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10 Cards in this Set
- Front
- Back
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When can eyes be open in coma
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metabolic coma
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Neurologic basis of coma
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cortical dysfunction primary or secondary to brainstem injury
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Do all brainstem lesions cause coma
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those below pons do not
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How to test thalamic function
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pain. Improper response: decorticate (subthalamic)/ decerebrate (mudbrain/ upper pontine) movement.
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How to test the Midbrain
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pupillary reflex.
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Pontine pupils
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bilaterally small, react to light.
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Pinpoint pupils
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small, reactive. Opiates
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How to test pons
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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.
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How to test medulla
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medulla controls cardiorespiratory. Test with apnea. Positive if arterial PCO2 >60mmHG
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Toxic metabolic coma affects what part of the CNS
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BS and cortex, more likely cortex only. Reversible
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