Raised ICP and Nerve Palsies

Question 1

name the 2 kinds of hydrocephalus that exist

Answer 1

congenital

acquired

Question 2

2 ways in which ICP can become raised?

Answer 2

increased pressure in the fluid surrounding the brain

increase in pressure within the brain

Question 3

medical causes of raised icp

Answer 3

brain tumour
head injury
hydrocephalus
meningitis
stroke

Question 4

is intracranial volume constant or variable? why is this relevant?

Answer 4

constant; if you add to it something will have to leave

Question 5

name the 3 components that make up the intracranial volume

Answer 5

brain
blood
CSF

Question 6

the cranial cavity is flexible T or F

Answer 6

F

Question 7

what physical effect does raised icp have on the brain and its components?

Answer 7

damaged tissue
shift in tissue
herniation
contricted BVs and nerves

Question 8

what could a raised icp at the very back of the brain cause?

Answer 8

herniation of the brainstem

Question 9

visual symptoms associated with raised icp?

Answer 9

transient blurred vision
double vision
loss of vision
papilloedema
pupillary changes

Question 10

what do the meninges cover?

Answer 10

optic nerve

Question 11

name the 3 types of meninge

Answer 11

dura mater
arachnoid
pia

Question 12

what 2 structures does the subarachnoid space lie between?

Answer 12

arachnoid

pia

Question 13

what are meninges?

Answer 13

protective coverings of the brain and spinal cord

Question 14

what meninge contains blood vessels?

Answer 14

subarachnoid space

Question 15

sensory supply to the dura meninge?

Answer 15

CNV

Question 16

what meninge encloses the dural venous sinus?

Answer 16

dura mater

Question 17

what meninge is attached to the brain?

Answer 17

pia (encloses the entire brain)

Question 18

main role of pia?

Answer 18

cushion and protect brain

Question 19

how can the subarachnoid space be accessed non surgically?

Answer 19

lumbar puncture

Question 20

what levels of the spinal cord should a lumbar puncture be performed at?

Answer 20

L3/4 or L4/5

Question 21

why is the optic nerve at risk of damage from ICP?

Answer 21

is enclosed by meninges

icp will travel along subarachnoid space in the optic nerve sheath

Question 22

cranial nerves to come off pons?

Answer 22

CN V only

Question 23

what is a subdural haematoma?

Answer 23

vessels in subarachnoid space bursting and mixing with CSF

Question 24

what meninge gives the brain ability to move?

Answer 24

subarachnoid space

Question 25

what spinal level does the spinal cord end?

Answer 25

L2

Question 26

name the most central of the all the ventricles of the brain

Answer 26

3rd

Question 27

what ventricle does the central canal of the spinal cord follow on from?

Answer 27

4th

Question 28

2 ways csf can go after release from the 4th ventricle?

Answer 28

subarachnoid space | central canal of spinal cord

Question 29

what will optic nerve damage from raised icp look like on fundoscopy?

Answer 29

bulging/swollen optic disc -> papilloedema

Question 30

what vessels will be affected by papilloedema?

Answer 30

central artery and vein of retina

Question 31

symptoms of papilloedema?

Answer 31

blurred vision constricted visual field flickering graying of vision

Question 32

what kind of hernia could oculomotor nerve damage cause?

Answer 32

tentorial (of tentorium cerebelli)

Question 33

what does cn3 come off?

Answer 33

midbrain

Question 34

2 main fibres of the cn3 nerve

Answer 34

parasympathetic | somatomotor

Question 35

presentation of cn3 palsy

Answer 35

eye looks down and out slow light reflex dilated pupil ptosis

Question 36

main fibres on cn4?

Answer 36

somatormotor

Question 37

presentation of cn4 palsy

Answer 37

eye cannot move inferomedially looks to the side and up diplopia looking down

Question 38

what muscle is affected by cn4 palsy?

Answer 38

superior oblique

Question 39

what action cant be done if the superior oblique is affected?

Answer 39

intorsion

Question 40

nerve with the longest course to the dura

Answer 40

cn6

Question 41

presentation of cn6 palsy

Answer 41

medial deviation eye | cant move laterally

Question 42

what muscle is affected by cn6 palsy

Answer 42

lateral rectus

Question 43

what palsy presents with someone tilting their head to fix their vision?

Answer 43

cn4 palsy