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Flashcards in coma Deck (26):
1

no alteration of arousal

alert

2

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

lethargy

3

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

stupor

4

unarousable unresponsiveness

coma

5

unconsciousness occurs via what mechanisms (2)

1. affects both hemispheres
2. affects brainstem

6

where the system of arousal begins

reticular formation

7

where does the reticular formation reside?

posterior to pons

8

signs of trauma (4)

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

9

how to assess brainstem?

respirations, pupils, eye movements, motor

10

slow oscillation b/w hyper and hypoventilation

cheyne stokes respiration

11

normal respiration indicates that what is intact

brainstem + forebrain

12

rapid continuous hyperventilation 25+ bpm

central neurogenic respiration

13

prolonged inspiratory gasp with pause at full respiration

apneustic breathing

14

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

cluster

15

irregular breathing rate and rhymthm

ataxic

16

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

diffuse (metabolic, infectious, toxic)

17

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

cheyne stokes

18

pinpoint pupil that are reactive indicates lesion where?

pontine

19

dilated, asymmetric and fixed pupil

uncal

20

how to elicit eye movement in comatose patient (2)

1. oculocephalic reflex
2. vestibulo-oculogyric reflex

21

which test to use when suspect someone is braindead

vestibulo-oculogyric reflex

22

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

towards the cold

23

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

decorticate posturing

24

bilateral extension of elbows with extension of lower extremities

decerebrate posturing

25

metabolic onset is ____vs structural is___

slower; faster

26

do metabolic disorders have symmetric or focality?

symmetric