Week 2: Neuro Flashcards
intracranial pressure
the pressure exerted bc of the combined total volume of the three components within the skull: brain tissue, blood, and CSF
cerebral blood flow
the amount of blood in mL passing through 100g of brain tissue in 1 min
cerebral perfusion pressure
pressure needed to ensure adequate brain tissue perfusion
compliance
the expandability of the brain
increased ICP
life threatening situation that results from an increase in any or all of the three components within the skull
why is elevated ICP clinically significant
diminishes CPP, increases risks of brain ischemia & infarction, and is associated with a poor prognosis
major complications of uncontrolled, increased ICP
inadequate cerebral perfusion and cerebral herniation
gold standard for monitering ICP
ventriculostomy, in which a catheter is
inserted into the lateral ventricle and coupled to an external transducer.
nursing goals for pt with increased ICP
(1) maintain a
patent airway, (2) have ICP within normal limits, (3) demonstrate normal fluid and
electrolyte balance, and (4) have no complications secondary to immobility and
decreased level of consciousness.
head injury
any trauma to the scalp, skull, or brain. The term head trauma
is used primarily to signify cranio-cerebral trauma, which includes an alteration in
consciousness, no matter how brief.
scalp lacerations
most minor type of head trauma. Because the scalp contains
many blood vessels with poor constrictive abilities, the major complications
associated with scalp laceration are blood loss and infection.
skull fractures
frequently occur with head trauma. There are several ways to describe
skull fractures: (1) linear or depressed; (2) simple, comminuted, or compound; and (3)
closed or open.
concussion
sudden transient mechanical head injury with disruption of neural
activity and a change in the LOC and is considered a mild brain injury.
diffuse axonal injury
widespread axonal damage occurring after a mild,
moderate, or severe TBI.
contusion
bruising of the brain tissue within a focal area. A contusion often
develops in areas of hemorrhage, infarction, necrosis, and edema and frequently
occurs near the site of a skull fracture.
complications from head injury
epidural hematoma, subdural
hematoma, intraparenchymal or intracerebral hematoma, and traumatic subarachnoid
hemorrhage.
epidural hematoma
collection of blood that results from bleeding between the
dura and the inner surface of the skull
subdural hematoma
collection of blood that results from bleeding between the
dura mater and the arachnoid layer of the meningeal covering of the brain.
intraparenchymal hematoma
collection of blood within the
parenchyma that results from bleeding within the brain tissue itself and occurs in
approximately 16% of head injuries.
nursing goals for pt with acute head injury
(1)
maintain adequate cerebral oxygenation and perfusion; (2) remain normothermic; (3)
be free from pain, discomfort, and infection; and (4) attain maximal cognitive, motor,
and sensory function.
tumours of the brain may be
primary, arising from tissues within the brain, or secondary, resulting from a
metastasis from a malignant neoplasm elsewhere in the body.
why do brain tumours rarely metastisize
they are contained by structural (meninges) and
physiological (blood-brain) barriers.
preferred tx of brain tumours
surgery
nursing goals for pt with brain tumour
will (1) maintain
normal ICP, (2) maximize neurological functioning, (3) be free from pain and
discomfort, and (4) be aware of the long-term implications with respect to prognosis
and cognitive and physical functioning.
stereotactic radiosurgery
procedure that involves closed-skull destruction of an
intracranial target using ionizing radiation focused with the assistance of an
intracranial guiding device. A sophisticated computer program is used while the
patient’s head is held still in a stereotactic frame.