Understanding Pathophysiology, 6e
Understanding Pathophysiology, 6e
6th Edition
ISBN: 9780323354097
Author: Sue E. Huether RN PhD, Kathryn L. McCance RN PhD
Publisher: Elsevier Science
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Chapter 15.1, Problem 1QC
Summary Introduction

To explain: The reason why structural and metabolic factors are capable of producing comas.

Concept introduction: Cognitive functions are managed by neural systems. These include memory or language system, attentional system, and emotive systems. These systems normally function through motor systems.

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Consciousness results from the interaction between neurons located in the ascending reticular activating system that provides arousal; those in the cerebral cortex provide awareness. Arousal is the state of awakeness that maintains consciousness. Any alterations in the level of arousal may alter cognitive functions. A coma is an unresponsive state with an inability to respond to external stimuli and to inner requirements. It results from a diffused insult to both cerebral hemispheres and a lesion in ascending reticular activating system. It may be due to structural, metabolic, or functional factors. Structural alterations may be caused due to infection, neoplasms, congenital alterations, and degenerative changes leading to diffused or localized dysfunction. Metabolic factors may cause reduction in arousal due to loss of delivery of energy substrates. These cause hypoxia, hypoglycemia, and electrolyte disturbances, which in turn lead to dysfunction in nervous system.

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