Consciousness, Orientation, and Memory

Abstract

Consciousness, orientation, and memory are three closely linked and interdependent processes. This chapter covers these three facets of cognition, and introduces the clinical assessment of cognition more generally. The word consciousness can refer to being awake, to being responsive to stimuli, and being able to consciously experience stimuli. Consciousness is traditionally attributed to brain stem reticular structures, but also depends on the coordinated activities of the thalamus, hypothalamus, and basal forebrain, which integrate and relay information to the cortex. The changes in orientation most often seen in central nervous system dysfunction relate to knowing time, place, and person. Orientation testing can be unreliable, as chronically disoriented patients may learn compensation techniques. Like all assessments of a patient's cognitive functioning, valid memory test results require adequate attention, motivation, and effort from the patient.

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