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Flashcards in altered mental status Deck (21)
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1
Q

deep dreamlike state from which one cannot be aroused

A

coma

2
Q

awake but responds to commands only

A

lthargic

3
Q

appears asleep, responds to light glabellar tap/stimulus

A

obtunded

4
Q

appears alseep, very sluggish

A

stuperous

5
Q

appears awake, but nonresponsive

A

vegetatitve state

6
Q

few voluntary movements, will blink in response to visual threat, resist eyelid elevation

A

catatonia

7
Q

pt awake but can only move eyes/eyelids

A

CPM

8
Q

causes of coma

lesions that damage ___ in thalamus or projections

pupils enlarged, loss of light reflex, loss vertical/adduction mvmnt
lesion is in ___

eye mvmnt preserved but as before, lesions is to ___

A

RAS

upper brainstem

upper cerebral hemisphere

9
Q

cause of com

destruction of large portion of both ____

suppression via __/___

A

cerebral hemispheres

drugs/metabolism

10
Q

when uncus impacts tentorial opening just anterior/adjacent to midbrain
___ herniation

displaced brain tissue compresses ___ as it traverse the SA space

results in enlagred ___, w coma

A

uncal tentorial

midbrain

ipsilateral pupil

11
Q

symmetric downward movement of thalamic medial structures through tentorial opening w compressed upper midbrain

mitotic pupils/drowsiness

___ herniation

A

central transtentorial herniaton

12
Q

Cerebral neurons depend on ___/___

coma from H/I/H/H
__/__ failure
altered ____

A

oxygen/glucose

hypoxia/isheia/hypoGly/hyperosmolarity
hepatic/reanl
neuron excitability

13
Q

dec flexion of elbow/wrists and supination of arms
___ rigidity

suggests bilateral damage __ to midbrain

dec extension of wrists/elbows w pronation
___ rigidity
damage to __ or caudal __

A

decorticate
rostral

decerebrate
midbrain, diencephalon

14
Q

one enlarged pupil suggest mass effect compressing __

bilaterla fixed/dilated pupils suggests sevre ___

pinpoint pupils w __/__ OD or __ hemorrhage

A

CN3

midbrain damage
Pons

15
Q

conjugate horizontal ocular deviation indicates damage to __ on other side, or __ on same side

brisk downward, slow upward movement of eyes, loss of horizontal eye mvmnt
Bilateral __ damage

A

pons, frontal lobe

pontine

16
Q

positive dolls eyes reflex

need __ motor nuclei and connections to __/_/__

suggests reduced __ on brainstem

A

ocular
MB/Pons/Medulla

cortical influence

17
Q

Caloric stimulation to induce ___ in labrynths

will have tonic deviation of ___ to side of cool water w ___ in opposite

loss indicates damage to __
absence of nystagmus suggest __ damage

A

convection currents
both eyes, nystagmus
brainstem
cerebral hemispheres

18
Q

shallow, slow, regular breathing

suggests __/__

A

met/drugs

19
Q

cyclic w apnea is ___

suggest __ damage or __ w light coma

A

CS

bihemospheral damage/metabolic

20
Q

rapid, deep breathing is __

seen w ___

A

Kussmaul

Macid

21
Q

terminal respirations, agonal gap w ___ damage

A

medullary