TBI/ICP Flashcards
1
Q
3 intracranial components
A
- brain tissue
- blood
- CSF
2
Q
6 factors that influence ICP
A
- arterial pressure
- venous pressure
- intraabdominal/intrathoracic pressure
- posture
- temperature
- blood gases (especially CO2)
3
Q
ICP normal range
A
5-15 mmHg
4
Q
ICP emergency level
A
20 mmHg
5
Q
herniation
A
- brain tissue is forcibly shifted from a compartment of greater pressure to a compartment of less pressure
- forces cerebellum and brainstem down through foramen magnum causing respiratory distress/arrest
6
Q
vasogenic cerebral edema
A
- most common type
- results from disruption of BBB
- fluid leaks from intravascular to extravascular space
- Sx range from headache to coma and death
7
Q
cytotoxic cerebral edema
A
- results from disruption of cell membrane integrity
- develops from trauma or toxins
- fluid and protein shifts from extracellular space into cells causing swelling and loss of cellular function
8
Q
interstitial cerebral edema
A
- usually caused by hydrocephalus (buildup of fluid in the brain)
- ventricular enlargement
- can be due to excess CSF production, obstruction of flow, or inability to reabsorb the CSF
9
Q
manifestations of increased ICP
A
- decreased LOC
- Cushing triad
- ipsilateral pupil dilation
- sluggish/no response to light
- fixed, unilateral dilated pupil (emergency)
- hemiparesis/hemiplegia
- decorticate/decerebrate posturing
- headache
- projectile vomiting not preceded by nausea
10
Q
Cushing triad
A
- systolic hypertension w/ widening pulse pressure
- bradycardia
- irregular respirations
medical emergency - sign of brainstem compression and impending death
11
Q
complications of uncontrolled increased ICP
A
- inadequate cerebral perfusion
- cerebral herniation
12
Q
tentorial (central) herniation
A
brain herniates downward through foramen magnum
13
Q
uncal herniation
A
lateral, downward herniation
14
Q
cingulate herniation
A
lateral displacement of brain tissue
15
Q
diagnostics for increased ICP
A
- CT
- MRI
- EEG
- cerebral angiography
- CBC, coagulation, electrolytes, creatinine, ABGs, ammonia, drug/toxicology
- CSF analysis - protein, WBC, glucose
*lumbar puncture is contraindicated
