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Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e
Chapter 162. Altered Mental Status and Coma
Sections: Altered Mental Status and Coma: Introduction, Delirium, Dementia, Coma, References.
Topics Discussed: coma; mental state abnormal.
Excerpt:"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 162-1...."
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