Coma Flashcards
What is lethargy?
Motor slowness, tried, sleepy, easily aroused, aware of self and envt
What is a stupor?
Unresponsiveness from which Pt can only be aroused by vigorous/noxious stimuli
What is Coma?
Unarousable unresponsiveness
Cannot be aroused
No purposeful response to the envt.
What part of the brain is responsible for consciousness
Pontine reticular activating system. Posterior portion of the Pons => Thalamus => Cortex
How can unconsciousness be achieved?
Systemic/broad effect: sepsis, bleeding into ventricles, hydrocephalis, massive stroke affecting both hemispheres. Swelling of one hemisphere effecting other. Stroke affecting PRAS.
What are signs of cranial trauma?
Racoon eyes
Battle Sign
Hemoptypanum
Rhinorrhea or otorrhea
What are the signs of cranial trauma on funduscopic exam?
Papilledema (increased ICP)
What part of the neuro exam can give you a sense of the condition of the hemispheres/ brainstem?
Resp, pupils, eye movement, motor
What part of the brain is damaged in Cheyne-stokes resps?
Hemispheric: Metabolic, Toxic/infectious
What is the pattern of Cheyne-stokes resps?
Crescendo/decrescendo/apnea
How can you assess a Pt’s respirations if Pt on a ventilator?
Take off ventilator, breathing beyond rate of the ventilator
What are the different types of pupillary response?
Thalamic: small but reactive
Midbrain: Midpos and fixed
Pontine: pinpoint but reactive
Uncal: Dilated, asymetric and fixed
What is the prognosis of an uncal pupil?
impending death by brain herniation
CN3
WHat is Oculocephalic Reflex?
(Doll’s eyes) Supranuclear influences on oculomotor nerves are removed (eyes stay fixed)
What is Vestibulo-oculogyric- reflex?
Caloric Testing
Eyes deviate TOWARD cold (slow beat) and away from warm
