8.2 control of consciousness Flashcards

1
Q

what is consciousness?

A

awareness of external environment and internal states

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2
Q

where do conscious thoughts arise from?

A

the cerebral cortex

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3
Q

why would anti histamines make you feel drowsy?

A

histmamine stimulates the cerebral cortex

if inhibited, = less stimulation = feel drowsy

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4
Q

what Is the reticular formation and what is the role of the reticular formation?

A

it is a population of specialised interneurones in the brainstem

keeps the cortex awake
outputs from reticular formation send cholinergic (excitatory) projections to cortex

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5
Q

what connects the cortex and reticular formation, and what is the importance of this connection?

A

connected by reciprocal excitatory projections, forming a positive feedback loop

consciousness requires the cortex and reticular formation to be functioning normally and connected

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6
Q

how is the reticular formation connected to the cortex?

A
  • basal forebrain send excitatory cholinergic fibres to cortex
  • hypothalamus sends excitatory histaminergic fibres to cortex
  • thalamus sends excitatory glutamatergic fibres to the cortex
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7
Q

how does the reticular formation aid muscle tone?

A

it sends projections down the spinal chord, responsible for maintaining muscle tone

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8
Q

what can be used clinically asses consciousness?

A
the Glasgow coma scale (GCS)
assesses
- eye movements
- motor response
- verbal response
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9
Q

what is the role of an electroencephalogram?

A

measures combined activity of thousands f neurones in a particular region of the crtex

high temporal resolution, low spatial resolution

good for detecting neuronal synchrony and evidence of normal cerebellar function

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10
Q

what are the functions of sleep?

A
  • generally unknown
  • energy conservation/ repair
  • memory consolidation
  • clearance of extracellular debris
  • resetting of the CNS
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11
Q

what are the stages of sleeping?

A
  • awake with eyes open (high frequency irregular)
  • awake with eyes closed (high frequency. regular)
  • stage 1 sleep (background theta and interspersed sleep spindles that are high frequency)
  • stage 2/3 sleep (background theta and interspersed sleep spindles)
  • stage 4 - delta waves, regular
  • REM sleep (dreaming occurs in this stage, so similar to the EEG in a conscious patient)
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12
Q

what is the neural mechanism of non REM sleep?

A
  • complex
  • deactivation of the reticular activating system (and hence cortex) + inhibition of the thalamus
  • facilitated by removal of sensory inputs (fewer positive influences on positive feedback loop)
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13
Q

what is the n rural mechanism of REM sleep?

A
  • initiated by neurones in the pons i.e imitation appears to be an active process
  • similar EEG to when awake with eyes open (B waves) but difficult to rouse due to strong thalamic inhibition
  • decreased muscle tone due to glycinergic inhibition of lower motor neurones
  • eye movements and some other cranial nerve functions can be preserved e.g teeth grinding
  • autonomic effects are seen e.g penile erection, loss of thermoregulation
  • essential for life (long term deprivation = death)
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14
Q

what is insomnia?

A

unable to sleep

commonly caused by underlying psychiatric disorders as opposed to primary insomnia

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15
Q

what is narcolepsy?

A

rare disorder

fall asleep randomly

some causes are caused by mutations in the orexin gene

(Orexin is a peptide transmitter involved in sleep)

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16
Q

what is sleep apnoea?

A

common condition, often caused by excess neck fat leading to compression of airways during sleep and frequent waking

causes excessive daytime sleepiness

17
Q

what do the different GCS gradings for eye opening suggest, 1-4?

A

1 = no response. damage to brainstem and maybe cortex,

2 = response to pain. impaired cortical function but brainstem is preserved so that reflex opening can occur.

3 = response to speech suggests slightly diminished cortical function but still functioning brainstem.

4 = spontaneous eye opening suggests normal cortical and brainstem function

18
Q

what do the different GCS gradings for motor response suggest, 1-6?

A

1 = no response to pain suggests severe brainstem damage

2 = extensor response to pain suggests a lesion below the red nuclei. this response isn’t psychological at all.

3 = flexor response to pain suggests a lesion above the level of the red nuclei. This response is still semi-physiological.

4 = withdraws to pain suggests a physiological reflex response to stimuli

5 = localises to stimuli suggests diminished higher cortical function, but still connections working from sensory to motor cortex.

6 = obeys command. suggests normal function working connections from auditory system to brainstem/cord.

19
Q

what do the different GCS gradings for verbal response indicate, 1-5?

A

1 = no response. suggests severe brainstem damage and maybe the cortex.

2 = incomprehensible sounds suggests cortical damage with brainstem mediated groans

3 = inappropriate words suggests language centres have been damaged

4 = confused conversation suggests diminished higher cortical function but language centres are still functioning adequately

5 = orientated in the/place suggests normal cortical function