Cushing's triad vs. reflex can anyone please explain?

[Chantilly]

I have a Neuro test comming up and there is much confusion about Cushing's triad and reflex. I am also getting conflicting information about what Cushing's triad is, some resources say that it is widening pulse pressure, bradycardia, and hypertension; while others say it is hypertension, bradycardia, and irregular respirations.

From what I understand Cushing's triad is the signs you would see (i.e widened pulse pressure, hypertension) and Cushing's reflex is what is going in the body that is causing the signs of Cushing's triad. Is this right? I'm hoping someone can lend a helping hand because I am driving myself crazy trying to figure it out.

[yoginurse2b]

Hi, I got a Neuro test coming up too.

Cushing's triad (triad as in three) are: HTN, bradycardia and irregular respirations.

I checked my textbook is says that "Cushing's reflex, a classic yet late sign of increased ICP, is manifested by severe HTN with a widened pulse pressure and bradycardia"

So I'm not very sure, but I have a feeling both mean the same?

[Daytonite, BSN, RN]

I have looked at Cushing's syndrome in two pathophysiology books and neither one of them uses or mentions "triad" or "reflex". Where did you hear this terminology used? According to Pathophysiology: A 2-in-1 Reference for Nurses, page 494, the cardiovascular symptoms of Cushing's are:

• hypertension due to sodium and secondary fluid retention
  
• heart failure
  
• left ventricular hypertrophy
  
• capillary weakness from protein loss which leads to bleeding and ecchymosis
  
• dyslipidemia
  
• ankle edema

According to http://en.wikipedia.org/wiki/Cushing%27s_triad the triad of symptoms is:

• hypertension
  
• bradycardia
  
• decreased respirations, or widening pulse pressure

and indicates increased intracranial pressure. A link to Cushing's reflex describes that as "The Cushing reflex, consisting of an increase in sympathetic outflow to the heart as an attempt to increase arterial blood pressure and total peripheral resistance and that is conflicting with the baroreceptor attempt to apply vagal tone and decrease heart rate, is a hypothalmic response to ischaemia, usually due to poor perfusion (delivery of blood) in the brain."

[dnf4bjc]

Hi Chantilly, from what i know about Neuro stuff you are correct. Cushings Triad are the three measurable signs and the relfex is what causes the signs. Thats how it was described in the text book we studied in. I think the HTN associated with Cushing's has a widened pulse pressure-a bigger gap between systolic and diastolic-same same, you know? Anyway. Good luck with your test!

[bgalindo86]

maybe i shouldn't have read these posts because I understood both separately and now i'm confused.

And I also have a Neuro test on Mon. (in 4 days), dang:confused:

[2ndyearstudent, CNA]

maybe i shouldn't have read these posts because I understood both separately and now i'm confused.

And I also have a Neuro test on Mon. (in 4 days), dang:confused:

dnf4bjc gave you a very good answer.