is observed on the side of the body contralateral to the lesion.

Which of the following is incorrect? Agnosias may involve ___

the inability to make simple gestures, sequences of moment, or use common tools during movement.

When present, the doll's eye reflex should be interpreted to mean that the patient ___

probably has no structural damage to the brainstem.

Your patient is in a very sleepy state and it takes considerable effort for you to wake them. Once awake, their responses are slowed. This state of arousal is best described as ___

obtunded.