Clinical States of Consciousness

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Clinical States of Consciousness

• Awake, daydreaming, drowsy, highly focused
  (reported)
• Dreaming (mostly REM)
• Semi-conscious ,confused, groggy (reported)
• Locked in State, paralyzed except for eye
  movement (conscious)
• Minimally Conscious State, demonstrates minimal
  but definite behavioral evidence of self or
  environmental awareness

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Clinical States of Consciousness

• Persistent Vegetative State, only non purposeful
  movements and reflexes, may startle or orient to
  sound or light or reflexly smile or cry
• Coma, reflexes only
• Death (Clinical vs Brain vs Cardiac)

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Clinical Brain Death on Life Support

• No cerebrally mediated movements ie no response
  to pain (certain spinal reflexes may be present
  from response to metabolic changes or other
  stimuli)
• Absent brain stem reflexes (pupils and eye
  muscles)
• Apnea off respirator (Guidelines)

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Confirmatory Tests

• Cerebral angiography
• Flat EEG (30 minutes)
• Six hour interval repeat exam, no drugs, no
  hypothermia
• Controversy exists for Organ Donation after
  cardiac death (Brain vs Cardiac death)

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Dreaming

• Mostly during REM sleep (also seen in mammals)
• Function, many theories ( rehearse avoidance
  behaviors, resolve conflicting emotions, creative
  solutions, integrate and consolidate knowledge
  and many more)
• Visual and emotion centers activated, motor
  paralysed except eyes

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Medical Conditions

• Metabolism, nutrients,
• Cerebrovascular disease, hypotension
• Neurodegenerative diseases
• Infections
• Hormonal Imbalances
• Immunologic disorders

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Drugs and Anesthesia

• drugs that mimic or block neurotransmitters
• drugs that alter release or reuptake of
  neurotransmitters
• Anesthetics may modify ion channels in membranes
• http//www.wisc-online.com/objects/index_tj.asp?ob
  jIDAP1201

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Drugs

• Level of alertness
• Level of feeling
• Altered visual, auditory and sensory
  perceptions,
• Altered thinking
• Addiction
• Many other

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C and Psychiatric Conditions

• Schizophrenia (hallucinations, thought disorder)
• Anxiety disorders (GAD, OCD, PA)
• Depression
• Bi polar disease
• Personality disorders (psychopath example)
• Genes plus environment (nature/nurture)

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Psychopharmacology

• http//www.wisc-online.com/objects/index_tj.asp?ob
  jIDNUR3503
• http//www.mayoclinic.com/health/antidepressants/M
  M00660

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External Stimulation

• ECT (depression
• Transcranial magnetic stimulation (OCD and
  Depression)
• www. http// neuronetics.com/howtmsworks.html

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Psychotherapy

• Psychodynamic (psychoanalysis)
• Cognitive Therapy
• Exposure and response prevention (OCD)
• Desensitization (Phobias)

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Hypnosis

• Trance like state of mind with focused attention,
  calm and relaxed, open to suggestions
• Used to treat pain, change negative behaviors,
  reduce anxiety, lower blood pressure, reduce
  chem-induced nausea and vomiting

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Hypnosis

• Technique Guided vs Self
• Neuronal correlates of hypnosis (color tests)
• Myths loose free will, unconscious, rare
  amnesia, against will, restore lost memories
• NH VT not regulated

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Meditation

• http//uk.youtube.com/watch?vsf6Q0G1iHBI
• http//www.sciam.com/article.cfm?idmeditation-enh
  ances-attention-video

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Assignment

• Labyrinth
• 3500 years old
• Medieval churches eg Chartres
• Creates mindfulness
• Rollins Chapel

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http//www.flickr.com/photos/77615443_at_N00/64365347
/
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Normal Quirks

• Blind spot, Cutaneous rabbit, synesthesia
• Change blindness http//www.usd.edu/psyc301/Change
  Blindness.html
• Inattention blindness
• Motion induced blindness
• Optical and auditory illusions http//www.brl.ntt.
  co.jp/IllusionForum/basics/visual/english/GE.munst
  er.html

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Pathologic Variations Consciousness

• Blind sight
• Capgras delusion
• Phantom limb
• Hemiagnosia
• Déjà vu
• Split brain

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Unexplained Phenomena

• Mind reading
• Out of body experience
• Near death experience
• Remote viewing
• Psychics
• http//video.google.com/videoplay?docid-339686992
  0557391806qrandihlen

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Debunking contd

• http//uk.youtube.com/watch?vQlfMsZwr8rc