L7: Coma - Pt 3 Flashcards

1
Q

Clinical manifestations of ↑↑ ICP

A
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2
Q

Clinical manifestations of ↑↑ ICP

  • Non-Specific
A
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3
Q

Clinical manifestations of ↑↑ ICP

  • Neurological
A
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4
Q

Clinical manifestations of ↑↑ ICP

  • Comlications
A
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5
Q

Cushing Response

  • Indicates
A

Impending brain herniation

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6
Q

Cushing Response

  • Components
A

◈ Hypertension
◈ Bradycardia
◈ Decreased sensorium
◈ Sometimes + pupillary changes

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7
Q

Cushing Response

  • Mechanism
A
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8
Q

Assessment of Coma

  • Neurological Ex
A
  1. Level of consciousness
  2. Posture
  3. Cranial nerve examination
  4. Random blood sugar
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9
Q

Neuro Ex in Coma

  • LVL of Consciousness
A

A. AVPU score
B. Murray score for incubated child
C. Modified Glasgow Coma Scale

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10
Q

Consciousness Assessment in Coma

  • AVPU
A
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11
Q

Consciousness Assessment in Coma

  • Murray score for incubated child
A
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12
Q

Consciousness Assessment in Coma

  • Modified GCS
A
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13
Q

Significance of Modified Glasgow Coma scale

A
  • Provides easily reproducible basic neurologic exam
  • Allows physicians to track neurologic changes over time and multiple examiners
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14
Q

Posture in Assesment of Coma

A
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15
Q

Decorticate Posture

  • Site of Lesion
A

◈ Cerebral hemisphere
◈ Internal capsule
◈ Thalamus

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16
Q

Decorticate Posture

  • Mechanism
A

Damage to the corticospinal tract

17
Q

Decorticate Posture

  • Signs
A

◈ Abnormal rigidity
◈ Flexion of arms
◈ Extension of legs
◈ Clenched fists

18
Q

Decorticate Posture

  • Illustration
19
Q

Decerebrate Posture

  • Site of Lesion
20
Q

Decerebrate Posture

  • Mechanism
A

Damage below the red nucleus in the midbrain

21
Q

Decerebrate Posture

  • Signs
A

◈ Arched back head
◈ Extension of arms
◈ Extension of legs
◈ Extension of elbows

22
Q

Decerebrate Posture

  • Illustration
23
Q

Pupil Examination in Assessment of Coma

  • Causes of small Bilateral Fixed Pupils
A

Pontine lesion

24
Q

CN Ex in Coma

25
CN Ex in Coma - Pupillary Light Reflex
26
CN Ex in Coma - Corneal Reflex
27
CN Ex in Coma - Oculo-cephalic / Oculo-caloric reflex
28
CN Ex in Coma - gag Reflex
29
Pupil Examination in Assessment of Coma
30
Pupil Examination in Assessment of Coma - Causes of small Bilateral Reactive Pupils
◈ Barbiturate ◈ Narcotic ◈ Organophosphate
31
Pupil Examination in Assessment of Coma - Causes of small Unilateral Reactive Pupils
◈ Midbrain dysfunction ◈ Sympathetic dysfunction
32
Pupil Examination in Assessment of Coma - Causes of Normal Bilateral Fixed Pupils
Midbrain dysfunction
33
Pupil Examination in Assessment of Coma - Causes of Large Bilateral Reactive Pupils
◈ Post-ictal ◈ Anticholinergics ◈ Metabolic
34
Pupil Examination in Assessment of Coma - Causes of Large Bilateral Fixed Pupils
◈ Toxic ◈ Anoxic ◈ Metabolic
35
Pupil Examination in Assessment of Coma - Causes of Large Unilateral Fixed Pupils
◈ Third nerve lesion ◈ Tentorial herniation