Neurological 1 Flashcards
cerebrum
largest part of brain
contain L/R hemispheres and 4 lobes
cerebrum “f”
motor/sensory "f" language memory visual/spatial relationships higher order process
what does cerebrum contain
hypothalamus
thalamus
basal ganglia
limbic system
hypothalamus “f”
endocrine, autonomic “f”
thalamus “f”
relays sensory/motor inputs for cortex
basal ganglia “f”
voluntary, autonomic mvmt
limbic system “f”
emotional behavior, basic drives
brainstem “f”
relays sensory info, control vasomotor and respiratory activity, arousal
what does brainstem contain
midbrain, pons, medulla, reticular formation, reticular activating system
cerebellum
coordinates all our voluntary mvmts/activites, balance
skull
bony structure, outermost area, protects brain from external trauma
meninges
protective membranes that cover brain/spinal cord
3 layers of meninges
dura mater
arachnoid membrane
pia mater
dura mater
outermost layer, tough, strong sheath of con. tis.
offers most protection
epidural space
space b/w dura and skull
subdural space
space b/w dura and arachnoid membrane
arachnoid membrane
spongy, spiderweb like membrane
subarachnoid space
space b/w arachnoid and pia mater
pia mater
thin inner layer
covers contours of brain
provides support for bld vessels.
CSF
cerebrospinal fluid
circulates thru 4 ventricles and subarachnoid space
reabsorbed into venous circulation thru arachnoid villi which protrudes from venous sinuses into arachnoid space
CSF “f”
provides cushioning
dec force of impact
carries nutrients
main components of CSF
H20
Na
protein
glucose
how much CSF flows everday
100-125 ccs
how much CSF do we make each day
600 ccs
ICP
intracranial pressure
pressure exerted by total vol from components w/in skull
% of brain tissue
80%
% of blood
10%
% of CSF
10%
normal ICP
5-15 mmHg
what happens to ICP if tumor or inc fluid
inc ICP
patho of ICP
inc ICP
compensated by dec production of CSF, displacement of CSF
if ICP continues, BV altered
results in intracranial HTN
stage 1 of ICP
vasoconstriction
external compression of venous system
stage 2 of ICP
ICP exceeds brain’s compensatory capacity
pressure compromises oxygenation
arterial vasoconstriction occurs
stage 3 of ICP
ICP begins to approach arterial pressure
brain tissue experiences hypoxia, hypercapnea
loss of autoregulation
vasodilation occurs, causing BP to drop, BV inc
leads to more ICP
stage 4 ICP
brain tissue shifts
herniation
more ICP, compression of brain stem, inc ischemia
death
CM of ICP
change in LOC change in VS, late sign- Cushings triad dec motor "f" HA occular signs vomitting
Cushings triad
inc SBP
bradycardia
irregular respiratory pattern
decorticate
flex arms, wrists, fingers with adduction of upper extremities
hands/arms across chest, wrists flexed
decerebrate
worse
extenstion, internal rotation of upper extrem.
wrist flexion
arms at sides, wrists curled up
treatment for ICP
treat/manage cause
diuretics
corticosteroids
mech ventilation (hyperventilation)
disorders that cause ICP
cerebral edema
hydrocephalus
cerebral edema
inc fluid content of brain
inc tissue volume
inc ICP
etiology of cerebral edema
trauma inf tumor hypoxia Na imbalance
treatment for cerebral edema
diuretics
hydrocephalus
abnormal inc CSF volume
etiology of hydrocephalus
overproduction of CSF
obstruction of CSF flow
defective reabsorption
types of hydrocephalus
noncommunicating
communicating
noncommunication hydrocephalus
flow within subarachnoid space and ventricles obstructed
see in kids, related to malformation
communicating hydrocephalus
impaired absorption within subarachnoid space or inc secretion
see in adults, related to impaired absorption, inc secretion of CSF, tumor inf, head injury
treatment for hydrocephalus
treat cause
shunting procedure
closed trauma
head striking surface or object striking head
dura intact
causes contusions and concussions
open trauma
injury tears scalp tissue and exposes skull, dura mater, or brain
causes skull fractures or brain lacerations
open channel= inc risk for inf
more common- closed or open?
closed trauma
closed head injury includes
focal contusions
diffuse concussions
contusions
bruising of brain tissue
focal
patho of contusions
damage results from compression of skull at point of impact and rebound
small tears in bld vessels
types of contusions
coup
countercoup
coup
bruising under injury site
countercoup
bruising opposite traumatized site
rebound effect
CM for contusions
loss of consciousness
loss of reflexes
brief dec in HR/BP
residual deficits
DT for contusions
Xrays MRI CT scans
treatment for contusions
controlling ICP
managing symptoms
concussion
diffuse
sudden transient mechanical head injury with disruption of neural activity
CM for concussion
disruption in LOC loss of reflexes causing falls amnesia about event HA nausea fatigue
post concussion syndrome
HA dizziness poor concentration/memory fatigue irritability depression personality/behavioral problems
