Coma Flashcards

1
Q

What is lethargy?

A

Motor slowness, tried, sleepy, easily aroused, aware of self and envt

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2
Q

What is a stupor?

A

Unresponsiveness from which Pt can only be aroused by vigorous/noxious stimuli

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3
Q

What is Coma?

A

Unarousable unresponsiveness
Cannot be aroused
No purposeful response to the envt.

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4
Q

What part of the brain is responsible for consciousness

A

Pontine reticular activating system. Posterior portion of the Pons => Thalamus => Cortex

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5
Q

How can unconsciousness be achieved?

A

Systemic/broad effect: sepsis, bleeding into ventricles, hydrocephalis, massive stroke affecting both hemispheres. Swelling of one hemisphere effecting other. Stroke affecting PRAS.

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6
Q

What are signs of cranial trauma?

A

Racoon eyes
Battle Sign
Hemoptypanum
Rhinorrhea or otorrhea

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7
Q

What are the signs of cranial trauma on funduscopic exam?

A

Papilledema (increased ICP)

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8
Q

What part of the neuro exam can give you a sense of the condition of the hemispheres/ brainstem?

A

Resp, pupils, eye movement, motor

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9
Q

What part of the brain is damaged in Cheyne-stokes resps?

A

Hemispheric: Metabolic, Toxic/infectious

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10
Q

What is the pattern of Cheyne-stokes resps?

A

Crescendo/decrescendo/apnea

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11
Q

How can you assess a Pt’s respirations if Pt on a ventilator?

A

Take off ventilator, breathing beyond rate of the ventilator

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12
Q

What are the different types of pupillary response?

A

Thalamic: small but reactive
Midbrain: Midpos and fixed
Pontine: pinpoint but reactive
Uncal: Dilated, asymetric and fixed

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13
Q

What is the prognosis of an uncal pupil?

A

impending death by brain herniation

CN3

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14
Q

WHat is Oculocephalic Reflex?

A

(Doll’s eyes) Supranuclear influences on oculomotor nerves are removed (eyes stay fixed)

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15
Q

What is Vestibulo-oculogyric- reflex?

A

Caloric Testing

Eyes deviate TOWARD cold (slow beat) and away from warm

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16
Q

What is Decorticate Posturing?

A

Bilateral Flexion at elbows and wrists with ext of lower ext

17
Q

What is Decerebrate Posturing?

A

Bilateral ext of elbows w/ ext of lower extremities