Orientation to time

AAOX3 Awake and orientated to time, place, and person AP Anteroposterior... 

Evaluation of memory and orientation is critical to the differentiation of a psychiatric versus a nonpsychiatric medical disorder. Memory for immediate, recent, and remote events can be readily tested, as well as orientation to time, place, person, space, and situation. Assuming the level of anxiety is not sufficient to impair responses to questions in these areas, deficits usually imply some impairment of brain functioning, which may or may not be reversible. 

Because recent memory is disenabled in both states, it is not surprising that orientation to time, place, and person is impaired in hypnotic trance and dreaming. That this process is considerably more floridly deranged in dreaming may possibly be due to the more extreme changes in neuro-modulatory balance that occur in REM sleep (for details see subsequent discussion). 

The patient, an 84-year-old male resident of a veteran s home, was admitted to the hospital following a fall in which he had sustained a fracture of his left radius and several lacerations. Physical examination on admission revealed a well-nourished elderly male in no great distress (body mass index (BMI), 22.5 kg/m2). He was moderately confused but with prompting was oriented to time, place, and person. There was no obvious pallor, cyanosis, or jaundice, and his skin and mucous membranes were unremarkable apart from the injuries he sustained in the fall. His right lower extremity was swollen and tender, and he walked cautiously and with a pronounced limp. 

Awareness of temporal specification, such as time of day, day of the week, or year. Orientation to time is one of the functions assessed in a psychiatric mental status exam. 

American Association of Medical Assistants analgesic-associated nephropathy analgesic abuse nephropathy attending physician s admission notes awake and oriented to time, place and person assessment adjustment pass American Academy of Pediatrics... 

A1 Martini, a 44-year-old man who has been an alcoholic for the past 5 years, had a markedly diminished appetite for food. One weekend he became unusually irritable and confused after drinking two fifths of scotch and eating very little. His landlady convinced him to visit his doctor. Physical examination indicated a heart rate of 104 beats/min. His blood pressure was slightly low, and he was in early congestive heart failure. He was poorly oriented to time, place, and person. 

Grossly oriented to time, place and person good concentration and memory or... 

If well enough, MMSE/M-ACE and conpare with baseline if not, check orientation to time and place + attention with serial 7s/WORLD backwards... 

Two days before this episode, this patient had injected 2 g of MDMA IV and was admitted to the ICU of the hospital with nausea, repeated vomiting, diarrhoea and diaphoresis without hyperthermia. At that time his BP was 170/120 mm Hg, pulse was 120 bpm and temperature was normal. He had dysarthria and ataxia but he was oriented to time, place and person. His laboratory test results were within normal range except for hypokalaemia of 2.8mmol/L and an alcohol level of 1.26%. His symptoms resolved after treatment with midazolam and the next morning he was asymptomatic. 

Because of the generality of the symmetry principle that underlies the nonlinear optical spectroscopy of surfaces and interfaces, the approach has found application to a remarkably wide range of material systems. These include not only the conventional case of solid surfaces in ultrahigh vacuum, but also gas/solid, liquid/solid, gas/liquid and liquid/liquid interfaces. The infonnation attainable from the measurements ranges from adsorbate coverage and orientation to interface vibrational and electronic spectroscopy to surface dynamics on the femtosecond time scale. 

Other orientational correlation coefficients can be calculated in the same way as tf correlation coefficients that we have discussed already. Thus, the reorientational coiTelatio coefficient of a single rigid molecule indicates the degree to which the orientation of molecule at a time t is related to its orientation at time 0. The angular velocity autocorrelatio function is the rotational equivalent of the velocity correlation function ... 

The perturbation theory presented in Chapter 2 implies that orientational relaxation is slower than rotational relaxation and considers the angular displacement during a free rotation to be a small parameter. Considering J(t) as a random time-dependent perturbation, it describes the orientational relaxation as a molecular response to it. Frequent and small chaotic turns constitute the rotational diffusion which is shown to be an equivalent representation of the process. The turns may proceed via free paths or via sudden jumps from one orientation to another. The phenomenological picture of rotational diffusion is compatible with both... 

This ratio of orientational relaxation times is sometimes used to identify the situation corresponding to perturbation theory [85]. 

Comparison of formulae (2.51) and (2.64) allows one to understand the limits and advantages of the impact approximation in the theory of orientational relaxation. The results agree solely in second order with respect to time. Everything else is different. In the impact theory the expansion involves odd powers of time, though, strictly speaking, the latter should not appear. Furthermore the coefficient /4/Tj defined in (2.61) differs from the fourth spectral moment I4 both in value and in sign. Moreover, in the impact approximation all spectral moments higher than the second one are infinite. This is due to the non-analytical nature of Kj and Kf in the impact approximation. In reality, of course, all of them exist and the lowest two are usually utilized to find from Eq. (2.66) either the dispersion of the torque (M2) or related Rq defined in Eq. (1.82) ... 

Let us demonstrate that the tendency to narrowing never manifests itself before the whole spectrum collapses, i.e. that the broadening of its central part is monotonic until Eq. (6.13) becomes valid. Let us consider quantity x j, denoting the orientational relaxation time at ( = 2. If rovibrational interaction is taken into account when calculating Kf(t) it is necessary to make the definition of xg/ given in Chapter 2 more precise. Collapse of the Q-branch rotational structure at T = I/ojqXj 1 shifts the centre of the whole spectrum to frequency cog. It must be eliminated by the definition... 

Inequality (6.67) is the softest criterion of perturbation theory. Its physical meaning is straightforward the reorientation angle (2.30) should be small. Otherwise, a complete circle may be accomplished during the correlation time of angular momentum and the rotation may be considered to be quasi-free. Diffusional theory should not be extended to this situation. When it was nevertheless done [268], the results turned out to be qualitatively incorrect orientational relaxation time 19,2 remained finite for xj —> 00. In reality t0j2 tends to infinity in this limit [27, 269]. 

Limiting ourselves to derivation of the Hubbard relation in the simplest case ( = 1 (for t = 2 see Appendix 9), we write out the definition of orientational relaxation time... 

In a termolecular reaction, three chemical species collide simultaneously. Termolecular reactions are rare because they require a collision of three species at the same time and in exactly the right orientation to form products. The odds against such a simultaneous three-body collision are high. Instead, processes involving three species usually occur in two-step sequences. In the first step, two molecules collide and form a collision complex. In a second step, a third molecule collides with the complex before it breaks apart. Most chemical reactions, including all those introduced in this book, can be described at the molecular level as sequences of bimolecular and unimolecular elementary reactions. 

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