# help with ams



## ttoude (Jan 13, 2009)

PT has AMS 80 Central and radial pulses diminished pedal pulses. non-reactive left pupil that is moving erratically and independently of the right one. 

Any guess'?


----------



## KEVD18 (Jan 13, 2009)

not enough cowbell


----------



## ttoude (Jan 13, 2009)

Not enough, that's what I said. That all the "S" I could gather. 23yo male, no drugs, NKA/NKDA, Lorazapam, Meal @ 30min ago, "E" unknown. 

Aggressive too.


----------



## KEVD18 (Jan 13, 2009)

its good that you shave your head or are naturally bald, because that joke flew over your head so fast it would have burned every follicle you had right off.


----------



## Jon (Jan 13, 2009)

Can you back up and present this like you would write a chart?

We don't all use the same shorthand... please present this case to us in "plain talk"

And Kev... same goes for you:


----------



## ttoude (Jan 13, 2009)

I can't believe I missed that one. that's my second fav SNL skit. Mr. Peepers is the first.

I mean really I'm just tryin to do the best cow bell I can do!


----------



## ttoude (Jan 13, 2009)

that's all the info I got


----------



## mycrofft (Jan 14, 2009)

*Pt related to Marty Feldman?*

.................


----------



## june125 (Jan 19, 2009)

what is ams? and what are the pts vitals, there is more to this than you are giving us.


----------



## Veneficus (Jan 19, 2009)

ttoude said:


> PT has AMS 80 Central and radial pulses diminished pedal pulses. non-reactive left pupil that is moving erratically and independently of the right one.
> 
> Any guess'?



it sounds like ams is altered mental status. i am guessing the 80 is a systolic estimation based on radial pulse. (inaccurate but accepted by some) and some kind of insult to the optic nerve. No drugs other than the lorazepam?

with his age, the meal, insult to optic nerve, and aggression I would hazard to guess:
1. cancer
2. arterio/venous malformation that ruptered. (aka hemorrhagic CVA)
3. focal seizure from benzo withdrawel

not in any particular order.

have no idea what "S" or "E" stands for.


----------



## june125 (Jan 19, 2009)

I would have to agree with a hemorrhagic cva or a seizure, but would like more information to go on.


----------



## boingo (Jan 19, 2009)

Veneficus said:


> it sounds like ams is altered mental status. i am guessing the 80 is a systolic estimation based on radial pulse. (inaccurate but accepted by some) and some kind of insult to the optic nerve. No drugs other than the lorazepam?
> 
> with his age, the meal, insult to optic nerve, and aggression I would hazard to guess:
> 1. cancer
> ...



I believe the occulomotor (3rd cranial nerve) controls pupillary reaction, but I could be mistaken.


----------



## Veneficus (Jan 20, 2009)

boingo said:


> I believe the occulomotor (3rd cranial nerve) controls pupillary reaction, but I could be mistaken.



sorry, my mistake I was thinkng CN III, and came up with optic instead of occulomotor


----------



## rhan101277 (Jan 20, 2009)

I thought CNIII controlled eye movement only.  I think it innervates the eye muscles.  I know the constriction, dilation of the eye is controlled by the iris.  As far at it changing with dark and light I think it starts with some chemicals, then goes to the optic nerve.


----------



## Veneficus (Jan 20, 2009)

according to Moore and Dailey, Clinically Oriented Anatomy,

CN III oculomotor nerve, controls parasympathetic innervation of pupilary sphincter and ciliary muscle. controls pupil constriction.  page 1126

lesion of CN II, optic nerve, causes loss of pupilary constriction and visual field defects. page 1130


----------



## WiFi_Cowgirl (Jan 20, 2009)

Any head trauma?


----------

