2: Memory, Coma, Motor Regions

Question 1

Glasgow Coma Scale

Answer 1

most common neurological scoring system used to describe level of consciousness following a traumatic brain injury

Question 2

GCS contraindication

Answer 2

not used w children (esp young ones who don’t have reliable language skills)

Question 3

3 behaviours assessed by GCS

Answer 3

eye opening
best verbal response
best motor response

Question 4

ways to interpret the total score of the GCS

Answer 4

15 = best response
8 or less = Comatose client (in a state of coma)
3 = totally unresponsive

Question 5

how is the GCS expressed

Answer 5

indicating the total sum of the score but also the individual elements:
“GCS 9 = E2 V4 M3 at 07:35”

Question 6

general classification of brain injury

Answer 6

Severe, GCS <8-9
Moderate, GCS 8 - 12
Minor, GCS >/= 13

Question 7

4 main Vital Signs monitored + 2 additional signs monitored

Answer 7

1. blood pressure
2. pulse rate
3. respiratory rate
4. temperature
   * oxygen saturation
   * *pupillary size

Question 8

average normal values for the 4 vital signs

Answer 8

1. blood pressure: less than 120/80 mmHg
2. pulse rate: 60-100 bpm
3. resp rate: 12-16 breaths/min
4. temp: 36.5 - 37.2 degrees Celsius

Question 9

high blood pressure?

Answer 9

140/90 mmHg or greater

Question 10

high body temp (fever)?

Answer 10

1 degree above normal range. can also have hyPOthermia

Question 11

two monitoring tests for the brain

Answer 11

EEG

Neuroimaging

Question 12

EEG? function?

Answer 12

ElectroEncephaloGraphy: detects electrical activity of brain (only 0.1% - 1%) still, useful for investig neuro disorders

Question 13

Neuroimaging options

Answer 13

1. X-rays: plain/computed tomography (CT) etc
2. Magnetic Resonance (MRI/MRA [Mag. Res. Angiography])
3. Radioisotopes: PET scan (Positron Emission Tomography)/ SPECT (Single photon emmission computed tomography)

Question 14

sequence for assessing a comatose patient

Answer 14

1. Glasgow Coma Scale
2. Vital signs
3. X-rays

Question 15

Causes for coma (x3)

Answer 15

1. Diffuse brain dysfunction
   - metabolic/toxic disorders depressing brain function (drug overdose, chronic hypoxia, epilepsy)
2. Direct effect
   - within brainstem
   - a lesion may inhibit reticular formation
3. Pressure effect
   - mass lesion within the brain that compresses the brainstem thus inhibiting retic. formation

Question 16

duration of long and short term memory

Answer 16

LT-days to years

ST - seconds to hrs

Question 17

consolidation

Answer 17

process of fixing short to long term memory

Question 18

path travelled by “memory” in process of consolidation

Answer 18

1. from sensory association areas to hippocampus
2. after encoding, relayed back to sensory association areas and no longer dependent on hippocampal complex for retrieval

Question 19

working memory

Answer 19

temporary memory - holds and interconnects various pieces of info for task at hand

Question 20

short-term memory

Answer 20

initial storage of newly acquired info

Question 21

destine of ST memory

Answer 21

1. can be consolidated into LT

2. is forgotten

Question 22

how to consolidate ST memory to LT

Answer 22

1. active practice

2. rehearsal

Question 23

LT memory overview

Answer 23

1. larger storage capacity than ST

2. different types stored in different association areas of brain

Question 24

two types of LT memory

Answer 24

1. declarative

2. procedural

Question 25

declarative LT memory

Answer 25

1. episodic memory (life events) | 2. semantic memory (facts)

Question 26

procedural LT memory

Answer 26

"muscle memory" such as playing piano/riding bike

Question 27

synaptic differences between LT and ST memory

Answer 27

ST: involves transient modifications of pre-existing synapses (eg. less neurotransmitter transmitted) LT: permanent structural OR functional changes in synapses. also involves formation of new, permanent synapses

Question 28

synthesis of proteins difference between LT and ST

Answer 28

LT activates specific genes controlling synthesis of proteins for making of new synapses ST does not, only strengthens preexisting synapses

Question 29

relevance of ST and LT

Answer 29

storage of newly acquired info always involves at least these 2 stages

Question 30

compare: inability to retrieve

Answer 30

ST: permanently forgotten LT: usually only transiently unable to access

Question 31

compare: retrieval time

Answer 31

ST: rapid retrieval LT: slower retrieval* *except deeply ingrained memories

Question 32

compare: duration

Answer 32

ST: sec to hrs LT: days to yrs

Question 33

compare: capacity

Answer 33

ST: limited LT: v large

Question 34

compare: time of storage AFTER acquisition of new info

Answer 34

ST: immediate LT: must be transferred to LT through consolidation; enhanced by repetition/practice

Question 35

compare: mechanism of storage

Answer 35

ST: transient mods in preexisting synapses (eg. altering amount of neurotransmt) LT: permanent structural OR functional changes in synapses; creation of new synapses - involves protein synthesis