Quiz 1 - definitions, substrates, evaluation of consciousness Flashcards Preview

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Flashcards in Quiz 1 - definitions, substrates, evaluation of consciousness Deck (53)
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31

pupils in damage to caudal levels of midbrain

- CNIII damage as in mesencephalon
- added damage to sympathetics
- pupils midsized (4-7mm)
- no reaction to light

32

pupils in damage to pons/medulla

- same as midbrain
- midsize and fixed

33

pupils in isolated pons or isolated medulla damage with maintained integrity of midbrain

- only loss of sympathetics
- very constricted pupils (1mm or less)

34

pupils in suppression of brainstem by drugs

- loss of light reflex

35

what happens in auditory ice water test if reticular formation is functional but there is diffuse cerebral damage?

- eyes go toward ice water side and stay there for minutes
- no nystagmus

36

in terms of eye movement, diffuse damage to cerebral cortex results in loss of.....

- fast component of vestibulo-ocular reflex (nystagmus)
- degree of suppression is proportionate to degree of damage

37

eye movements in damage to midbrain

dysconjugate eye movements

38

tonic conjugate deviation of the eyes during caloric stimulation indicates that....

the brainstem/reticular activating system is still intact

39

eye movement in damage to brainstem through the pons

- no reaction at all to caloric stimulation
- no corneal reflex

40

how will a lightly stuporous patient react to noxious stimuli?

- localize it
- knock it away or grab it

41

how will a deep stupor patient react to noxious stimuli?

- withdrawal (stereotyped)

42

noxious stimulation reaction of a comatose patient with damage to diencephalon

decorticate posturing

43

elements of decorticate posturing

- flexion of arms, wrists, fingers
- extension of lower limps
- may be asymmetric at first, appearing first on side of greater damage

44

noxious stimulation reaction of a comatose patient with damage to mesencephalon or upper pons

decerebrate posturing

45

elements of decerebrate posturing

extension and internal rotation of arms and legs

46

what motor response is usually seen in pontine and medullary damage?

flaccid paralysis

47

last reflex that can still be detected as metabolic dysfunction progresses

light reflex

48

5 categories of metabolic dysfunction

1) oxygen
2) toxic
3) acid-base/ionic
4) postictal
5) traumatic

49

examples of toxic metabolic dysfunction

endogenous - liver, kidney failure
exogenous - drug overdose
CNS - meningitis, encephalitis

50

what is most commonly the cause of depressed consciousness in a demented patient?

- metabolic
- demented patient's remaining cortical function is much more sensitive to stressors such as renal dysfunction, infections, drugs...

51

two major causes of vegetative state

- hypoxic ischemia
- shear force from trauma

52

are those in vegetative state conscious? aware?

no and no

53

contrast minimally conscious state with vegetative state

- require same interventions
- MCS can respond to stimuli and stimulant medications
- MCS partial or intermittent evidence of awareness to self and environment