This document discusses various types of sensory distortions and deceptions, including illusions and hallucinations. It describes different categories of sensory distortions that can involve vision, hearing, touch, smell, taste, and the sense of time. It also discusses hallucination types like auditory, visual, olfactory, gustatory, kinaesthetic and others. Various causes are provided for different sensory distortions and hallucinations, including neurological, psychiatric and substance-related factors. Assessment references are also included at the end.
Hallucination definition, explanation. Difference between true perception and hallucinations. Mental images. Pseudo-hallucinations. Causes of hallucinations. Types of hallucinations.
Individuals are capable of receiving information and
organizing it into meaningful entities. This processing
of the information to represent reality is called
PERCEPTION.
Perception is derived from Latin term, perceptio,
which means organization, identification, and
interpretation of sensory information.
It refers to the way world looks, sounds, feels, tastes
and smells, i.e. whatever is experienced by the person.
Sensory Distortions:-
perception of the
constant real object in a
distorted manner.
Sensory Deceptions:-
new perception in
response to external
stimuli.
Sensory Distortion:-
Change in intensity
Change in quality
Change in spatial form
Distortions of experience of time
Changes in Intensity (hyperaesthesia and
hypoaesthesia):-
Hyperaesthesia:- increased intensity of sensations.
intense emotions
lowering of physiological threshold
Anxiety and depressive disorder as well as hangover from
headache or migraine,- increased sensitivity to noise
(hyperacusis)
Hypomanic under influence of LSD (lysergic acid
diethylamide), seeing colours as bright and intense.
A true hypoacusis occurs in delirium, threshold for all
sensations are raised, associated with depression and ADD
(attention-deficit disorder).
Changes in Quality:- are mainly visual distortions
which colour all perceptions, because of toxic
substances.
Xanthopsia- colouring of yellow; by santonin
Chloropsia- colouring of green
Erythropsia- colouring of red
In derealisation, everything appears to unreal, while in
mania object looks perfect and beautiful.
Changes in Spatial Form (dysmegalopsia):- is
change in perceived shape of object, caused due to-
retinal disease
disorders of accommodation
disorders of convergence
temporal lobe lesions (mainly affecting posterior lobe)
Micropsia, seeing objects as smaller; macropsia
(meagalopsia) seeing objects as bigger.
Macropsia and micropsia have been used for changes
in perception of size in dreams and hallucination.
Micropsia:- is a visual disorder
in which patient sees object;
smaller than they really are
farther away than they really
are
experience of retreat of objects
into distance, without any
change in size (porropsia)
Oedema of retina image falls on
functionally smaller part of
retina
Partial paralysis of
accommodation
Macropsia:-
Scarring of retina with retraction
(distortion produced by scarring is
usually irregular, metamorphopsia
is more likely to occur)
Complete paralysis or
over-reactivity of accommodation
during near vision causes
macropsia.
If accommodation is normal but
convergence is weakened,
macropsia occurs and vice versa.
Although hypoxia and rapid
acceleration of body can affect
accommodation and convergence,
dysmegalopsia is rare among high
altitude pilots.
Disorders of Experience of Time:- There are two
varieties of time, physical and personal.
The psychiatric disorders are affected by personal
time.
Time flies when one is happy (in case of mania) and
time stops when one is sad (in case of de
Hallucination definition, explanation. Difference between true perception and hallucinations. Mental images. Pseudo-hallucinations. Causes of hallucinations. Types of hallucinations.
Individuals are capable of receiving information and
organizing it into meaningful entities. This processing
of the information to represent reality is called
PERCEPTION.
Perception is derived from Latin term, perceptio,
which means organization, identification, and
interpretation of sensory information.
It refers to the way world looks, sounds, feels, tastes
and smells, i.e. whatever is experienced by the person.
Sensory Distortions:-
perception of the
constant real object in a
distorted manner.
Sensory Deceptions:-
new perception in
response to external
stimuli.
Sensory Distortion:-
Change in intensity
Change in quality
Change in spatial form
Distortions of experience of time
Changes in Intensity (hyperaesthesia and
hypoaesthesia):-
Hyperaesthesia:- increased intensity of sensations.
intense emotions
lowering of physiological threshold
Anxiety and depressive disorder as well as hangover from
headache or migraine,- increased sensitivity to noise
(hyperacusis)
Hypomanic under influence of LSD (lysergic acid
diethylamide), seeing colours as bright and intense.
A true hypoacusis occurs in delirium, threshold for all
sensations are raised, associated with depression and ADD
(attention-deficit disorder).
Changes in Quality:- are mainly visual distortions
which colour all perceptions, because of toxic
substances.
