Neurological Tests of Major Importance

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  • 0:06 Conducting Diagnostic Testing
  • 0:54 Glasgow Coma Scale
  • 3:13 Brainstem Reflexes
  • 5:35 Signs of Meningitis
  • 6:16 Lesson Summary
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Lesson Transcript
Instructor: Artem Cheprasov

Artem has a doctor of veterinary medicine degree.

This lesson will talk about how altered states of consciousness are assessed in individuals with serious brain trauma. We will also discuss two signs that may indicate meningitis in a patient.

Conducting Diagnostic Testing

The computer, tablet, or TV you are watching this lesson on is a collection of chips, wires, and circuits all sending signals to one another in order to interpret their environment and produce a response, image, or sound. This is exactly what your nervous system does as well. Your nervous system is a collection of cells, molecules, and neuronal circuits that interpret your environment and respond to it with movement and sound.

In cases of nervous system injury, it's important to diagnose how severe a problem is or what it may be a result of. Just like you can run diagnostic tests on your PC, so too can doctors conduct certain tests that clue them in to the cause of a problem affecting the nervous system or indicate the severity of the problem.

Glasgow Coma Scale

As a case in point of the latter, there's something known as the Glasgow Coma Scale, which is a scale that was designed to assess and monitor the duration and depth of a person's impaired consciousness or coma as a result of various disease processes.

This scale tests a person's eye, motor, and verbal response to a variety of stimuli. The grades for each portion of the test are added up to classify the extent of brain injury. These cumulative scores range from a minimum of 3 to a maximum of 15.

  • Scores of 8 or less signify severe head injury
  • Scores of 9-12 indicate moderate head injury, and
  • Scores of 13-15 indicate mild head injury
  • Finally, scores between 3 and 8 are indicative of a coma as a result of no eye opening, no ability to follow any commands, and no verbalization of words.

For the eye-opening response, there are four grades. A 4 is given to a patient that opens their eyes spontaneously - that is to say, without external stimuli. A 3 is given to a person who only opens their eyes to a verbal cue, a 2 is if the eyes only open in response to a painful stimulus, and a 1 is if they do not open at all.

For the verbal response, there are five grades. A 5 is given to those giving cohesive and oriented responses to questions, a 4 for confused responses to questions, a 3 for random and inappropriate words, a 2 for moans and groans, and a 1 for no verbal response.

Finally, for the motor response, there are 6 total grades. A 6 is given when commands for movement are obeyed, a 5 when a person can localize a painful stimulus by purposefully moving towards it, a 4 if they simply withdraw from the painful stimulus, a 3 for abnormal flexion in response to pain, a 2 if the painful stimulus causes extension instead of flexion, and a 1 if there is no response to pain.

Brainstem Reflexes

Other things that can be assessed in order to gauge neurologic function in a patient are known as brainstem reflexes. Your brainstem, for lack of a better example, is sometimes called your reptilian brain because its functions are so well-conserved and important to your survival. These include the regulation of your heart, lungs, and blood pressure. Without the brainstem, you cannot survive. The absence of brainstem reflexes, reflexes so primitive and powerful that you essentially cannot consciously control them, is termed 'brainstem death' and carries a very poor prognosis for survival.

Brainstem reflexes that may be tested include:

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