Neuro Exam
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| Cranial vault contains what? | Brain tissue, blood, measured lateral ventricle
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| Normal amount of blood is ____mL. Normal amount of CSF is _____ mL | 75 mL, 75 mL
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| Normal ICP is up to how much mmHg? What is the upper limit? Treat if > ? | 10; 15; 20
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| What hypothesis states that an increase in any one of the components causes a change in the volume of others? | Monroe-Kellie Hypothesis
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| According to Monroe-Kellie Hypothesis, compensation is accomplished by displacing or shifting _____; Increasing the absorption or diminishing production of ____; Decreasing cerebral blood volume | CSF; CSF
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| Increased ICP may reduce CBF and result in _____ and cell ______ | Ischemia; cell death
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| In early stages of cerebral ischemia, vasomotor centers are stimulated and systemic pressures rise to maintain CBF, accompanied by a ________, ______ pulse and RR ______. | slow, bounding; irregularities
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| CO2 in blood also plays a role in regulation of CBF. Increase in PaCO2 causes _________. Decrease in PaCO2 causes _________. | Vasodilation; Vasoconstriction
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| Body tries to compensate for ICP. Compensatory mechanisms include? | Autoregulation; decreased production and flow of CSF
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| Term refers to the brain's ability to change the diameter of blood vessels to maintain a constant cerebral flow of blood during changes in systemic blood pressure | Autoregulation
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| Autoregulation can be impaired in pts with sustained _____ | ICP
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| Condition seen in pts with significantly decreased CBF. | Cushing's response
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| What are the s/s of Cushing's Triad? | Bradypnea, HTN, Bradycardia
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| Clinical manifestations of increased ICP depend on the rate of pressure increase and location in the brain. Changes in LOC indicates | Cerebral hypoxia
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| An early sign (other than change in LOC) of ICP is changes in cranial nerve exam, especially slow-reacting ________ | Pupils
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| First sign of ICP is | Vomiting without nausea
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| Unrelieved ICP may result in pathologic ______ | posturing
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| What are three complications of ICP? | Brain stem herniation, SIADH, DI
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| Changes in VS with ICP can manifest as? | HR brady to tachy; Increase systemic BP with widening pulse pressure; T may rise; RR pattern irregular (may have Cheyne-Stokes)
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| Medical management goal of ICP is the prevention of ______ _______ d/t _______ ______ and ____. | 2nd injury; cerebral edema and ICP
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| Treatment of ICP may be medical or ________ | Surgical
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| Procedure for ICP monitor: Catheter into the right lateral ventrical; facilitates intraventricular drug admin and facilitates removal and/or sampling of CSF | Ventriculostomy
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| On ICP monitor A wave indicates | cerebral ischemia
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| On ICP monitor B wave indicates | incracranial HTN and variations in RR cycle
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| On ICP monitor C wave indicates | variations in systemic arterial pressure and RR
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| What are three complications of ICP monitor device? | Ventricular infection, meningitis, occlusion of cath with brain tissue or blood
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| What are three main interventions for decreasing cerebral edema? | Osmotic diuretic (Mannitol), Fluid restrictions, Hypothermia
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| Osmotic diuretic (Mannitol) pulls fluids from brain tissue into _______ space | vascular
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| Reduce CSF and intracranial blood volume by ______ CSF. PaCO2 should be brought to ____ to _____ | Draining; 30-34
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| Maintain oxygenation and decrease metabolic demands by obtaining ABGs and pulse ox, sedation with ________ and paralyzing agent such as ______ | Barbiturates, Propofol
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