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    1 Neuro Assessment

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    shuchi joshi
    This document discusses levels of consciousness and arousal. It outlines 5 levels from most aroused to least - conscious, lethargic, obtunded, stupor, and coma. Each level is defined by the ability to respond to stimuli. The document also discusses the ascending and descending reticular activating systems that control arousal and sleep-wake cycles. Finally, it defines minimally conscious and persistent vegetative states.

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    1 Neuro Assessment

    Uploaded by

    shuchi joshi
    30 views10 pages
    This document discusses levels of consciousness and arousal. It outlines 5 levels from most aroused to least - conscious, lethargic, obtunded, stupor, and coma. Each level is defined by the ability to respond to stimuli. The document also discusses the ascending and descending reticular activating systems that control arousal and sleep-wake cycles. Finally, it defines minimally conscious and persistent vegetative states.

    Original Description:

    Classification and Basic assessment of neurological disorders

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    This document discusses levels of consciousness and arousal. It outlines 5 levels from most aroused to least - conscious, lethargic, obtunded, stupor, and coma. Each level is defined by the ability to respond to stimuli. The document also discusses the ascending and descending reticular activating systems that control arousal and sleep-wake cycles. Finally, it defines minimally conscious and persistent vegetative states.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    30 views10 pages

    1 Neuro Assessment

    Uploaded by

    shuchi joshi
    This document discusses levels of consciousness and arousal. It outlines 5 levels from most aroused to least - conscious, lethargic, obtunded, stupor, and coma. Each level is defined by the ability to respond to stimuli. The document also discusses the ascending and descending reticular activating systems that control arousal and sleep-wake cycles. Finally, it defines minimally conscious and persistent vegetative states.

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    NEUROLOGICAL ASSESSMENT

    -SHUCHI JOSHI
    ARIP
    03-07-2017
    09:00-10:00
    CONSCIOUSNESS AND AROUSAL
    • determine the degree to which an individual is able to
    respond.
    • Ascending reticular activating system: includes
    • core neurons in the brainstem, the
    • locus ceruleus, and raphe nuclei
    • Function- to arouse and awaken the brain and control
    sleep– wake cycles.
    • High levels of activity are associated with extreme
    excitement (high arousal), whereas lesions in the
    brainstem are associated with sleep and coma.

    • Descending reticular activating system (DRAS) :


    • pontine and medullary reticulospinal tracts.
    • Pontine (medial) reticulospinal tract enhances spinal
    cord antigravity reflexes and extensor tone of lower
    limbs.
    • Medullary (lateral) reticulospinal tract has the
    opposite effect, reducing antigravity control.
    5 LEVELS OF CONSCIOUSNESS
    • Consciousness- a state of arousal accompanied by
    awareness of one’s environment.
    • A conscious patient is awake, alert, and oriented to his
    or her surroundings.

    • Lethargy - altered consciousness in which a person’s


    level of arousal is diminished.
    • The lethargic patient appears drowsy but when
    questioned can open the eyes and respond briefly.
    • The patient easily falls asleep if not continually
    stimulated and does not fully appreciate the
    environment.
    • The therapist should speak in a loud voice while calling
    the patient’s name. Questions should be simple and
    directed toward the individual (e.g., How are you
    feeling?).

    • Obtunded state - diminished arousal and awareness.


    • The obtunded patient is difficult to arouse from
    sleeping and once aroused, appears confused.
    • Attempts to interact with the patient are generally
    nonproductive.
    • The therapist should shake the patient gently as if
    awakening someone from sleep and again use simple
    questions.
    • Stupor - a state of altered mental status and
    responsiveness to one’s environment.
    • The patient can be aroused only with vigorous
    or unpleasant stimuli (e.g. sharp pressure or
    pinch, or rolling a pencil across the nail bed).
    • No significant voluntary verbal or motor
    responses.
    • Mass movement responses may be observed
    in response to painful stimuli or loud noises.
    • The unconscious patient is said to be in a coma
    and cannot be aroused.
    • The eyes remain closed and there are no sleep–
    wake cycles.
    • The patient does not respond to repeated painful
    stimuli and may be ventilator dependent.
    • Reflex reactions may or may not be seen,
    depending on the location of the lesion(s) within
    the CNS.
    • Clinically the patient can progress from one level
    of consciousness to another.
    • Minimally conscious (vegetative) state-
    • return of irregular sleep–wake cycles and normalization of
    the so-called vegetative functions
    • respiration, digestion, and blood pressure control.
    • The patient may be aroused, but remains unaware of his or
    her environment. There is no purposeful attention or
    cognitive responsiveness.

    • Persistent vegetative state –


    • individuals who remain in a vegetative state 1 year or
    longer after TBI and 3 months or more for anoxic brain
    injury. This state is caused by severe brain injury.

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