nervous system

Question 1

unique to brain death

Answer 1

-Irreversible loss of brainstem functions-No control of vital homeostatic functions

Question 2

brain and cerebral death common

Answer 2

irreversible loss of cortical function*
No conscious awareness*
No response to stimuli

Question 3

unique to cerebral death

Answer 3

Control of vital homeostatic functions-Brainstem still functions

Question 4

cushing triad (ICP)

Answer 4

HTN
↓HR↓RR

Question 5

vasogenic edema

Answer 5

cause- breakdown of BBB,
mech- albumin and water–>brain
time- gradual
location- injury site

Question 6

Uncal vs central herniation

Answer 6

uncal- temporal lobe compresses the brainstem
central-diencephalon compresses the brainstem…

Question 7

Cingulate herniation

Answer 7

lateral displacement of the cerebrum within the intact skull

Question 8

Transcalvarial herniation

Answer 8

parts of the brain pass through an open skull fracture

Question 9

Cerebellar herniation

Answer 9

cerebellum –>vertebral canal and compresses the spinal cord

Question 10

during what stages is there evidence of brainstem compression during intracranial HTN

Answer 10

stage 3 and 4

Question 11

Which events are associated with calcium cascade activation?

Answer 11

Apoptosis
Glutamate excitotoxicity

Question 12

cerebral perfusion pressure

Answer 12

MAP/BP- promotes CPP
↑ICP ↓CPP
-brain ischemia when CPP <40

Question 13

stage 1 intracranial HTN (3)

Answer 13

no signs
↓CSF (move to spine, ↑reabsorption)
arterioles vasoconstrict

Question 14

stage 2 intracranial HTN (3)

Answer 14

hypoxia-altered consciousness
vasoconstriction-↑ BP

Question 15

stage 3 intracranial HTN (3)

Answer 15

↓ consciousness
small sluggish pupils
cushing triad

Question 16

stage 4 intracranial HTN (3)

Answer 16

coma-cortex
fixed dilated pupils-brainstem
cardiac and resp. failure -brainstem
↓ BP
brain herniation

Question 17

pneumonic for brain herniation syndromes

Answer 17

Auntie is cinulate and moved next door, while uncal moved downstairs with Cera’s big bellum

Question 18

events of ischemic neuron injury in order (5)

Answer 18

1-Anaerobic glycolysis
2-Low ATP
3-Sodium pump failure
4 -Cytotoxic edema
5-Neuron injury

Question 19

noncommunicating vs communicating hydrocephalus

Answer 19

nonc.- circulation/obstruction=structural
in children
comm.- production/reabsorption=functional
in adults

Question 20

Which cells are activated during an acute inflammatory response within the brain?

Answer 20

astrocytes and microglia

Question 21

excitotoxic neuron injury

Answer 21

secondary neuron injury
neuron injured- release ↑neurotransmitters (glutamate)- activate calcium cascade-apoptosis

Question 22

neuroinflammation (5)

Answer 22

bad
BBB- broken
chronic
peripheral immune cells
exacerbates inflammation and damages more tissue

Question 23

acute inflammation

Answer 23

good
BBB- intact
acute
microglia and astrocytes
scar

Question 24

Munro‐Kellie Hypothesis

Answer 24

increase in one volume–>
decrease in at least one other
volume, to maintain ICP

Question 25

what are the 3 volumes in the skull

Answer 25

brain tissue, CSF and blood

Question 26

what are the 3 types of cerebral edema

Answer 26

vasogenic, interstitial, and cytotoxic

Question 27

interstitial edema (4)

Answer 27

cause- hydrocephalus
mech- CSF into brain tissue
time- gradual
location- entire brain

Question 28

cytotoxic edema

Answer 28

cause- ischemia
mech- Na/K pump not working, Na draws water into cell
time- rapid
location- entire brain

Question 29

what does hydrocephalus cause (3)

Answer 29

ventricular dilation
cerebral edema
intracranial HTN