Xanthopsia- colouring of yellow; by santonin
Chloropsia- colouring of green
Erythropsia- colouring of red
In derealisation, everything appears to unreal, while in
mania object looks perfect and beautiful.
Changes in Spatial Form (dysmegalopsia):- is
change in perceived shape of object, caused due to-
retinal disease
disorders of accommodation
disorders of convergence
temporal lobe lesions (mainly affecting posterior lobe)
Micropsia, seeing objects as smaller; macropsia
(meagalopsia) seeing objects as bigger.
Macropsia and micropsia have been used for changes
in perception of size in dreams and hallucination.
Micropsia:- is a visual disorder
in which patient sees object;
smaller than they really are
farther away than they really
are
experience of retreat of objects
into distance, without any
change in size (porropsia)
Oedema of retina image falls on
functionally smaller part of
retina
Partial paralysis of
accommodation
Macropsia:-
Scarring of retina with retraction
(distortion produced by scarring is
usually irregular, metamorphopsia
is more likely to occur)
Complete paralysis or
over-reactivity of accommodation
during near vision causes
macropsia.
If accommodation is normal but
convergence is weakened,
macropsia occurs and vice versa.
Although hypoxia and rapid
acceleration of body can affect
accommodation and convergence,
dysmegalopsia is rare among high
altitude pilots.
Disorders of Experience of Time:- There are two
varieties of time, physical and personal.
The psychiatric disorders are affected by personal
time.
Time flies when one is happy (in case of mania) and
time stops when one is sad (in case of de
The presentation describes what id perception; differences between sensation, perception and imagery; disorders of perception and how to assess perception using mental status examination.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
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2. Sensation : is the first stage in receiving information
from outside the self.
Perception : occurs when a stimulus has undergone
processing according to its form, color, motion.
The subject is able to recognize that an object is in his
field of vision- sensation intact
He is unable to recognize what the object or its
function is - impaired perception
3. Constant real perceptual object in a distorted
way…………sensory distortion.
New perception that may or may not be in response
to an external stimulus………..sensory deception.
4. Sensory distortions….a) Visual perception
b) Auditory perception
c) Splitting of perception
Sensory deceptions …a) Illusions
b) Hallucinations
c) Pseudohallucinations.
5. Disturbance of the mental state with/without
organic brain pathology
Involve any elementary aspects of perception like
uniqueness , size , shape, colour ,location,motion or
general quality.
Significance ,,,,?
Perceived object is correctly
recognized and identified yet there is a deviation
from its customary appearance.
6. Changes in spatial form
Metamorphopsia
Alteration in the customary shape of perceived object.
Dysmegalopsia
Retinal disease,disorders of accomodation and
convergence,temporal & parietal lobe lesions
Rare association with schizophrenia.
May occur in poisoning with atropine or hyoscine.
7. Macropsia : size of perception is large.
Micropsia : size of perception is small.
Hemimicropsia : apparent reduction in one hemi field
of vision – temporal lobe epilepsy
Palinopsia : recurrence or prolongation of visual
phenomenon beyond the customary limits of
appearance of the real event
eg: “cat noticed in the street one day kept appearing at
various times and situation over the next few days”
Paraprosopia :when metamorphopsia affect faces.
8.
9. Changes in intensity
Visual hyperasthesia: increased intensity of colour
Acrometopsia :complete absence of colour
-unilateral/bilateral occipital lesions (lingual,
fusiform gyri)
Dyschromatopsia : perversion of colour perception
-unilateral posterior lesions
10. Spatial location
Telopsia : subjects appearing far away
Pelopsia : subjects appearing nearer.
Alloaesthesia :when the perceived object is in a
different position
Akinetopsia: unable to perceive the motion of the
object. seen in B/L posterior cortical damage.
Eg: ‘ she had difficulty in pouring tea into a cup because
the fluid appeared to be frozen’.
11. Changes in quality
Colouring of yellow- xanthopsia,green-chloropsia &
red- erythropsia.
-poisoning with digitalis
Derealization : everything appears unreal and strange.
Eg: a factory worker sees a grass hopper and becomes
disturbed and excited at the site of this very strange
and unknown animal.
12. Uniqueness of perception
Palinacousis : persistance of sounds that are heard
Intensity of perception
Hyperacusis : increased sensitivity to noise.
Anxiety & depressive disorders, migraine,
hangover from alcohol.
Hypoacusis: threshold for noise is raised
Delirium, depression & attention-deficit
disorder.
13. Unable to form the usual, assumed links between two
or more perceptions.
Rare phenomenon
Described sometimes with organic states & also with
schizophrenia
Eg: a patient watching television experienced a
feeling of competition between the visual and auditory
perceptions
14. Physical and personal
Personal: Determined by personal judgement of passage
of time.
