GCS Scale, Memory and Amnesia Flashcards
GCS scale includes
eye opening
verbal responses
motor responses
eye opening grades
1-4
eye opening 4
spontaneous
eye opening 3
to verbal command
eye opening 2
to painful stimulation
eye opening 1
no response
verbal response grades
1-5
verbal response 5
oriented and converses
verbal response 4
disoriented and converses
verbal response 3
inappropriate words
verbal response 2
incomprehensible sounds
verbal response 1
no response
motor response grades
1-6
motor response 6
obeys verbal commands
motor response 5
localizes to pain
motor response 4
withdraws from pain
motor response 3
decorticate rigidity (flexion)
motor response 2
decerebrate rigidity (extension)
motor response 1
no response
motor response 1
no response
memory
ability to register, store and ultimately retrieve the info
temporal classification –> memory
immediate –> within minutes
short term –> minutes to hours
long term –> days, months, years
declarative memory
explicit
types of declarative memory
episodic
semantic
episodic
experiences specific to a context
time or place
semantic
fact-based
knowledge
independent of context
location of declarative memory
medial temporal lobe
hippocampus
amygdala
thalamus
prefrontal cortex
memory centers declarative memory
very close together
easy to destroy these memory centers with a single dz
procedural memory
implicit, automatic, skill acquisition
examples of procedural memory
riding a bike
playing the piano
getting out of bed
walking
dressing
etc.
what does procedural memory do
increase many of the fxnal activities we could do in rehab
location of procedural memory
basal ganglia
cerebellum
primary motor cortex
premotor cortex
supplemental motor areas )SMA)
can the procedural memory centers be wiped out by a single dz
no
spread out enough
anterograde memory
from time of injury forward (future)
anterograde amnesia
loss or disturbance of memory for events that occur after an event
inability to remember events that occur after the brain injury
retrograde memory
from time of injury backwards
past
retrograde amnesia
loss or disturbance of memory for events that occurred before and event
inability to remember events that occurred before the brain injury
post-traumatic amnesia
inability to form consistent day-to-day memories
“eternal now”
many range from minutes to hours
when is a person determined to be “out of PTA”
when they can give a clear, accurate and ordered account of what is happening around them
&
can maintain episodic memory from day to day
what does PTA also measure
severity of TBI
longer duration of PTA correlates w/
longer period to recovery
what may PTA not be reliable for
outcomes d/t factors influencing accurate measure of PTA
PTA <5 min
very mild
PTA 5-60 min
mild
PTA 1-24 hrs
moderate
PTA 1-7 days
severe
PTA 1-4 weeks
very severe
PTA >4 wks
extremely severe
duration of PTA correlates well w/
GCS score
how long does PTA occur
4 times longer than length of unconsciousness
mild
GCS 13-15
PTA <1 hr
LOC <30 min
moderate
GCS 9-12
PTA 30 min-24 hrs
LOC 1-24 hrs
severe
GCS 3-8
PTA >1 day
LOC >24 hrs
