Stupor & Coma Flashcards Preview

Neuro Y2 > Stupor & Coma > Flashcards

Flashcards in Stupor & Coma Deck (23):
1

vasogenic edema

edema due to breakdown of BBB and fluid infiltration from vessel leakage

2

cytotoxic edema

edema due to cell damage

3

Hydrocephalus

excess accumulation of the CSF in the ventricular system (usually due to impaired flow or resorption of CSF

4

wallerian degeneration

degeneration of an axon distal to the site of injury

5

stupor

pathological reduced LOC from which person can be aroused w/ intense or persistant stimulation

6

hysterical coma

coma-like state w/ normal EGG, nystagmus and neuro signs

7

what maintains consciousness?

the reticular formation of the rostral brainstem

8

what depresses consciousness?

bilateral diffuse suppression of cerebral cortical activity or damage to the reticular formation

9

decorticate position

upper ext. flexion and low ext. extension (damage to diencephalon)

10

decerebrate position

upper and lower ext. extension (damage to mesencephalon or upper pons)

11

what are the milestones of decreasing respiratory function?

sighing and yawning --> Cheyne-Stokes resp. pattern --> central neurogenic hyperventialtion --> ataxic respirations, apnea

12

what is the last brainstem reflex to be affected with midbrain damage?

pupillary light reflex

13

general effects of damage/pressure on the upper diencephalon (thalamus)?

drowsy, yawning, sighs
small, reactive pupils (SNS affected)
depression of nystagmus
left hemiparesis, bilateral paratonia

14

general effects of damage/pressure on the lower diencephalon (hypothalamus)?

coma
cheyne-stokes respirations
small reactive pupils
no nystagmus
hemiparesis, decorticate posturing

15

general effects of damage/pressure on the mesencephalon (midbrain)?

coma
Cheyne Stokes of Central neuro hyperventilation
pupils fixed in mid-position
dysconjugate ocular response
decerebrate posturing

16

general effects of damage/pressure on the upper pons?

coma
hyperventialtion or ataxic respirations
midposition, fixed pupils
decr. ocular responses
decerebrate

17

general effects of damage/pressure on the lower pons or medulla?

coma
ataxic or apneic respirations
midposition fixed pupils
no ocular-vestibular reflexes
flaccid body

18

What is the most common cause of stupor or coma?

metabolic encephalopathy

19

What is the vegetative state?

pt. is wakeful but is not aware of self and environment (brainstem and hypothalamus are spared)

20

What commonly causes the vegetative state?

1. diffuse hypoxic-ischemic neuronal damage (MI)
2. diffuse axonal injury (trauma)

21

What is the minimally conscious state?

profound lack of consciousness, but partial or intermittent evidence of awareness of self and environment

22

Locked-in syndrome

state of profound paralysis in which the patient is alert and awake - can still perform vertical eye movements and eyelid movements

23

general criteria for brain death

no drugs on board, normal temp, normal BP, coma, apnea, no reflexes, can be confirmed with neuroimaging, CT or MR angiography, or EEG testing (isoelectric)