neuro pt. 1

Question 1

what makes up the CNS

Answer 1

brain
spinal cord

Question 2

what are the 3 layers of the meninges

Answer 2

dura
arachnoid
pia

Question 3

what is the space between the skull bone and dura

Answer 3

epidural space

Question 4

what is the space between the dura and arachnoid

Answer 4

subdural space

Question 5

what is the space between the arachnoid and pia

Answer 5

subarachnoid space

Question 6

outermost layer of meninges directly beneath skull

Answer 6

dura mater

Question 7

what does a rupture of the dura mater result in?

Answer 7

epidural or subdural hematoma

Question 8

which layer of the meninges circulates CSF and contains cerebral vasculature

Answer 8

arachnoid mater

Question 9

rupture of an artery in the arachnoid mater cuases what?

Answer 9

subarachnoid hemorrhage

Question 10

what absorbs CSF for removal

Answer 10

arachnoid villi

Question 11

what does a blockage in arachnoid villi cause?

Answer 11

communicating hydrocephalus

Question 12

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

Answer 12

pia mater

Question 13

what is responsible for production of CSF

Answer 13

choroid plexus within the ventricles

Question 14

what is csf reabsorbed by?

Answer 14

arachnoid villi

Question 15

what does csf function as?

Answer 15

shock absorber and protects brain tissue

Question 16

what does csf contain?

Answer 16

glucose!!
amino acids, other nutrients

Question 17

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

Answer 17

2 internal carotid arteries
2 vertebral arteries

Question 18

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

Answer 18

circle of willis

Question 19

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

Answer 19

2) glucose

Question 20

what is pressure in the cranial vault called

Answer 20

ICP

Question 21

3 components of ICP

Answer 21

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

Question 22

describe the monroe-kellie doctrine

Answer 22

-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.

Question 23

how is autoregulation accomplished?

Answer 23

changes in diameter of vessles (vasoconstriction/dialtion)

Question 24

what happens when BP increased with impaired autoregulation

Answer 24

it can inc. cerebral blood flow and ICP

Question 25

what is cerebral blood flow (CBF) affected by?

Answer 25

cerebral perfusion pressure (CPP)

Question 26

what shows adequacy in delivering oxygen to the brain

Answer 26

cerebral perfusion pressure (CPP)

Question 27

what is the formula for calcualting CPP

Answer 27

MAP - ICP = CPP

Question 28

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

Answer 28

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

Question 29

describe the compensatory mechanism of metabolic autoregualtion (CO2 changes)

Answer 29

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

Question 30

what are the 3 things that effect ICP

Answer 30

cerebral blood flow CSF brain tissue volume

Question 31

what component of ICP does cerebral edema effect?

Answer 31

brain tissue volume

Question 32

what is cerebral edema caused by

Answer 32

brain trauma, CNS infection, brain tumors, CVAs

Question 33

what secondary complication does cerebral edema lead to?

Answer 33

impairs circulation leading to hypoxia

Question 34

what are the 2 types of cerebral edema

Answer 34

vasogenic cytotoxic

Question 35

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

Answer 35

central herniation

Question 36

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

Answer 36

cushing's triad **bilateral pupillary dilation!!!** flaccid paralysis

Question 37

is cushings triad a sign of imminent death?

Answer 37

yes

Question 38

s/sx of cushing's triad

Answer 38

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

Question 39

what does cushings triad indicate?

Answer 39

brainstem compression imminent death

Question 40

when is an ICP monitoring device not indicated

Answer 40

mild/mod brain injury (awake)

Question 41

complications of ICP monitoring devices

Answer 41

infection obstruction hemorrhage mispalcement

Question 42

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

Answer 42

3) cushing triad