DEATH AND DYING MIDTERM PREP

What is psychology?

The study of behavior, including overt behavior and mental processes.

What are rationalism and empiricism?

Rationalism uses reason/logic; empiricism relies on observable phenomena and data.

What is empiricism?

The use of observable phenomena or data to gain knowledge.

What is rationalism?

The use of reason, logic, and deduction to reach conclusions.

What is naturalistic observation?

Observing behavior as it naturally occurs without manipulating it.

What is a benefit of naturalistic observation?

It allows behavior to be observed in a natural setting.

What is a limitation of naturalistic observation?

Reactivity, difficult analysis of qualitative data, and difficulty observing some behaviors.

What is a case study?

An in-depth investigation of one or a few cases using methods such as interviews or observation.

What is a benefit of a case study?

It provides detailed information and compelling supporting evidence.

What is a limitation of a case study?

Interaction can reduce objectivity, and the case may be unusual or unrepresentative.

What is a survey?

A research method that asks people questions to collect information.

What is a benefit of surveys?

They can access behaviors that are difficult to observe directly.

What are limitations of surveys?

Low response rates, deception, wishful thinking, social desirability, yea/nay-saying, and poor wording.

What is an experiment?

A study that manipulates a variable to determine whether it causes an effect.

What is the main advantage of an experiment?

Precise control and the ability to draw causal conclusions.

What are limitations of experiments?

Artificial situations plus ethical and practical concerns.

What are the basic steps of scientific research?

Learn the topic, form a hypothesis, design the study, collect data, analyze statistics, and draw conclusions.

Why do researchers use samples?

They cannot measure everyone, so samples allow researchers to study populations and generalize findings.

What is an operational definition?

A precise description of the observable procedures or behaviors used to define and measure a variable.

What is inferential statistics?

Statistics used to determine whether results may be due to chance and to generalize findings to populations.

What does a p-value indicate?

The likelihood of obtaining the observed result if there were no real effect.

What p-value cutoff does the class emphasize?

Whether p is greater than .05 or less than or equal to .05.

What does p ≤ .05 mean?

The result is statistically significant under the class's stated criterion.

What is effect size?

A measure of the magnitude or practical size of a difference or relationship.

How is effect size different from statistical significance?

P-value addresses chance; effect size describes how large the observed effect is.

Why can a large sample be useful?

It generally gives a better basis for generalizing from a sample to a population.

What brain functions can cranial nerve reflexes assess?

Basic brain functioning; the specific nerves are not identified in the notes.

What does the Doll's eyes test measure?

Arousal-related eye movement when the head is tilted from side to side.

What is arousal?

Wakefulness or alertness, supported by the brainstem, thalamus, and reticular activating system.

What is awareness/consciousness?

Conscious perception, cognition, memories, intentions, and awareness of self or environment.

What brain areas support awareness?

The cerebral cortex/frontoparietal network and thalamus.

What are the two types of awareness?

Environmental awareness and self-awareness.

What is environmental awareness?

Awareness of information coming through the senses.

What is self-awareness?

Awareness involving inner speech, mental imagery, mind wandering, and personal/social identity.

Does being awake guarantee awareness?

No. A person must be awake to be aware, but wakefulness does not guarantee awareness.

Is consciousness all-or-nothing?

No. Consciousness exists on a continuum.

What does the medulla control?

Basic vital functions such as breathing and circulation.

What does the pons do?

It contributes to sleep and arousal and connects the brainstem with the cerebellum.

What does the midbrain do?

It integrates vision and hearing and contributes to dopamine, arousal, breathing, pain, and reflexes.

What does the thalamus do?

It relays almost all sensory information except smell to the cortex and integrates it.

What does the hypothalamus do?

It regulates basic biological needs, autonomic functions, and survival processes.

What does the limbic system do?

It is involved in emotion and memory.

What does the hippocampus do?

It supports learning, memory, and memory consolidation.

What does the amygdala do?

It is involved in fear, emotional processing, and aggression.

What does the cerebrum/cortex do?

It supports thinking, learning, memory, consciousness, and voluntary movement.

What does the occipital lobe do?

Processes vision.

What does the parietal lobe do?

Processes touch, body position, and somatosensory information.

What does the temporal lobe do?

Processes hearing and language comprehension.

What does the frontal lobe do?

Controls movement and supports higher-level thinking.

What does the prefrontal cortex do?

It supports planning, decision-making, and self-control.

What are mirror neurons associated with?

Social cognition and imitation.

What are the general functions of the brain hemispheres?

The left emphasizes language/verbal functions; the right emphasizes visual-spatial abilities, faces, and music.

What does Broca's area do?

It is associated with speech production.

What does Wernicke's area do?

