Clinical study of the patient: state of consciousness

The state of consciousness is both clear and clouded. Depending on the level of the problematic of consciousness, there are the following types of consciousness.

1. The stupor state (stupor) - the state of stunning. The patient can not properly navigate the environment, answers questions with a noticeable delay. This condition occurs when contusions, certain poisoning.

2. The sopor state (sopor), which is also hibernation. The patient may leave it for a short period of time with a loud shout or physical contact. Basic reflexes saved. This condition is fixed in infectious diseases, for example, at the onset of the development of acute uremia.

3. A coma is an unconscious state. Characterized by an absolute lack of response to external stimuli, the lack of reflexes and the breakdown of key vital functions of functions. The causes associated with the comatose state are very extensive, but the loss of consciousness during a coma of any etiology is directly related to problems in the functioning of the cerebral cortex associated with a number of factors. Among them, the key place is occupied by the problem of blood circulation in the brain and anoxia. Equally important is the effect of edema of the brain and its membranes, an increase in intracranial pressure, the impact on the brain tissue of toxic substances, hormonal disorders and problems with metabolism, as well as an imbalance of mineral substances and acid-base balance (CSB).

Coma begins both suddenly and gradually, moving from different stages of impaired consciousness. The whole period of time that passes before the development of a state of complete coma is called the pre-comatose state. There are the following basic types of comatose states.

· Alcoholic coma - face cyanotically with dilated pupils, shallow breathing, small pulse, rapid, low blood pressure is recorded, the smell of alcohol is perceived from the mouth.

· Apoplexic coma (cause: hemorrhage in the brain) - the face is pink-red, breathing is slow, deep, with noises, the pulse is full and rare.

· Hypoglycemic coma is sometimes manifested in the treatment of diabetes with insulin.

· Diabetic (hyperglycemic) coma occurs when diabetes is neglected.

· Hepatic coma occurs in acute or insufficiently acute dystrophy and necrosis of the hepatic parenchyma, as well as in the final stage of cirrhosis of the liver.

· Uremic coma is associated with acute toxic and various chronic kidney diseases.

· Epileptic coma - different cyanotic face, clonic and tonic convulsions, bite of the tongue. Often occur involuntary urination, defecation. The pulse is usually speeded up, the eyeballs look around, the pupils are dilated, and wheezing is heard in the breath.

4. In other cases, irritative disorders of consciousness may be encountered that are associated with the excitation of the central nervous system. In particular, we are talking about such manifestations as hallucination, delirium (violent - with alcohol intoxication, with pneumonia, in particular, those who abuse alcohol; silent delirium - with typhoid, etc.).

A close examination of the patient will reveal other mental disorders (such as depression or apathy).

And this is even more interesting:

  1. Clinical study of the patient: complaints
  2. Clinical study of the patient: the fat layer
  3. Clinical study of the patient: anamnesis of life
  4. Clinical study of the patient: edema
  5. Clinical study of the patient: a history of the disease