RT Book, Section
A1 Huff, J. Stephen
A2 Tintinalli, Judith E.
A2 Stapczynski, J. Stephan
A2 Ma, O. John
A2 Yealy, Donald M.
A2 Meckler, Garth D.
A2 Cline, David M.
SR Print(0)
ID 1121511795
T1 Altered Mental Status and Coma
T2 Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 8e
YR 2016
FD 2016
PB McGraw-Hill Education
PP New York, NY
SN 9780071794763
LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1121511795
RD 2024/04/20
AB Disorders  of  consciousness  may  be  divided  into  processes  that  affect  either  arousal  or  content  of  consciousness,  or  a  combination  of  both.  Arousal  behaviors  include  wakefulness  and  basic  alerting.  Anatomically,  neurons  responsible  for  these  arousal  functions  reside  in  the  reticular  activating  system,  a  collection  of  neurons  scattered  through  the  midbrain,  pons,  and  medulla.  The  neuronal  structures  responsible  for  the  content  of  consciousness  reside  in  the  cerebral  cortex.  Content  of  consciousness  includes  self-awareness,  language,  reasoning,  spatial  relationship  integration,  emotions,  and  the  myriad  complex  integration  processes  that  make  us  human.  One  simplistic  model  holds  that  dementia  is  failure  of  the  content  portions  of  consciousness  with  relatively  preserved  alerting  functions.  Delirium  is  arousal  system  dysfunction  with  the  content  of  consciousness  affected  as  well.  Coma  is  failure  of  both  arousal  and  content  functions.  Psychiatric  disorders  and  altered  mental  states  may  share  features  such  as  hallucinations  or  delusion.  Some  distinctions  between  the  different  states  are  summarized  in  Table  168-1.