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Neuroscience 1B > Glasgow Coma Scale > Flashcards

Glasgow Coma Scale Flashcards

1
Q

Chronological order: Levels of consciousness

A

1) Alert & oriented
2) Confusion/Disoriented
3) Somnolence/Drowsiness
4) Obtundation
5) Stuporous
6) Comatose

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2
Q

State of strong desire for sleep or drowsiness

A

Somnolence

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3
Q

State where you are less aware of your surroundings

A

Obtundation/Lethargy

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4
Q

Partial or nearly complete unconsciousness

A

Stupor

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5
Q

Consciousness has 2 dimensions:

A

Arousal and Cognition

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6
Q

A primitive function sustained by deep brainstem and medial thalamic structures

A

Arousal

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7
Q

Require an intact cerebral cortex and major subcortical nuclei

A

Cognition

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8
Q

Patient is awake and aware of self and environment. When spoken to in a normal voice, patient looks at you and responds fully and appropriately to the stimuli

A

Alertness

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9
Q

When spoken to in a loud voice, patient appears drowsy but opens eyes and looks at you, responds to questions, and then fall asleeps

A

Lethargy

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10
Q

When shaken gently, patient opens eyes and looks at you but responds slowly and is somewhat confused. Alertness and interest in environment are decreased

A

Obtundation

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11
Q

Patient arouses from sleep only after painful stimuli. Verbal responses are slow or absent. Patient lapses into unresponsiveness when stimulus stops. Patient has minimal awareness of self or environment

A

Stupor

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12
Q

Despite repeated painful stimuli, patient remains unarousable with eyes closed. No evident response to inner need or external stimuli is shown.

A

Coma

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13
Q

It is the severest form of impairment of arousal; simply the inability to obey commands, speak or open the eyes to pain

A

Coma

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14
Q 
Coma is defined as, except:
A. state of unconsciousness of <6hrs
B. GCS = 8
C. fails to respond "normally" to painful stimulus, light or sound
D. no normal sleep-wake cycle
A

A.

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15
Q

3 prerequisites for coma/loss of consciousness

A
  1. Diffuse lesion of both cerebral hemispheres (cortical or subcortical white matter)
  2. Bilateral diencephalic dysfunction (“mus”)
  3. Brainstem (RAS)
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16
Q 
The ff are toxic or metabolic causes of coma, except:
A. hypercalcemia
B. vasculitis
C. meningitis
D. epidural hematoma
A

D

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17
Q

Syndrome which is usually caused by clogging of the BASILAR artery leading to an infarct; patient is aware but cannot move or communicate verbally due to complete paralysis of nearly all voluntary muscles in the body except for vertical eye movements and blinking

A

Locked-In Syndrome

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18
Q

Pseudocoma

A

Locked-in syndrome
Psychiatric: catatonia conversion syndromes
Neuromuscular weakness: myasthenia gravis, Guillain-Barre syndrome

19
Q

Results from damage to both or one corticospinal tract. Posture is characterized with the arms ADDUCTED and FLEXED, wrists and fingers are FLEXED on chest, and the legs are stiffly EXTENDED and INTERNALLY rotated with PLANTAR FLEXION of the feet

A

Decorticate Posture (M3)

20
Q

Results from damage to upper brainstem. Posture is characterized with the arm ADDUCTED and EXTENDED, wrists PRONATED and fingers are FLEXED. The legs are stiffly EXTENDED with plantar flexion of the feet

A

Decerebrate posture (M2)

21
Q

Decerebrate is higher than decorticate in the GCS (T or F)

A

F

  • M2 : decerebrate
  • M3 : decorticate
22
Q

a.k.a. flexor posturing or “mummy baby”

A

Decorticate posture (M3)

23
Q

Disinhibition of RUBROSPINAL and VESTIBULOSPINAL tracts

A

Decorticate

24
Q

Disinhibition of RETICULOSPINAL and VESTIBULOSPINAL tracts

A

Decerebrate

25
Q

Substrate for decorticate posturing

A

Diencephalon

26
Q

Substrate for decerebrate posturing

A

Brainstem (RAS)

27
Q 
Decorticate
- Rubrospinal tract
   manifestation: 
   origin:
- Vestibulospinal tract
  manifestation:
  origin:
A

Rubrospinal
M: flexed arms
O: Red Nucleus

Vestibulospinal
M: Extended legs
O: Lateral vestibular nucleus

28
Q 
Decerebrate
- Reticulospinal tract
  manifestation:
  origin:
- Vestibulospinal tract
  manifestation:
  origin:
A

Reticulospinal tract
M: Extended arms and neck
O: Reticular formation

Vestibulospinal tract
M: Extended legs
O: Lateral vestibular nucleus

29
Q

Level of coma: GCS 7-8

A

Surface coma

30
Q

Substrate for surface coma

A

both cerebral hemispheres (cortical or subcortical white matter)

31
Q

Level of coma: GCS 5-6

A

Moderate coma

32
Q

Substrate for moderate coma

A

thalamus/subthalamus/hypothalamus/epithalamus

33
Q

Lvele of coma: GCS 3-4

A

Deep coma

34
Q

Substrate for deep coma

A

Brainstem (RAS)

35
Q

Clinical absence of brain and brainstem functions

A

brain death

36
Q

Blood alcohol content of a brain dead patient

A

<0.08%

37
Q

The ff reflexes are absent in coma, except:
A. absent oculovestibular reflex (calorics)
B. absent oculocephalic reflex (doll’s eye)
C. absent gag reflex
D. NOTA

A

D

38
Q

Reserved as the last test when diagnosis of brain death is almost certain

A

Apnea test

39
Q

Defined as abdominal or chest excursions that produce adequate tidal volumes

A

Respiration

40
Q 
Positive results for Apnea test, except:
A. >2minutes with pCO2 >60mmHg
B. Rise of pCO2 of >20mmHg from baseline
C. pH <7.3
D. NOTA
A

D

41
Q

Movements of body parts after brain death, as long as 32 hours after brain death; spinal cord discharges as it undergoes cell death

A

Lazarus reflex

42
Q

(2) Neurosurgeons who formulated the tool for evaluating the conscious state of a person

A

Graham Teasdale

Bryan J. Jennett

43
Q

It is a neurological scale that aims to give a reliable, objective way of recording the conscious state of a person

A

Glasgow Coma Scale

44
Q

Highest possible GCS

A

E4V5M6

Neuroscience 1B (12 decks)

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