A nurse is making the initial rounds and enters the room of a patient who is suffering from severe brain trauma. The nurse sees the patient with a rigid extension of all extremities. The patient's forearms are hyper-pronated and the feet are plantar-flexed. Which positioning is the patient exhibiting?


• Decerebrate positioning is characterized by rigidity in all four extremities with hyper-pronation of the forearms and plantar-flexion of the feet (toes pointed). It usually indicates more severe brain damage than decorticate positioning.

• Patients who are suffering from severe brain trauma may exhibit involuntary responses, namely decorticate and decerebrate positioning.

• Incorrect: Decorticate positioning is characterized by stiffness in all extremities with arms bent (imagine the arms are pulled in towards the "core"), clenched fists, and legs held out straight.

• Incorrect: Opisthotonic positioning is when the patient shows arching of the back and neck. This may be seen in conjunction with decerebrate posturing.

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