Approach to Stupor and Coma Flashcards
What regions of the brain MUST be involved to develop coma
BL hemispheric dysfunction
Brain stem dysfunction
or both
What is the definition of arousal
Level of alertness; ability to interact with environment
What is the definition of Awareness
Sum of cognitive mental functions
What system/tract is most responsible for awareness
ARAS
Ascending Reticular Activating System
what is the definition of stupor
Arouses only to noxious stimuli and not environmental
When assessing someone for stupor and coma what is the purpose of looking for signs and symptoms
Too look for the root cause! That way it can be treated. Hard to make cards for every association. but when looking at sx try to think what could cause that sign
how can a unilateral injury cause coma if both hemispheres must be involved to cause coma
Mass effect! the lesion creates swelling or displacement that impinges the other side of the brain
What are the essential components to the neurological exam
Pupillary response Corneal Reflex Extraocular movements Cough/gag reflex Motor Response Respiratory pattern
What are the three Ps of pinpoint pupils
Pontine lesions
oPiates
Pilocarpine
If eyes are spontaneously roving conjugately what does that mean
implies brainstem intact
If the eyes are spontaneously roving but dysconjugate what does that mean`
brainstem lesion
What is the doll’s eyes test
eyes move horizontally or vertically opposite of the head if CN III IV and VI are intact
What should the eyes do if there is a normal caloric test
deviate toward the water. down if BL caloric
What are cheynes-stokes breathing patterns
hyperpnea followed by apnea
what is apneustic breathing
long inspiration followed by apnea. seen in structural lesions anoxia, hypoglycemia, meningitis
