STUDY - Technical - New Dacian's Medicine
Decorticate
posture (Classical / Allopathic Medicine)
A sign of
corticospinal damage, decorticate posture (decorticate
rigidity, abnormal flexor response) is characterized by
adduction of the arms and flexion of the elbows, with wrists
and fingers flexed on the chest. The legs are extended and
internally rotated, with plantar flexion of the feet. This
posture may occur unilaterally or bilaterally. (See
Recognizing decorticate posture.)
Decorticate
posture usually results from stroke or head injury. It may be
elicited by noxious stimuli or may occur spontaneously. The
intensity of the required stimulus, the duration of the
posture, and the frequency of spontaneous episodes vary with
the severity and location of cerebral injury.
Although a serious
sign, decorticate posture carries a more favorable prognosis
than decerebrate posture. However, if the causative disorder
extends lower in the brain stem, decorticate posture may
progress to decerebrate posture.
ALERT:
If you observe decorticate posture:
- obtain vital signs, and evaluate the patient's level of consciousness (LOC) (If LOC is impaired, insert an oropharyngeal airway, elevate his head 30 degrees, and turn his head to the side to prevent aspiration, unless spinal cord injury is suspected.)
- evaluate the patient's respiratory rate, rhythm, and depth (Prepare to institute emergency measures if necessary.)
- institute seizure precautions.
After the patient has stabilized, perform a focused assessment.
If you observe decorticate posture:
- obtain vital signs, and evaluate the patient's level of consciousness (LOC) (If LOC is impaired, insert an oropharyngeal airway, elevate his head 30 degrees, and turn his head to the side to prevent aspiration, unless spinal cord injury is suspected.)
- evaluate the patient's respiratory rate, rhythm, and depth (Prepare to institute emergency measures if necessary.)
- institute seizure precautions.
After the patient has stabilized, perform a focused assessment.
HISTORY:
Ask the patient about headache, dizziness, nausea, abnormal vision, and numbness or tingling.
Ask the patient's family when decorticate posture was first noticed.
Ask the patient's family about behavior changes.
Review the patient's medical history for cerebrovascular disease, cancer, meningitis, encephalitis, upper respiratory tract infection, and recent trauma.
Ask the patient about headache, dizziness, nausea, abnormal vision, and numbness or tingling.
Ask the patient's family when decorticate posture was first noticed.
Ask the patient's family about behavior changes.
Review the patient's medical history for cerebrovascular disease, cancer, meningitis, encephalitis, upper respiratory tract infection, and recent trauma.
Recognizing
decorticate posture
Decorticate posture results from damage to one or both corticospinal tracts. With this posture, the arms are adducted and flexed, with the wrists and fingers flexed on the chest. The legs are usually extended and internally rotated, with plantar flexion of the feet.
PHYSICAL ASSESSMENT:
Take the patient's vital signs.
Determine the patient's LOC, using the Glasgow Coma Scale as a reference. Be alert for signs of increased intracranial pressure (such as bradycardia, increasing systolic blood pressure, and widening pulse pressure) and neurologic deterioration (such as altered respiratory pattern and abnormal temperature).
Test motor and sensory functions.
Evaluate pupil size, equality, and response to light.
Test cranial nerve and deep tendon reflexes.
Decorticate posture results from damage to one or both corticospinal tracts. With this posture, the arms are adducted and flexed, with the wrists and fingers flexed on the chest. The legs are usually extended and internally rotated, with plantar flexion of the feet.
PHYSICAL ASSESSMENT:
Take the patient's vital signs.
Determine the patient's LOC, using the Glasgow Coma Scale as a reference. Be alert for signs of increased intracranial pressure (such as bradycardia, increasing systolic blood pressure, and widening pulse pressure) and neurologic deterioration (such as altered respiratory pattern and abnormal temperature).
Test motor and sensory functions.
Evaluate pupil size, equality, and response to light.
Test cranial nerve and deep tendon reflexes.
SPECIAL
CONSIDERATIONS:
Assess the patient frequently to detect subtle signs of neurologic deterioration.
Assess the patient frequently to detect subtle signs of neurologic deterioration.
PATIENT
COUNSELING:
Instruct the patient and his family on what to expect from diagnostic testing and treatment. Provide emotional support.
Instruct the patient and his family on what to expect from diagnostic testing and treatment. Provide emotional support.
Bibliography:
1. Rapid Assessment, A
Flowchart Guide to Evaluating Signs & Symptoms, Lippincott
Williams & Wilkins, 2004.
2. Professional Guide to
Signs and symptoms, Edition V, Lippincott
Williams & Wilkins, 2007.
3. Guide to common
symptoms, Edition V, McGraw - Hill, 2002.
Dorin,
Merticaru (2010)