Coma CC5 Flashcards
cheynne stokes respiratiorn means ___ isnt working
diencephalon
Pupillary Light Reaction
sympathetic probem.. eyes can’t
dilate
Pupillary light reflex
Parasympathetic problem then the eyes can’t
constrict
OculoVestibular reflexes: vestibular nucleus excitation causes excitations of contralateral
lateral rectus (via 6)
OculoVestibular reflexes: vestibular nucleus excitation causes excitations of ipsilateral
medial rectus via 3
Decorticate = lesion above the
red nucleus of the midbrain
Decorticate posture
what is flexed and adducted
arm, wrist, finger flexion, adduction of upper extremity
decorticate posture what is extended
leg extension, internal rotation, plantar flexion
Decerebrate = lesion below the red nucleus, release of __ output
vestibulospinal
with both decorticate and decerebrate you get
extension of legs and planatr flexion
sx of decerberate posturing
- internal rotation of arms, clenching of jaws, stiff extension of limbs - extension of trunk and legs (opisthotonos), plantar flexion
Bilateral Diencephalic Stage (thalamus)
respiration pattern?
Cheyenes- Stokes
Bilateral Diencephalic Stage (thalamus)
pupillary size?
Small pupils with small range of constriction
Bilateral Diencephalic Stage (thalamus)
eye reflexes?
Eye reflexes normal (because brainstem is unaffected)
Bilateral Diencephalic Stage (thalamus)
Motor Responses at rest and to stimulation
Motionless, bilateral Decorticate posturing upon stimulation
if someone is in a coma it is the ___ or ____
reticular formation or bilateral cortex
occulovestibular reflexes tests the inetrgrity of the
pons and portion of the midbrain
___ consistes of opthotonos
decerebrate
opsithotonos involves the
extension of the trunk and neck
Bilateral Midbrain Stage (reticular activating system)
respiratory pattern
Central Neurogenic Hyperventilation, rarely cheynne stokes
Bilateral Midbrain Stage (reticular activating system)
pupillary size and rxn?
Irregular, no pupillary constriction
Bilateral Midbrain Stage (reticular activating system)
Oculocephalic and Oculovestibular Reflexes ??
Disconjugate eye reflexes - only CN6/ abduction present
Bilateral Midbrain Stage (reticular activating system)
Motor Responses at rest and to stimulation
Motionless, bilateral Decerebrate posturing upon stimulation
Central Neurogenic Hyperventilation suggests eihter (2)
- bilateral midbrain stage (reticular activating system)
- late 3rd nerve stage
Small pupils with small range of constriction
suggests either
bilateral or uniulateral dienephalic stage
No vestbibularoculo reflexes suggests
bilateral pontine stage
if ipsilateral eye can’t move medially that suggests
late 3rd nerve stage (midbrain)
Can cause either Decorticate or Decerebrate response
late 3rd nerve stage
___ stage can cause Babinski’s sign on both sides
unilateral diencephalic
Bilateral Pontine Stage
Motor Responses at rest and to stimulation
Motionless, Flaccid muscles
Motionless, bilateral Decerebrate posturing upon stimulation
Bilateral Midbrain Stage (reticular activating system)
Bilateral Midbrain Stage (reticular activating system)
Motor Responses at rest and to stimulation
Motionless, bilateral Decerebrate posturing upon stimulation
no pupillary consitrction suggests
bilateral midbrain, bialteral pons, late 3rd nerve stage
Ipsilateral pupil widely dilated suggests
late 3rd nerve stage
ptosis suggests
Late 3rd Nerve Stage (midbrain)
RR deep and regular –> central hyperventilation –> ___ lesion
midbrain
uncal herination puts pressure on the
midbrain
