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1st sign of increased ICP
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last thing that happens before death w/ increased ICP?
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ICP
| Question | Answer |
|---|---|
| 1st sign of increased ICP | change in mention |
| last thing that happens before death w/ increased ICP? | herniation |
| cranial nerve 9 and 10 test | cough an gag |
| CN 5 | corneal reflex and blink |
| CN 3 | pupillary response do every day |
| Oculocephalic Reflex testing nerves? | contraindicated w/ pt.'s with SCI if pt. keeps looking at examiner= intact reaction (positive) if eyes turn were head is going = absent abnormal brain stem function 3,6,8 |
| Cushings triad | irregular resp.(chynes stroke) bradycardia and increased SBP w/ widended pulse pressure |
| lumbar puncture | L3 and L4 -contraindicated in increase ICP - can do it judicially to drain CSF -lateral recumbent position |
| decrease glucose in CSF? | bacterial infection, meningitis |
| regular ICP? | 0-15 regular >=20mmgh for >5min is increased ICP |
| CPP normal range | 60-100 >100 is cerebral HTN <70 cerebral ischmia <40 irreversible brain ischmia |
| kernig's | pain in the neck when extending the knee |
| brudinski? | involuntary flexion of the hip when the neck is flexed towards the chest |
| what do we level ventricular drain ? | external: tragus inside: foraman of monro |
| what fracture do we see raccoon eyes and battle signs | basilar skull fracture |
| epidural hematoma is ____ bleed? | arterial bleed |
| pt. says worst HA of my life? | subarachnoid hemmorhge |
| ipsilateral pupil change, what hematoma | epidural (same side ipsilateral pupil change) |
| which one occurs in minutes to days? | subdural |
| has 3 categories - involves venous artery -highest mortally rate -torn cortical vein most common cause -occurs within hours to days | subdural hematoma |
| what is the most common cause of intra cerebral hematoma? | uncontrolled HTN |
| safest rate to drain CSF? | 480/500ml/day 20ml/hr |
| uncle herniation early signs | early: babinski, cheynes stokes, ipsilateral dilated pupil late: central-lateral hemiplasia, |
| cerebellar tonsil herniation ? | decreased RR, bradycardia, decreased HR and cushngs |
| subdural, what kind of bleed? | VENOUS S.V |
| Epidural, what kind of bleed? | arterial bleed |
| pt. comes in and says having worst HA of their life, what kind of hematoma? | SAH subarachnoid hemmorahe |
| SAH tx: to prevent vasospasm? | nimodipine |
| SAH is the rupture of the circle of? | SAH IS RUPTURE OF THE CIRCLE OF WILLIS |
| SCI: | |
| INJURY ON S2 S4= | SEXUAL DYSFUNCTION |
| PT. SCI BELOW T12? | ERECTION BUT NO EJACULATION |
| PT. SCI ABOVE T11? | ERECTION , 10% EJACULTION |
| AUTONOMIC DYSREFELXIA? | ABOVE T6 |
| C1 to C3 ? | VENTILATOR DEPENDENT |
| C4 to C5 | AKA pt. needs phrenic nerve stimulator to breath PHRENIC NERVE INVOLVEMENT May need phrenic nerve pacemaker |
| BELOW C5 – T6 | DIAPHRAGMATIC BREATHING IN TACT (ABLE TO breath on their own) with varied muscle impairment (intercostal and abdominal) |
| SPINAL SHOCK S/S? | INCREASE BP, INCREASE TEMP BUT EVERYTHING GOES DOWN BOWEL AND BLADDER DYSFINCTION |
| SPINAL SHOCK IS THE ELECTRICAL _____ FROM THE SPINAL CORD | SILENCE |
| Autonomic Dysreflexia S/S | INCREASE BP POUNDING HA DECREASED HR BLURRED VISON -DIAPHORITIC *MEDICAL EMERGENCY * ABOVE T6 |
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