L11: Coma

Question 1

Consciousness

Answer 1

Question 2

Wakefulness

Answer 2

arousal, vigilance, alertness

Question 3

Awareness

Answer 3

self or environment

Question 4

• No awareness without wakefulness
• Wakefulness can occur without awareness (vegetative state)

Answer 4

….

Question 5

Def of Coma

Answer 5

Question 6

Def of Coma

• The Eyes

Answer 6

Closed & do Not open spontaneously or to verbal command (E2).

Question 7

Def of Coma

• Awareness & Arousal

Answer 7

No

Question 8

Def of Coma

• Verbal Stimulation

Answer 8

No Response

Question 9

Def of Coma

• Painful Stimulation

Answer 9

• No response or non-purposeful reflex movements mediated through spinal cord or brainstem pathways.

Question 10

Def of Coma

• speech

Answer 10

No Spontaneous Speech or Movement

Question 11

Def of Coma

• Movemenmt

Answer 11

No Purposeful movement of the face or limbs

Question 12

Def of Coma

• Duration

Answer 12

Lasts > 1h (of syncope and concussion)

Question 13

Def of Coma

• Noxiuos Stimuli

Answer 13

• Vocalization → limited or Absent (V2)
• Motor activity → Absent/Abnormal/Reflexive (not purposeful or defensive) (M4)

Question 14

Coma is Characterized by …..

Answer 14

1. No sleep wake cycles.
2. Transitional.
3. Injury or functional disruption of bilateral cortical structures or ARAS.

Question 15

Causes of Coma

Answer 15

Question 16

Causes of Coma

• Structural

Answer 16

Question 17

Causes of Coma

• Metabolic

Answer 17

Question 18

Generalized Neuronal Dysfunction

Answer 18

Question 19

Diffrentiating Features of Metabolic Coma

Answer 19

Question 20

GCS

Answer 20

Question 21

GCS

• Eye

Answer 21

Question 22

GCS

• Verbal

Answer 22

Question 23

GCS

• Mltor

Answer 23

Question 24

GCS

• Interpretation

Answer 24

Question 25

Basic Approach to trauma sccording to GCS

Answer 25

Question 26

Basic Approach to trauma sccording to GCS - GCS 15

Answer 26

- Age < 65 - No clinical evidence skull - No retrograde amnesia - No seizure - No significant mechanism of injury or serious assault

Question 27

Basic Approach to trauma sccording to GCS - Otehrwise

Answer 27

CT

Question 27

Basic Approach to trauma sccording to GCS - GCS 13-14

Answer 27

but 15 within 2 hours of injury and above

Question 28

General Ex of **Coma**

Answer 28

Question 29

INVx for **Coma**

Answer 29

Question 30

INVx for **Coma** - Blood

Answer 30

Question 31

INVx for **Coma** - CT

Answer 31

Question 32

INVx for **Coma** - Lumbar Puncture

Answer 32

Question 33

INVx for **Coma** - Pupillary Respones

Answer 33

Question 34

INVx for **Coma** - EEG

Answer 34

Question 35

Initaial TTT of **Coma**

Answer 35

Question 36

Initaial TTT of **Coma** - Airway

Answer 36

Question 37

Indications of Intubation in **Coma**

Answer 37

Question 38

Breathing management in Coma

Answer 38

Question 39

Circulation Managemnet oin **Coma**

Answer 39

Question 40

Disability Management in Coma

Answer 40