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DISORDERS OF CONSCIOUSNESS (DoCs)
Join me for another #neuropalliative care Tweetorial about a very broad and complicated topic: @MedTweetorials #NeuroTwitter #NeuroPal #hapc #MedEd
Join me for another #neuropalliative care Tweetorial about a very broad and complicated topic: @MedTweetorials #NeuroTwitter #NeuroPal #hapc #MedEd
My goal for this 🧵 is to define key features of coma, vegetative state (VS), and minimally conscious state (MCS). And why it matters for #PalliativeCare.
This is not a Tweetorial on brain death or prognostication right after brain injury. Stay tuned for those🤓 2/17
This is not a Tweetorial on brain death or prognostication right after brain injury. Stay tuned for those🤓 2/17
To understand differences between disorders of consciousness (DoC) is to separate the ideas of being awake and being aware:
3/17
3/17
But first, an anatomy refresher:
3 major glands involved: parotid, submandibular (SM), sublingual (SL)
💦 Unstimulated state: about 70% of saliva from SM + SL
💦 Stimulated state: 5x ⬆️ production, mostly via parotid
⚡CN 7 innervates SM & SL
⚡CN 9 innervates parotid
2/11
3 major glands involved: parotid, submandibular (SM), sublingual (SL)
💦 Unstimulated state: about 70% of saliva from SM + SL
💦 Stimulated state: 5x ⬆️ production, mostly via parotid
⚡CN 7 innervates SM & SL
⚡CN 9 innervates parotid
2/11
Saliva is produced via parasympathetic (muscarinic cholinergic) tone and cleared via swallowing.
Drooling = when thin saliva is present past the lip margin
Etiologies:
1. Impaired clearance (think neuromuscular dz ⬇️ swallowing)
2. Overproduction (think 💊 side effect)
3/11
Drooling = when thin saliva is present past the lip margin
Etiologies:
1. Impaired clearance (think neuromuscular dz ⬇️ swallowing)
2. Overproduction (think 💊 side effect)
3/11
