Certified Pediatric Emergency Nurse (CPEN) Practice Exam

What does a decorticate posturing indicate during a neurological assessment?

1. Extremely low consciousness

2. Response to verbal command

3. Arms extended and legs flexed

4. Arms flexed and legs extended

The correct answer is: Arms flexed and legs extended

Decorticate posturing is characterized by the arms being flexed at the elbows and held close to the body, with the legs extended and internally rotated. This type of posturing often arises from damage to the corticospinal pathways, which can occur in severe brain injuries or other neurological conditions. The presence of decorticate posturing generally indicates a significant level of neurological impairment, specifically suggesting that the brain's upper motor pathways are affected. In this context, decorticate posturing serves as an important clinical sign that can help healthcare professionals gauge the severity of a patient's condition. This posturing is typically assessed during a neurological examination and can indicate poor prognostic outcomes, especially if observed in a comatose patient. While other forms of response may be observed in various conditions, such as decerebrate posturing, which involves arms extended and legs extended, decorticate posturing is specific and provides crucial information regarding the patient's level of consciousness and brain function.