Intracranial Regulation - Adults

Question 1

What does the brain require a constant supply of

Answer 1

oxygen and glucose

Question 2

What is a normal ICP

Answer 2

5-15

Question 3

True or false: ICP fluctuates constantly

Answer 3

true

Question 4

When do we know that the Monroe-Kelli doctrine is failing

Answer 4

if the ICP is 30 or greater

Question 5

3 components of the Monro-Kelli hypothesis

Answer 5

blood, csf, brain tissue

Question 6

How is CSF easily displaced

Answer 6

absorbing into the external jugular vein

Question 7

How is the external jugular vein easily obstructed

Answer 7

neck positioning

Question 8

Cerebral perfusion pressure

Answer 8

the amount of pressure required to provide blood flow to the brain

Question 9

What is the normal cerebral perfusion pressure

Answer 9

70-100

Question 10

Equation for CPP

Answer 10

MAP-ICP

Question 11

If ICP increases, CPP _______

Answer 11

decreases

Question 12

What happens when ICP increases and CPP decreases

Answer 12

no perfusion

Question 13

Interventions to decreased ICP

Answer 13

raise HOB, head alignment, limit stimulation, mannitol, fluid restriction, no vasopressors

Question 14

If MAP decreases, CPP _________

Answer 14

decreases

Question 15

What happens when MAP decreases and CPP decreases

Answer 15

low blood pressure, can’t get blood to the brain

Question 16

Interventions to increase MAP

Answer 16

fluid bolus, vasopressors

Question 17

Early s/s of increased ICP

Answer 17

headache, visual disturbances, n/v, dizziness, small vs changes, PERRLA changes

Question 18

Late s/s of increased ICP

Answer 18

seizures, decreased LOC, posturing, Cushing’s triad, fixed and dilated pupils

Question 19

s/s Cushing’s triad

Answer 19

increased SBP with widening pulse pressure, bradycardia, irregular respirations

Question 20

Uncontrolled ICP causes

Answer 20

herniation (4 types), supratentorial, ischemia

Question 21

Central/tentorium herniation

Answer 21

brain moves through foramen magnum, affecting cranial nerve 3

Question 22

Cingulate herniation

Answer 22

lateral displacement under falx cerebri, compresses anterior cerebral artery –> ischemic strokes

Question 23

Uncal herniation

Answer 23

temporal lobe puts pressure on the brainstem, affects cranial nerve 3

Question 24

Tonsillar herniation

Answer 24

cerebellar tonsils move through foramen magnum, putting pressure on the brainstem –> headache, stiff neck, paralysis, coma

Question 25

Supratentorial

Answer 25

displacement of cerebrum above tentorium

Question 26

How does ischemia occur

Answer 26

inadequate cerebral perfusion