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Stack #240027
| Question | Answer |
|---|---|
| Beneath the skull there are 3 layers of the meninges | dura mater: outer layer, arachnoid mater: delicate middle layer, pia mater: innermost layer covers surface of brain |
| 3 areas where fluid/blood can accumulate | epidural, subdural, subarachnoid space |
| Brain structures | cerebrum, frontal, parietal, temporal, occipital |
| frontal controls | personality, emotions, motor, problem solving, reasoning |
| parietal controls | sensory |
| occipital controls | vision |
| temporal controls | hearing, language, speech |
| cerebellum controls | balance, coordination |
| CNS structures | basal ganglia, corpus callosum, diencepalon, thalamus, hypothalamus, cerebellum |
| Brain stem has ascending & descending pathways through 3 majoe divisions | midbrain channels: auditory & visual reflexes, pons channels: relays & controls part of respiratory function, reticular activating system: regulates blood pressure & respiration |
| Spinal cord is the largest | nerve in the body, holds the nerves which act as body's communication system brain to other parts of the body |
| Cerebrovascular circulation consist of | CSF which is produced by the ependymal cells in the choroid plexus |
| How much CSF is produced per day | 500ml to maintain a constant circulating volume of 125-150ml, normal pressure 75-180mmh20 |
| What is hydrocephalus | interruption in CSF circulation |
| 2 types hydrocephalus | Communicating hydrocephalus: system intact but too much fluid, 2 Noncommunicating hydrocephalus: system is not intact |
| Cerebral arteries are | PCA, MCA, ACA, |
| PCA supplies | occipital, midbrain, thalamus, inferior medial temporal lobe |
| MCA supplies | lateral areas of the temporal, frontal, parietal lobes |
| ACA supplies | medial area of the temporal, frontal, & parietal lobes |
| All cerebral ateries are connected via the | circle of wills |
| Does the brain stores O2 or glucose? | No, it depends on the constant blood flow (750ml/min) |
| Cerebral ischemia is when | disruption of blood flow |
| 2 types of cerebral ischemia | global, local/focal |
| Global cerebral ischemia is due to | Complete: cardiac arrest, aortic occlusion, choke hold, cephalic artery occlusion Incomplete: hemorrhage, IC HTN, permanent, reperfusion |
| Focla cerebral ischemia is due to | Multifocal: emboli, patchy CHF, proximal MCAC, MCAO & cyanosis, thrombosis, intraluminal filament, permanent, reperfusion |
| ICP is controlled by 2 mechanism | compensatory & autoregulation |
| ICP compensatory mechanism includes | shunting CSF, increase/decrease CSF production, decrease blood volume |
| ICP autoregulatory mechanism includes | alteration in MAP, alteration in CO2 |
| Causes of increased ICP | increase blood, brain & CSF volume, & space-occupying lesions |
| Compliance is the ability of the brain to | accommodate changes in IC volume without significant changes in ICP |
| With decrease compliance | only small increases in IC volume can result in large increase in ICP |
| Decompensation in the brain results in | brain damage |
| Levels of consciousness are triggered by what part of the brain stem | RAS this includes (alert, confused, lethargic, obtunded, stupor, coma) |
| Neuro motor examination is done by checking | bicep, triceps, hand graso, hip flexor/extensor, dorsal/plantar flexion |
| Noxious stimulus is checked by | sternal rub, trapezius pinch, supraorbital pressure this is used to evaluate motor strength in patients who are receptively aphasic or neuro can't follow commands |
| Sensory portion of neuro is to test the | sensory pathways that ascend via the spinal cord from the periphery to the sensory processing centers of the brain (numbness/tingling anywhere)Pt's with spinal cord injuries/lesions use touch, pain, joint position sense, vibration or dermatome chart |
| After completing motor & sensory exam procede to | reflex assessment |
| Reflex assessment includes | babinski, clonus, grasp reflex |
| A positive babinski is when & means | when the great toe flexes toward the top of the foot and the other toes fan out after the sole of the foot has been firmly stroked. Indicates damage to the nerve paths connecting the spinal cord and the brain |
| A positive clonus is when | series of involuntary muscular contractions due to sudden stretching of the muscle. |
| Dysfunction of the CN can mean | swelling or compression around the brainstem, which can lead to brain compromise |
| Are VS a reliable indicator of neurological deterioration | no they tend to occur/change too late to prevent irreversible brain damage |
| Do alternations in respiratory patterns begin early or late | early, in IC hypertension due to compression of the respiratory centers |
| Changes in the ICP can affect the HR & BP, true or false | true |
| Cushing's triad is a specific set of VS that occur when increase in ICP | widen pulse pressure(difference in systolic & diastolic), bradycardia, bradypnea |
| Death by neuro criteria | fixed pupils nonreactive, absent corneal, oculocephalic, oculovestubular, gag, cough reflex, no spontaneous respiration PaCO2 < 90, no motor function to deep stimuli |
Created by:
tauvia2003