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Dr.karimiSeptember 2014
Rasool akram Hospital
Depressed Consciousnessand Coma
DefinitionConsciousness Defined as the awareness of one’s self or
surroundings;
consciousness or awareness is defined as the combination of :
Orientation , the accurate perception of what is experienced;
Judgment , the ability to process input data to generate
; and memory, the ability to store
Definition
Depressed mental status represents an a alteration in arousal and is a common presenting complaint in the emergency department (ED).
sleepiness
decreased alertness
frank coma
Definition
Confusion
The term confusion connotes an alteration in higher cerebral functions, such as memory, attention, or awareness. In addition, the ability to sustain and focus attention is impaired.
Syncope
Syncope is the sudden transient loss of consciousness with a loss of postural tone.
ARAS
The ascending reticular activating system (ARAS) is the neuroanatomic
structure primarily responsible for arousal and cortical activation
The input of somatic and sensory stimuli to the cerebral cortex is
controlled by the ARAS and functions to initiate arousal from sleep.
The differential diagnosis for depressed level of consciousness often overlaps with that for
confusion (see Chapter 17). Frequently, diagnosis and management occur simultaneously, and a structured systematic approach is used.