Critical Care Registered Nurse (CCRN) Practice Exam

Which description accurately defines decorticate posturing?

1. Arms extended and pronated

2. Arms flexed at the elbows close to the body

3. Head tilted forward with eyes closed

4. Legs rigidly extended and parallel

The correct answer is: Arms flexed at the elbows close to the body

Decorticate posturing is characterized by a specific flexion of the arms at the elbows, with the arms typically being drawn towards the body. This posture is indicative of damage to the brain's corticospinal pathways and is often associated with severe brain injury or significant neurological impairment. The positioning of the arms in this posture suggests that the brain's motor pathways are communicating a specific reflex response to injury, leading to compromise in higher brain functions. In contrast, other options describe different postures or physical presentations that do not correspond with decorticate positioning. For example, arms extended and pronated suggest a different motor response that might arise from brainstem injuries, while the description of the head tilted forward and eyes closed aligns more with a state of decreased responsiveness rather than the active flexion seen in decorticate posturing. The reference to legs being rigidly extended and parallel is characteristic of another form of posturing called decerebrate posturing, which indicates a different level of brain dysfunction. Understanding these distinctions is critical for assessing neurological status in patients.