The nurse becomes concerned when a client who sustained a head injury from a motor vehicle crash begins to demonstrate an abnormal posture. (See image). What does this posture suggest to the nurse about the client's brain functioning?
A) Altered level of consciousness
B) Developing a seizure disorder
C) Brain stem impairment
D) Corticospinal tract impairment
Answer: C
Brain function deterioration usually follows a predictable progression in which higher levels of function are impaired first and progress to impairment of more primitive functions. Altered level of consciousness (LOC) is an early manifestation of the deterioration of the function of the cerebral hemispheres. Seizure disorders have various types of motor postures. Structures in the brainstem have characteristic changes in motor function. Evidence of brainstem involvement includes decerebrate posturing that is distinguished by rigid extension. Corticospinal tract impairment is characterized by decorticate posturing which is rigid flexion.
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