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Glascow Coma Scale – Know how to calculate a score What is decorticate posturing? What is...

Glascow Coma Scale – Know how to calculate a score

What is decorticate posturing?

What is decerebrate posturing?

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Solutions

Expert Solution

#.Glascow coma scale is a neurological assessment scale or a tool to measure the consciousness of an individual or patient.It is divided into three categories namely

  1. Eye opening (4)
  2. Verbal response (5)
  3. Motor response (6)

The total score is 15.If the score is below 3 , it is considered to be in coma.

Score 13-15=minor injury

9-12=moderate injury

Less than 8=severe injury

The scoring can be done in the following ways

Eyes

  1. Patient does not opens the eye. It means the score is one.
  2. Patient will open eyes when someone painful stimuli is given like pinching the skin.Here the score is two
  3. If the client opens the eye just by calling name or by voice .It is scored three
  4. If the client opens the without any trigger or spontaneously .It is scored to be 4.

Verbal

  1. If the client does not responds to any means .zero response .It is scored one
  2. If the client responds only by making certain sounds .It is scored to be two
  3. If the client is able to utter few or certain words which is irrelevant .Then it is scored as three
  4. If the client is able to respond but in a state if confusion or disorientation .It is scored as four.
  5. Here the client is fully capable and oriented .Responds appropriately. It is scored as five

Motor

  1. Zero movements .It is scored as one
  2. The client may show some extension you painful stimuli .It is often in decerebrate position .It is scored as two
  3. The client shows some sort of irrelevant  flexion. It is often in decorticate position .It is scored as three
  4. The patient will show flexion when painful stimuli is given. It is scored four
  5. If the client is able to plot or locate where the pain site is .It is scored to be five.
  6. Here the patient is able to move or obey the commands or the orders . They show full range of movements.

#Decorticate position

When the corticospinal tract of the brain is affected it leads to decorticate posture .Here the client exhibits the following features

  • Arms are in adducted position
  • The elbow is extended
  • The head is backwards
  • The feet are in flexion
  • Fingers flexed and pronated
  • The upper limbs and lower limbs are straight

#Decorticate position

When the injury occurs in the upper brain stem it leads to this decorticate posture .Often fatal. Here the client exhibits the following features

  • Upper arms are adducted position (from shoulder to elbow towards the body )
  • The part from elbow to hand or wrist is flexed towards the chest
  • The feet are flexed
  • The fingers are flexed inwards

#The types of brain injury are

  • Focal:It occurs in one location or site of the brain.It can be categorized to be contusion ,concussions, hemorrhage (epidural, intracerebral ,subdural ,intraventricular)
  • Coup: The injury is generally observed on the area when the hot or impact occured
  • Counter coup: the injury is generally observed in the opposite side of the area in the brain where the injury occurred
  • Difuse injury:Here the injury cannot reveal any focal point of injuries on diagnostic tests. This can be classified to Ischemic brain injury, axonal injury
  • Open injury :the brain part is exposed to external environment
  • Closed injury :The injury is not exposed to external environment.

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