ICP

Question 1

3 constituents in the cranial vault

Answer 1

Blood, Brain, CSF

Question 2

Normal pressure inside the skull for adults

Answer 2

4-12 mm hg

Question 3

Range of pressure inside the skull

Answer 3

0-15 mm hg

Question 4

What happens when cranial pressure reaches 20 mm HG

Answer 4

The capillaries begin to be squeezed shut decreasing glucose and O2

Question 5

What happens when cranial pressure reaches 30 mm HG

Answer 5

Capillaries are completely closed

Question 6

What happens to the brain w/ high pressures

Answer 6

Brain to herniate through openings in the cranial fault - Brain will squeeze where it can go!

Question 7

silateral

Answer 7

neck up - same side

Question 8

contralateral

Answer 8

changes will be on the opposite side of the body

Question 9

Early intracranial pressure is

Answer 9

ICP without herniation

Question 10

Late intracranial pressure is

Answer 10

ICP with herniation

Question 11

% of blood, brain, CSF

Answer 11

80% brain
10 % blood
10 % CSF

Question 12

LOC in early ICP

Answer 12

Confusion
Confusion
Restless
Lethargy
Disoriented to.. Time, place, person (in that order)

Question 13

LOC in late ICP

Answer 13

Stupor & Coma

Question 14

Pupils in early ICP

Answer 14

Ipsilateral Dilation
Cat Eye (ovoid shape)
Sluggish response to light

Question 15

Pupils in late ICP

Answer 15

Dilated and non-reactive

Question 16

Motor function in early ICP

Answer 16

Hemiparesis (contralateral)

Question 17

Motor function in late ICP

Answer 17

Hemiplegia (contralateral)
Decortication
Decerebration - VERY LATE

Question 18

Vitals Signs for early ICP

Answer 18

HTN (brain is being a selfish bastard)

Question 19

Vitals Signs for late ICP

Answer 19

Cushing’s Triad

Question 20

Cushing’s Triad

Answer 20

1. Profound Bradycardia
2. Abnormal Resp (cheyne-stokes)
3. Increased systolic pressure (widened pulse pressure)

Question 21

Pediatric s/s of ICP fontanells and eyes

Answer 21

Buldging fonts

Sun-setting eyes

Question 22

Pediatric GI during ICP

Answer 22

Vomiting, Anorexia, Poor feeding

Question 23

Pediatric cry during ICP

Answer 23

High pitched

Question 24

Pediatric resps during ICP

Answer 24

Biot’s resp

Fast/Deep long periods of apnea

Question 25

For every 1 degree the head is tilted to the side..

Answer 25

Cerebral blood flow is dec by 2-3%

Question 26

Brain ICP tx

Answer 26

Diueretics
Hypertonic solutions (10 to 20% hypertonic)

Question 27

Mannitol

Answer 27

Osmotic diuretic

Pulls fluid into intravascular bed - Hard on renal

Question 28

Blood ICP tx

Answer 28

Bed 30-45 degrees, minimize venous blood flow out of brain

Normothermia
Seizures
Reduce noxious stimuli

Question 29

Every 1 degree of fever

Answer 29

increases cerebral blood flow by 5-7%

Question 30

CSF ICP tx

Answer 30

Surgical decompression

CSF drainage catheter