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10 Cards in this Set

  • Front
  • Back
When can eyes be open in coma
metabolic coma
Neurologic basis of coma
cortical dysfunction primary or secondary to brainstem injury
Do all brainstem lesions cause coma
those below pons do not
How to test thalamic function
pain. Improper response: decorticate (subthalamic)/ decerebrate (mudbrain/ upper pontine) movement.
How to test the Midbrain
pupillary reflex.
Pontine pupils
bilaterally small, react to light.
Pinpoint pupils
small, reactive. Opiates
How to test pons
doll’s eye reflex. Tests MLF (embedded in RAS). Comatose, eyes move to fixed point. Brainstem damage, eyes stay fixed at midline. Awake, eyes don’t move, follow movement.
How to test medulla
medulla controls cardiorespiratory. Test with apnea. Positive if arterial PCO2 >60mmHG
Toxic metabolic coma affects what part of the CNS
BS and cortex, more likely cortex only. Reversible