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critical care > neuro pt. 1 > Flashcards

neuro pt. 1 Flashcards

1
Q

what makes up the CNS

A

brain
spinal cord

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2
Q

what are the 3 layers of the meninges

A

dura
arachnoid
pia

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3
Q

what is the space between the skull bone and dura

A

epidural space

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4
Q

what is the space between the dura and arachnoid

A

subdural space

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5
Q

what is the space between the arachnoid and pia

A

subarachnoid space

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6
Q

outermost layer of meninges directly beneath skull

A

dura mater

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7
Q

what does a rupture of the dura mater result in?

A

epidural or subdural hematoma

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8
Q

which layer of the meninges circulates CSF and contains cerebral vasculature

A

arachnoid mater

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9
Q

rupture of an artery in the arachnoid mater cuases what?

A

subarachnoid hemorrhage

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10
Q

what absorbs CSF for removal

A

arachnoid villi

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11
Q

what does a blockage in arachnoid villi cause?

A

communicating hydrocephalus

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12
Q

which layer of meninges forms the choroid plexus within ventricles and is responsible for production of CSF

A

pia mater

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13
Q

what is responsible for production of CSF

A

choroid plexus within the ventricles

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14
Q

what is csf reabsorbed by?

A

arachnoid villi

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15
Q

what does csf function as?

A

shock absorber and protects brain tissue

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16
Q

what does csf contain?

A

glucose!!
amino acids, other nutrients

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17
Q

what are the 2 major sets of vessels that supply the brain?

A

2 internal carotid arteries
2 vertebral arteries

18
Q

what is a circular network that permits blood to circulate between hemispheres and anteriorly and posteriorly

A

circle of willis

19
Q

what should you expect to find in CSF?
1) blood
2) glucose
3) cloudy fluid
4) green fluid

A

2) glucose

20
Q

what is pressure in the cranial vault called

A

ICP

21
Q

3 components of ICP

A

1) blood volune
2) brain tissue volume
3) CSF

22
Q

describe the monroe-kellie doctrine

A

-ability of brain to self regulate
-inc. in volume of one intracranial component must be compensated by dec. in one or both other componensts
-if this doesn’t occur, ICP inc.

23
Q

how is autoregulation accomplished?

A

changes in diameter of vessles (vasoconstriction/dialtion)

24
Q

what happens when BP increased with impaired autoregulation

A

it can inc. cerebral blood flow and ICP

25
Q

what is cerebral blood flow (CBF) affected by?

A

cerebral perfusion pressure (CPP)

26
Q

what shows adequacy in delivering oxygen to the brain

A

cerebral perfusion pressure (CPP)

27
Q

what is the formula for calcualting CPP

A

MAP - ICP = CPP

28
Q

describe the compensatory mechanism of pressure autoregulation (related to MAP changes)

A

inc. MAP -> cerebral vasoconstriction -> dec. blood flow
dec. MAP -> cerebral vasodialtion ->inc. blood flow

29
Q

describe the compensatory mechanism of metabolic autoregualtion (CO2 changes)

A

inc. CO2/lactic acid = vasodialtion / inc. flow
dec. CO2 = vasoconstriction / less flow

30
Q

what are the 3 things that effect ICP

A

cerebral blood flow
CSF
brain tissue volume

31
Q

what component of ICP does cerebral edema effect?

A

brain tissue volume

32
Q

what is cerebral edema caused by

A

brain trauma, CNS infection, brain tumors, CVAs

33
Q

what secondary complication does cerebral edema lead to?

A

impairs circulation leading to hypoxia

34
Q

what are the 2 types of cerebral edema

A

vasogenic
cytotoxic

35
Q

displacement of brain tissue through structures in the skull because of inc. ICP

A

central herniation

36
Q

which symptoms occur in central herniation once compensatory mechanisms are exhausted?

A

cushing’s triad
bilateral pupillary dilation!!!
flaccid paralysis

37
Q

is cushings triad a sign of imminent death?

A

yes

38
Q

s/sx of cushing’s triad

A

-inc. pulse pressure (systolic inc., diastolic dec.)
-bradycardia (30-40)
-abnormal resp pattern (not if vented)

39
Q

what does cushings triad indicate?

A

brainstem compression
imminent death

40
Q

when is an ICP monitoring device not indicated

A

mild/mod brain injury (awake)

41
Q

complications of ICP monitoring devices

A

infection
obstruction
hemorrhage
mispalcement

42
Q

nurse cares for vented pt. post head injury. HR drops from 70 to 34 and BP = 205/76. Nurse suspects what?
1) cytotoxic edema
2) vasogenic edema
3) cushing triad
4) meningitis

A

3) cushing triad

critical care (23 decks)

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