Influence of mood: happy-time flies, sad-slow
Affected by psychiatric disorder
Severe depression- time passes slowly
Mania- time speeds by
15. Illusions : Misinterpretations of stimuli arising from an
external object
Hallucinations :Perception without an adequate
external stimulus.
16. Completion illusions: depends on inattention for their
occurrence.
‘ _ook’ misread as ‘Book’ though the faded letter was ‘L’
Affect illusions: arise in context of particular mood
state.
Delirious person may perceive the innocent gestures as
threatening.
Pareidolia: vivid illusions without patients effort.
Subject sees vivid pictures in fire or in clouds without
any conscious effort.
17. A perception without an object (Esquirol 1817).
A false perception which is not a sensory distortion or
a misinterpretation ,but which occurs at the same time
as real perceptions(Jaspers ,1962).
A hallucination is an exteroceptive or interoceptive
percept that does not correspond to an actual object
(smythies ,1956).
18. A hallucination is a perception without an object or the
appearance of an individual thing in the world without
any corresponding material event (cutting 1997).
According to Slade (1976) ,3 criteria are essential (a)
percept like experience in the absence of external
stimuli, (b) percept like experience that has the full
force and impact of a real perception (c ) percept like
experience that is unwilled ,occurs spontaneously and
cannot be readily controlled by the percipient.
19. Intense emotions.
Disorders of sense organs
Sensory deprivation
Disorders of central nervous system.
20. Auditory hallucinations
elementary & unformed- bells, whistling, machinery or
rattles.
Completely organized as hallucinatory voices
schizophrenia
May also occur in chronic alcoholic hallucinosis or
affective psychosis occasionally
21. Visual hallucination
Elementary- in the form of flashes of light
Partly organized- patterns
Completely organized-visions of people, objects or
animals
Occipital lobe tumours
Post-concussional state
Metabolic disturbances-hepatic failure
Alzheimer’s disease, senile dementia
22. Charles Bonnet’s syndrome( phantom images)-
Individuals experience complex visual hallucinations
in association with impaired vision without any
psychopathology or disturbance of consciousness
More common in elderly
Associated with central & peripheral reduction in
vision
Importance in differential diagnosis.
23. Delirium tremens
Alcohol withdrawal syndrome characterized by gross
changes in perception, mood and conscious state.
Pareidolic or affective illusions are often prodromal.
Lilliputian hallucinations-seeing tiny people or objects.
accompanied by pleasure & amusement.
24. Superficial : Affecting skin sensation
Thermic - heat and cold (‘my feet on fire’)
Haptic - of touch (‘a dead hand touched me’)
Hygric – a perception of fluid (‘ I can feel a water level
in my chest’)
25. Kinaesthetic hallucinations : The patient feels that his
limbs are being bent or twisted or his muscles
squeezed.
Schizophrenia
Withdrawal state from benzodiazepine or alcohol
intoxication.
Eg: ‘I thought my life was outside my feet and made
them vibrate’
26. Olfactory hallucination: schizophrenia , epilepsy.
Hallucination of smell which may or may not be
unpleasant.
Eg : people are pumping anaesthetic gas into the house
which the patient alone can smell.
27. Gustatory hallucinations: schizophrenia, depression,
temporal lobe epilepsy, psychotropic drugs- lithium or
disulfiram.
Eg: In schizophrenia and depression the flavour of food
may disappear alltogether or become unpleasant.
28. Autoscopy (phantom mirror image) : subjects see an
image of themselves in external space viewed from
within their own physical body.
Negative autoscopy : for instance, the patient looks in
the mirror and sees no image at all.
Extracampine hallucination (concrete awareness):
experienced outside the limits of the sensory field,
outside the visual field or beyond the range of
audibility
Eg:‘ I keep on hearing them talking about my disease
down in the post office’ (half a mile away)
29. Hypnogogic hallucination: perceptions that occur
while going to sleep.
Hypnopompic hallucination: perceptions that occur on
waking.
May be visual, auditory or tactile
Occur in many people in good health
Described with narcolepsy, cataplexy and sleep
paralysis.
Toxic states- glue sniffing , acute fever , post
infective depressive states.
30. Eg - ‘a feeling of someone pushing him over the bed’
or
‘seeing a man coming across the bedroom’
31. Functional hallucination : External stimulus is
necessary to provoke hallucination but the stimulus is
experienced as well as the hallucination
Eg : ‘ A schizophrenic patient heard hallucinatory voices
only when water was running through the pipes’.
Reflex hallucination : A stimulus in one sensory
modality producing a hallucination in another.
Eg : ‘ I can feel you writing in my stomach’
32. SIMS’ Symptoms in the mind psychopathology, fourth
edition.
Fish’s clinical psychopathology, third edition.