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20 Cards in this Set

  • Front
  • Back
meninges/spaces
EPIDURAL -dura mater (outside)
SUBDURAL - arachnoid membrane (thin later)
SUBARACHNOID - pia mater (continuous with CT in brain)
areas of brain
CEREBRUM - frontal/temporal/parietal/occipital
CEREBELLUM
BRAINSTEM
MIDBRAIN - pons, medulla, RAS
Monroe-kellie doctrine
brain + CSF + blood need to compensate to balance out - keep ICP constant
0-15 mm Hg
intracranial pressure curve
stable to set point
stage 1/2 adjust
stage 3 small changes increase ICP, BP up
stage 4 - herniation occurs (brain moves to area with less pressure)
cerebral blood flow
50 mL/100 g brain tissue
MBP -ICP
(SBP+2DBP)/3
MBP 50-100 ok
CPP 80-100 (need >60)
factors increasing CBP
acidosis (Dilation) - increased flow
hypoxia - low O2, anerobic, lactic acid - dilation
increased metabolism (hyperthermia) = >CBF
factors decreasing CBF
DECREASED VENOUS RETURN - blood cannot leave brainflexion of legs and hips/intraabdominal/intrathoracic pressure = blood cannot get out of brain
alkalosis /decreased CO2 (constriction) - less flow
decreased metabolism - hypothermia - decreased blood flow
cerebral edema
caused increased ICP
insult- tissue edema- >ICP - <CBF - <cellular O2 - tissue edema - >ICP - resp. centers compressed - >CO2 - vasodilation - increased ICP - death
ICP monitoring gold standard
ventriculostomy - into intraventricular space
order to drain until specific pressure
infection/drain too much = ventricle collapse = brain bleed
new methods of monitoring brain perfusion
brain tissue oxygen monitoring - partial pressure of O2 in deep white matter of brain tissue
pupillometer - takes subjectivity out of measurement
neuro vs lami check
brain vs spinal cord function
ICP
LOC (assess cerebral cortex and RAS) - sleep wake cycle or actually awake - pupil change/motor response = higher level of brain function
cushing's triad
pupil changes (cranial nerve III)
posturing
headache
vomitting
vital signs
body temp
cushing's triad
increased systolic BP - trying to send blood to brain
bradycardia
irregular respiration - body temp can fluctuate too
pupil changes
reactive to nonreactive
pinpoint - dilated
ipsilateral (same side as brain injury)
posturing
decorticate - diencephalon) inrerrotation, adduction, toes down, wrists flexed
decerebrate - brainstem - midbrain - arms adducts, extended wrist, hyperpronated, legs stiff, toes down
dolls eyes
absent if eyes remain midline/move with head
absent - eyes go opposite way head is turned
brain death testing
ice water calorics
herniation syndromes
supratentorial (above tentorium) - into brainstem
uncal (unilateral)
central (mideline)
infratentorial (lethal)
upward trasntentorial herniation - cerebellum and midbrainup
downward cerrebellar - cerebellum into foramen magnum
blunt trauma types
acceleration
deceleration
rotational
coup contra coup
basilar skull fx sx
battle sign
racoon's eyes
rhinorrhea/otorrhea
facial paralysis, tinnitus, vertigo