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Penurunan Kesadaran: Umam Fazlurrahman
Penurunan Kesadaran: Umam Fazlurrahman
KESADARAN
Umam Fazlurrahman
Definisi
Vigilance/ Kewaspadaan
Normal activity in the so-called ascending reticular
activation system (ARAS) is necessary for normal
alertness (vigilance; Fig. 32.1).
Lucidity / Sadar
Currently it is believed that normal lucidity depends on
sufficient tonic activity of the ARAS and cortical regions
as well as “phasic” (i. e., short lasting), synchronized
activation (i. e., binding) of thalamo−corticothalamic
and cortico-cortical networks.
Vigilance
Attention
If vigilance is normal,
then attention can be
examined -> “forward
digit span”
Cognitive Function
Physical Examination
Motor Functions
1. Hypoglycemic Coma
Patients with Diabetes Mellitus
Being treated with OAD
Being treated with insulin
2. Diabetic Coma
Ketoacidotic Coma
Hyperglycemia ensues with osmotic diuresis, dehydration, and loss
of electrolytes, as well as hyperketonemia with metabolic acidosis.
Extracellular hyperosmolality causes cerebral dysfunction and in
severe cases, coma
Hyperglycemic Hyperosmolar Nonketotic Coma
Coma Due to Metabolic
Disorders
3. Hepatic Coma