CNS System Disorders Flashcards
Post-hyperventilation Apnea
Lower brain stem centers regulate breathing pattern
Cheyne-Stokes respirations
Abnormal rhythm of breathing with alternating periods of hyperventilation and apnea.
Central neurogenic hyperventilation
Sustained hyperventilation caused by lesion in the central pons
Apneustic respirations
Prolonged respiratory and expiratory phases caused by injury to the pons or upper medulla
Cluster respirations
Periods or clusters of respirations of near equal depth, resulting from trauma or compression to the medulla or from chronic opioid abuse
Ataxic RR
Irregular respirations with prolonged periods of apnea with damage to the medulla
Ischemia/hypoxia
Dilated, fixed pupils
Hypothermia
Fixed pupils
Atropine/scopolamine
Dilated; fixed pupils
Sedatives
Moderately dilated; fixed to light pupils
Opiates
Pinpoint
Barbiturate intoxication
Fixed pupils
Oculomotor responses
Help determine the levels of brain dysfunction in coma (DOLL’S EYES)
Doll’s Eyes
Normal: eyes move opposite away the direction moving the head
Abnormal: they don’t go opposite to the head movement
Absent: No correlation with movement
Oculovestibular Relfex
Normal: eyes move into the direction of water flow
Abnormal: eyes do their own thing
Absent: Don’t move
Clinical Manifestations of Altered Arousal
- determine side of brain damaged
- pattern of response can be: purposeful and not purposeful or not present
- Vomitting, Yawning, and hiccuping
Purposeful
Intact corticospinal system
Inappropiate or not purposeful
Severe dysfunction of the corticospinal system
Vomiting, yawning and hiccuping involve the
Medulla
Vomiting without nausea indicates the direct involvement of the
Central neural mechanism (or pyloric obstruction)
(Total) Brain Death
Body cannot maintain internal homeostasis; irreversible brain stem and cerebellum, occurs.
(TOTAL) Brain death criteria
- UNRESPONSIVE coma
- no spontaneous movement
- irreversible cessation/no brainstem function (including brainstem and cerebellum)
Brain stem (ABC)
Breathing -RR
Circulation - BP
Airway - HR
Cerebral death
- Death of the cerebral hemispheres
- Irreversible coma
Cerebral Death (survival)
Emerge into a vegetative state or minimally conscious state.
Functional adequacy is a complex process involving three major neuronal systems:
Cognitive, sensory, motor
