Nurse Linda is caring for a client with head injury and monitoring the client with decerebrate posturing. Which of the following is a characteristic of this type of posturing?
A. Upper extremity flexion with lower extremity flexion
B. Upper extremity flexion with lower extremity extension
C. Extension of the extremities after a stimulus
D. Flexion of the extremities after stimulus
Correct Answer: C. Extension of the extremities after a stimulus
Decerebrate posturing is the extension of the extremities after a stimulus which may occur with upper brain stem injury. Decerebrate posturing is described as adduction and internal rotation of the shoulder, extension at the elbows with pronation of the forearm, and flexion of the fingers.
Option A: Decerebrate posturing is the extension, not flexion, of extremities. As with decorticate posturing, the lower limbs show extension and internal rotation at the hip, with the extension of the knee and plantar flexion of the feet. Toes are typically abducted and hyperextended.
Option B: The upper extremity should be in extension as well as the lower extremity. Decerebrate posturing can be seen in patients with large bilateral forebrain lesions with progression caudally into the diencephalon and midbrain. It can also be caused by a posterior fossa lesion compressing the midbrain or rostral pons.
Option D: There is an extension of extremities after a stimulus in decerebrate posturing. Teasdale and Jennett advocated not using the term ‘decerebrate’ in the assessment of coma due to its association with a specific physio anatomical correlation, but to rather use the term ‘extension.’