It is associated with language comprehension.

How do lower brain regions differ from upper cerebral regions?

Lower regions support vital/unconscious and arousal functions; upper cerebral regions support awareness and higher cognition.

What is coma?

A state with no arousal and no awareness.

How long must coma last before diagnosis according to the notes?

At least one hour, after ruling out transient unconsciousness and similar conditions.

What are major signs of coma?

Closed eyes, no sleep-wake cycles, no command following, no meaningful speech, and no purposeful responses.

What happens to metabolism during coma?

Brain metabolism may be reduced by about 50–70%.

What brain damage can cause coma?

Diffuse cortical/white-matter damage or a brainstem lesion.

What is unresponsive wakefulness syndrome (UWS)?

A state with arousal but no evidence of awareness.

What is preserved in UWS?

Sleep-wake cycles and relatively preserved brainstem/autonomic functions.

What behaviors can occur in UWS?

Reflexive behaviors such as blinking, swallowing, yawning, crying, smiling, or groaning.

What causes UWS?

Cortical/thalamic injury with relatively preserved brainstem function.

What is persistent UWS?

UWS lasting more than one month.

What is permanent UWS according to the notes?

More than three months after non-traumatic injury or more than one year after traumatic injury.

What is minimally conscious state (MCS)?

A state of preserved arousal with inconsistent but definite signs of awareness.

What are signs of MCS?

Purposeful behavior, command following, understandable speech, visual tracking, or appropriate emotional responses.

How are purposeful actions distinguished from reflexes in MCS?

They must be reproducible and sustained.

What happens to metabolism in MCS?

It is reduced by roughly 20–40%.

What supports consciousness in MCS?

Partial restoration of thalamocortical and corticocortical connections.

What is emergence from MCS?

Functional communication or consistent appropriate use of multiple objects.

What is locked-in syndrome (LIS)?

Full consciousness with near-complete paralysis, sometimes appearing like a coma.

What causes LIS?

Usually a brainstem lesion; the notes say about 90% are vascular.

How does a person with LIS communicate?

Usually through eye movements or blinking, sometimes aided by communication technology.

What is brain death?

Irreversible loss of brain function, including all brainstem reflexes and spontaneous respiration.

What must be excluded before diagnosing brain death?

Hypothermia, drug intoxication, electrolyte abnormalities, and endocrine disturbances.

What clinical findings support brain death?

A clear cause of coma, no confounders, coma, no spontaneous breathing, and loss of brainstem reflexes.

What confirmatory tests are named in the notes for brain death?

EEG, PET, and angiography.

What does EEG measure?

Overall net electrical brain activity.

What does PET measure?

Brain activity through radioactive markers and glucose consumption.

What does CT measure?

Brain structure using computer-enhanced X-rays.

What does MRI measure?

Detailed brain structure using magnetic fields and radio waves.

What does fMRI measure?

Brain activity through changes in blood flow and oxygen use.

What did Adrian Owen's research demonstrate?

Brain scans can reveal signs of communication or awareness in some people diagnosed as vegetative.

What percentage of UWS patients may actually be MCS?

Insufficient notes; the supplied notes do not provide a percentage.

What factors predict better recovery from impaired consciousness?

Younger age, traumatic injury, shorter duration, and earlier signs of consciousness.

What is the GCS?

A scale assessing eye, motor, and verbal responses.

What is a limitation of the GCS?

It requires verbal responses, making it problematic for intubated patients.

What does a very low GCS indicate?

Poor prognosis; the notes do not provide a specific cutoff.

What is the FOUR score?

A consciousness scale assessing eye, motor, brainstem reflexes, and respiration.

Why is the FOUR score useful?

It can help distinguish UWS, locked-in syndrome, and brain death.

What is the JFK Coma Recovery Scale-Revised?

A comprehensive scale used to distinguish UWS from MCS and assess recovery.

What does the JFK-CRS-R assess?

Auditory, visual, motor, verbal, communication, arousal, and brainstem-reflex functions.

What is the prognosis after six months of UWS following TBI?

The notes state 4% were able to live independently with varying disability and regain consciousness by one year.

What does accurate prognosis affect?

Treatment, rehabilitation, diagnosis, and end-of-life decisions.

Why is accurately determining death important?

It affects medical decisions, end-of-life care, organ donation, estate planning, and life-sustaining treatment.

How was death traditionally determined?

Primarily through cessation of pulse, circulation, and respiration.

Why did CPR complicate the traditional definition of death?

Cardiac arrest could become reversible, making the moment of irreversible death less clear.

What was Robert Schwab's 1963 death criterion?

Fixed/dilated pupils, absent reflexes and movement, apnea, and an isoelectric EEG.