coma, vegetative state

Question 1

what is a coma

Answer 1

a state of unrousable phychological unresponsiveness. don’t respond to any external stimuli

Question 2

what does consciousness depend on

Answer 2

1. intact ascending reticular activating system
2. a functioning cerebral cortex of both hemispheres which determines content of that consciousness

Question 3

what decreases consciousness

Answer 3

toxic/metabolic states
seizures
damage to reticular activating system
raised intracranial pressure (tumour or stroke)

Question 4

neurological assessment of coma

Answer 4

1. glasgow coma scale
2. brainstem function
3. motor function and reflexes

Question 5

how do you care for patients in a coma

Answer 5

1. maintain vital functions
2. avoid pressure sores
3. attention to bladder and bowel function
4. DVTs

Question 6

what is locked in syndrome

Answer 6

body and most facial muscles are paralysed but consciousness remains and the ability to preform certain eye movements is preserved

Question 7

extra dura haemotoma on a CT

Answer 7

concave/convex and shows a big bulge

Question 8

sub-dual on CT

Answer 8

banana shape

Question 9

how do you treat raised intracranial pressure

Answer 9

surgery to relieve pressure
osmotic agents e.g mannitol
maintain good pO2 and reduced PCO2
reduce metabolism- hypothermia

Question 10

what is the rosier scale

Answer 10

determine if someone has had a stroke

Question 11

what Is a hemicraniectomy

Answer 11

decompressive surgery for severe cerebral swelling post- stroke