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MS2 - Nervous System > Coma > Flashcards

Flashcards in Coma Deck (13)
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1
Q

Differentiate the terms delirium, stupor, and coma.

A

Delirium: fluctuating levels of consciousness with misperceptions and inability to maintain attention

Stupor: a sleep-like state from which the patient can only be aroused by vigorous stimuli

Coma: a state from which the patient cannot be aroused by stimuli; no sleep-wake cycles

2
Q

By GCS definition, “coma” means ____________.

A
  • inability to follow commands
  • inability to speak recognizable commands
  • inability to open either eye
3
Q

Define vegetative state.

A

A state in which sleep-wake cycles reestablish, but no cognitive function is present. A patient may open eyes spontaneously, but there is no evidence of perception, communication, or purposeful motor activity.

4
Q

The Uniform Determination of Death Act defines death as _________________.

A

(1) irreversible cessation of cardiopulmonary function or (2) irreversible cessation of brain function

5
Q

The three criteria of brain death (for the Death Act) are ____________________.

A

(1) unresponsiveness, (2) lack of motor response to painful stimuli, and (3) absence of brainstem reflexes

6
Q

Brain death is determined by neurologic finding of _____________.

A

(1) core body temp of less than 90° F
(2) toxicology tests find no explanation for neurologic state (CNS depressants must be subtherapeutic)
(3) adequate BP and pulse (SBP greater than 90; HR greater than 50
(4) no voluntary movements to pain or otherwise (spinal reflexes are not included in this)

7
Q

What is the cold caloric test?

A

Pour 20 mL in the external auditory canal. A positive result is eye movement.

8
Q

How do you elicit a cough reflex?

A

Suction the carina –this tests CN X

9
Q

The apnea test is done by __________________.

A

disconnecting the ventilator. If the patient has even a little brainstem function, then they will start breathing deeper/faster. If they don’t, then they will not. The test is stopped when the patient’s pCO2 has risen 20 mmHg above normal and no ventilatory effort is present.

10
Q

Consciousness is ____________________.

A

the product of biological events occurring within deep anatomical structures of the brain called the brainstem and thalamus

11
Q

Plum and Posner –in 1982 –defined unconsciousness as ______________________.

A

“bilateral impairment of cerebral functions or failure of the brainstem ascending reticular activating system or both”

12
Q

Upper extremity ______________ suggests a decerbrate (upper brainstem) lesion with a worse prognosis.

A

extension (EXTension = EXTra bad)

13
Q

Vegetative state is considered permanent ____ months after an anoxic event and _____ months after trauma.

A

3; 12

Decks in MS2 - Nervous System Class (111):