coma

Question 1

no alteration of arousal

Answer 1

alert

Question 2

motor slowness, tired, easily aroused, aware of self/environment

Answer 2

lethargy

Question 3

unresponsiveness from which the patient can be aroused only be vigorous, often noxious stimuli

Answer 3

stupor

Question 4

unarousable unresponsiveness

Answer 4

coma

Question 5

unconsciousness occurs via what mechanisms (2)

Answer 5

1. affects both hemispheres

2. affects brainstem

Question 6

where the system of arousal begins

Answer 6

reticular formation

Question 7

where does the reticular formation reside?

Answer 7

posterior to pons

Question 8

signs of trauma (4)

Answer 8

1. raccoon eyes
2. battle sign
3. hemotypanum
4. rhinorrhea or otorrhea

Question 9

how to assess brainstem?

Answer 9

respirations, pupils, eye movements, motor

Question 10

slow oscillation b/w hyper and hypoventilation

Answer 10

cheyne stokes respiration

Question 11

normal respiration indicates that what is intact

Answer 11

brainstem + forebrain

Question 12

rapid continuous hyperventilation 25+ bpm

Answer 12

central neurogenic respiration

Question 13

prolonged inspiratory gasp with pause at full respiration

Answer 13

apneustic breathing

Question 14

periodic respirations w/ variable amplitude & frequency with variable pauses b/w clusters

Answer 14

cluster

Question 15

irregular breathing rate and rhymthm

Answer 15

ataxic

Question 16

what type of brain problems are most commonly assc’d with cheyne stokes

Answer 16

diffuse (metabolic, infectious, toxic)

Question 17

which respiratory pattern is the only one not assc’d with the brainstem?

Answer 17

cheyne stokes

Question 18

pinpoint pupil that are reactive indicates lesion where?

Answer 18

pontine

Question 19

dilated, asymmetric and fixed pupil

Answer 19

uncal

Question 20

how to elicit eye movement in comatose patient (2)

Answer 20

1. oculocephalic reflex

2. vestibulo-oculogyric reflex

Question 21

which test to use when suspect someone is braindead

Answer 21

vestibulo-oculogyric reflex

Question 22

if brainstem is intact in comatose patient, which direction will the eyes deviate when cold water is injected into the ear?

Answer 22

towards the cold

Question 23

bilateral flexion at the elbows/wrists with extension of lower extremities

Answer 23

decorticate posturing

Question 24

bilateral extension of elbows with extension of lower extremities

Answer 24

decerebrate posturing

Question 25

metabolic onset is ____vs structural is___

Answer 25

slower; faster

Question 26

do metabolic disorders have symmetric or focality?

Answer 26

symmetric