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Nervous System > Raised ICP > Flashcards

Raised ICP Flashcards

1
Q

what is the normal values of ICP

A

5-15mmHg

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2
Q

what can be done to assess the value of the ICP

A

lumbar puncture

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3
Q

at what level is a lumbar puncture performed and why

A

L3/4 as the spinal cord has finished at L1 so less risk of damage

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4
Q

in raised ICP why would headaches be worse in the morning

A
  • lying down increases the venous pressure in the head

- slower breathing increases CO2 levels causing vasodilation which also increases blood volume in the head

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5
Q

in raised ICP why does coughing make headaches worse

A

compression of the vena cava means that venous return to the heart is momentarily paused leading to an increase in blood volume in the head

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6
Q

what are the signs and symptoms of raised ICP

A

headache, vomiting, visual disturbance, depression of consciousness, abducens palsy

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7
Q

why do you get vomiting with raised ICP

A

due to ischaemia

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8
Q

why do you get visual disturbance in raised ICP

A

due to compression of the optic nerve

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9
Q

what would be seen in fundoscopy in raised ICP

A

papilloedema - swelling of the optic disc due to raised ICP

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10
Q

why do you experience depression of consciousness in raised ICP

A

due to ischaemia of the reticular formation

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11
Q

why do you get abducens palsy in raised ICP

A

abducens nerve runs close to the skull so is easily compressed causing lateral rectus damage

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12
Q

what is the management for hydrocephalus

A

shunts from the ventricles, down the neck to the peritoneum

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13
Q

what is cytotoxic cellular oedema

A

this is where compression of brain tissue causes a lack of oxygen. this means the Na/K/ATPase doesn’t work as well giving a build up of Na in cells so water also accumulates in cells eventually causing them to burst

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14
Q

what are the 3 types of herniation which may occur in raised ICP

A

subfalcine, uncal and temporal

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15
Q

what is a subfalcine herniation

A

when the cingulate gyrus moves underneath the fall cerebri

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16
Q

what is the most common type of herniation

A

subfalcine

17
Q

what does uncal herniation result in

A

compression of the midbrain causing occulomotor damage, cerebral peduncle damage and decreased consciousness

18
Q

what does temporal herniation result in

A

compression of medulla, brainstem - affects respiratory and cardiovascular centres

19
Q

what is Cushing’s reflex

A

this is when there is herniation through foramen magnum which leads to bradycardia, high bp and low respiratory rate

20
Q

what causes the low respiratory rate in Cushing’s reflex

A

ischaemia of the medulla as this is where the respiratory centre is

21
Q

what re the causes of raised ICP

A 
increased blood volume 
increased CSF
cerebral oedema 
mass 
idiopathic
22
Q

what can cause an increase in blood volume In the head

A

venous outflow obstruction

venous sinus thrombosis

23
Q

what is hydrocephalous

A

accumulation of CSF due to an imbalance in production and removal of CSF

24
Q

what is a communicating hydrocephalous

A

where the CSF can still flow between the ventricles. however, there is reduced absorption or increased production of CSF

25
Q

what causes a communicating hydrocephalous

A

meningitis, subarachnoid haemorrhage and trauma

26
Q

what is a non-communicating hydrocephalus

A

where CSF can move between ventricles due to blockage e.g. from a tumour

27
Q

what is choroid plexus papilloma

A

where there is excessive secretion of CSF

28
Q

is choroid plexus papilloma a communicating or non-communicating hydrocephalus

A

communicating

29
Q

what can cause cerebral oedema

A

infarction. meningitis, encephalitis

30
Q

what are most brain tumours

A

metasteses

31
Q

where do mets in the brain usually come from

A

kidney, breast and lung

Nervous System (15 decks)

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