Causes of Coma Classification

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Questions and Answers

What are the two main classifications of the causes of coma mentioned in the text?

  • Psychiatric and neurological
  • Arousal and pupillary
  • Structural and metabolic (correct)
  • Toxic and respiratory

Which respiratory pattern is usually associated with irregular breathing in coma patients?

  • Central hyperventilation
  • Apneustic respiration
  • Normal or hyperventilation
  • Cheyne–Stokes (correct)

What may mimic coma according to the text?

  • Respiratory irregularities
  • Toxic substances
  • Psychiatric disorders (correct)
  • Metabolic imbalances

In coma patients, what is the typical status of pupillary size and reaction?

<p>Equal, reactive to light (B)</p> Signup and view all the answers

What can cause unequal or unreactive pupils to light, with fixed midposition?

<p>Epidural hemorrhage (B)</p> Signup and view all the answers

Which type of rigidity implies a destructive lesion of the corticospinal tracts within or very near the cerebral hemispheres?

<p>Decorticate Rigidity (C)</p> Signup and view all the answers

In the context of brain damage, which condition involves a hemiplegia that is flaccid early in its course?

<p>Flaccid Hemiplegia (B)</p> Signup and view all the answers

What does decerebrate rigidity typically involve?

<p>Jaws clenched and neck extended (B)</p> Signup and view all the answers

What does dilated, fixed pupils suggest in the context of anticholinergics or hypothermia?

<p>Brainstem infarct (D)</p> Signup and view all the answers

Which condition is characterized by the arms flexed tight to the sides with internally rotated legs?

<p>Abnormal Flexor Response (B)</p> Signup and view all the answers

What might cause decerebrate rigidity?

<p>Severe metabolic disorders such as hypoxia or hypoglycemia (B)</p> Signup and view all the answers

What type of response is seen in decerebrate rigidity?

<p>Abnormal Extensor Response (C)</p> Signup and view all the answers

Which condition involves sudden unilateral brain damage producing a hemiplegia that is flaccid early in its course?

<p>Flaccid Hemiplegia (A)</p> Signup and view all the answers

What is suggested by unequal or unreactive pupils with fixed midposition?

<p>Epidural hemorrhage (D)</p> Signup and view all the answers

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Study Notes

Causes of Coma

  • There are two main classifications of the causes of coma: structural and metabolic

Respiratory Patterns in Coma

  • Cheyne-Stokes respiration is usually associated with irregular breathing in coma patients

Differential Diagnosis of Coma

  • Psychogenic unresponsiveness, catatonia, and Locked-In syndrome may mimic coma

Neurological Examination in Coma

  • The typical status of pupillary size and reaction in coma patients is unequal or unreactive pupils with fixed midposition

Pupillary Abnormalities

  • Unequal or unreactive pupils to light, with fixed midposition can be caused by midbrain damage or anticholinergics

Types of Rigidity

  • Decorticate rigidity implies a destructive lesion of the corticospinal tracts within or very near the cerebral hemispheres
  • Decerebrate rigidity typically involves extension of all four limbs and arching of the back

Neurological Conditions

  • Spastic hemiplegia involves a hemiplegia that is spastic late in its course, whereas flaccid hemiplegia involves a hemiplegia that is flaccid early in its course
  • Middle cerebral artery syndrome involves sudden unilateral brain damage producing a hemiplegia that is flaccid early in its course

Decerebrate Rigidity

  • Decerebrate rigidity may be caused by a destructive lesion in the rostral pons or midbrain
  • Decerebrate rigidity typically involves an extensor response to stimuli

Ocular Signs

  • Dilated, fixed pupils suggest anticholinergics or hypothermia
  • Unequal or unreactive pupils with fixed midposition suggest midbrain damage

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