Chapter 5: Cognition, State of Arousal (O'Sullivan, Pages 138-146)

Vocabulary flashcards covering arousal, consciousness, coma scales, cognition, memory, attention, communication, aphasia, and motor tone as described in the notes.

Consciousness

A state of arousal accompanied by awareness of one's environment; a conscious patient is alert, awake, and oriented.

Arousal

The physiological/psychological state of being awake and responsive to stimuli.

Lethargy

Altered consciousness with diminished arousal; patient is drowsy but can respond briefly and falls asleep easily.

Obtunded

Diminished arousal and awareness; if aroused, the patient is usually confused.

Stupor

Altered mental status; aroused only with unpleasant stimuli (e.g., sternal rub).

Coma

State in which the patient cannot be aroused.

Glasgow Coma Scale (GCS)

A gold standard measure to assess cognition after acute traumatic brain injury, ranging from 3 to 15, with higher scores indicating better status.

GCS Severity Ranges

3–8 = severe brain injury (coma); 9–12 = moderate brain injury; 13–15 = mild brain injury.

Rancho Los Amigos Scale

Also called Levels of Cognitive Functioning; an 8-level clinical scale describing recovery patterns after brain injury; higher levels = better function.

Orientation (A&O x4)

Awareness of time, place, person, and event; A&O x4 means oriented to all four domains.

Time Orientation

Awareness of current day/month/year.

Place Orientation

Awareness of current location (city/state/facility).

Person Orientation

Awareness of identity, including one's own name and close contacts.

Event Orientation

Awareness of why the person is in the hospital or current event.

Attention

The directing of consciousness to a person, thing, perception, or thought.

Selective Attention

Ability to screen and process relevant information while filtering out distractions.

Sustained Attention

How long a person can stay focused on a task.

Alternating Attention

Ability to switch focus between two tasks.

Divided Attention

Ability to perform two tasks simultaneously (e.g., walk and talk).

Memory

Process of registration, retention, and recall of past experiences, knowledge, and ideas.

Short-term Memory

Memory for information retained for minutes to days.

Long-term Memory

Memory for information retained over years.

Amnesia

Partial or total memory loss that can be permanent or temporary.

HEP (Home Exercise Program)

A home exercise program; patients may need training for tasks, and families/caregivers may assist if the patient cannot remember instructions.

Dysarthria

Difficulty articulating words; speech errors.

Fluency (speech)

Flow of speech; problems may require the patient to stop and think of the word to use.

Aphasia

Deficits in auditory comprehension and/or language production.

Receptive Aphasia (Wernicke’s)

Fluent speech with poor comprehension; words may be nonsensical; problems with understanding, repetition, and naming; reading/writing may be affected.

Expressive Aphasia (Broca’s)

Non-fluent speech; difficulty forming words; patient understands but has trouble speaking and may struggle with repetition.

Global Aphasia

Most severe form; impaired fluency, comprehension, and repetition, often affecting multiple brain areas.

Wernicke’s Area

Posterior region of the brain involved in language comprehension; linked to receptive aphasia.

Broca’s Area

Motor speech area involved in production of speech; linked to expressive aphasia.

Angular Gyrus

Gyrus involved in language processing, reading, and writing.

Heschl’s Gyrus

Primary auditory cortex located in the Sylvian Fissure; important for auditory processing.

Sylvian Fissure

Lateral sulcus separating the frontal/parietal lobes from the temporal lobe; houses language and auditory regions.

Hypertonia

Increased or high muscle tone; four types discussed.

Spasticity

Increase in muscle tone related to the velocity of movement.

Rigidity

Constant resistance to movement throughout the range of motion.

Decorticate Rigidity

Sustained flexion of the upper limbs and extension of the lower limbs, with adduction and abnormal posturing indicating corticospinal involvement.

Decerebrate Rigidity

Sustained extension of trunk and limbs with extended elbows, adducted shoulders, forearms pronated, and wrists/fingers flexed.

Dystonia

Sustained muscle contractions causing twisting or abnormal postures; may resemble a tremor.

Hypotonia

Decreased or absent muscle tone (flaccidity); diminished reflexes; limbs are floppy and joints can be hyperextensible.

Paresis

Muscle weakness due to nerve damage.

Muscle Fasciculations

Involuntary muscle twitches.

Fibrillations

Involuntary, spontaneous twitches due to denervation.

Neurogenic Atrophy

Muscle wasting due to loss of nerve supply.

Muscle Atrophy

Loss of muscle bulk from reduced activity, lower motor neuron disorders, or malnutrition; assessed by visual inspection, girth, and other measurements.