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20 Cards in this Set
- Front
- Back
meninges/spaces
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EPIDURAL -dura mater (outside)
SUBDURAL - arachnoid membrane (thin later) SUBARACHNOID - pia mater (continuous with CT in brain) |
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areas of brain
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CEREBRUM - frontal/temporal/parietal/occipital
CEREBELLUM BRAINSTEM MIDBRAIN - pons, medulla, RAS |
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Monroe-kellie doctrine
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brain + CSF + blood need to compensate to balance out - keep ICP constant
0-15 mm Hg |
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intracranial pressure curve
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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) |
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cerebral blood flow
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50 mL/100 g brain tissue
MBP -ICP (SBP+2DBP)/3 MBP 50-100 ok CPP 80-100 (need >60) |
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factors increasing CBP
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acidosis (Dilation) - increased flow
hypoxia - low O2, anerobic, lactic acid - dilation increased metabolism (hyperthermia) = >CBF |
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factors decreasing CBF
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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 |
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cerebral edema
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caused increased ICP
insult- tissue edema- >ICP - <CBF - <cellular O2 - tissue edema - >ICP - resp. centers compressed - >CO2 - vasodilation - increased ICP - death |
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ICP monitoring gold standard
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ventriculostomy - into intraventricular space
order to drain until specific pressure infection/drain too much = ventricle collapse = brain bleed |
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new methods of monitoring brain perfusion
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brain tissue oxygen monitoring - partial pressure of O2 in deep white matter of brain tissue
pupillometer - takes subjectivity out of measurement |
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neuro vs lami check
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brain vs spinal cord function
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ICP
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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 |
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cushing's triad
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increased systolic BP - trying to send blood to brain
bradycardia irregular respiration - body temp can fluctuate too |
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pupil changes
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reactive to nonreactive
pinpoint - dilated ipsilateral (same side as brain injury) |
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posturing
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decorticate - diencephalon) inrerrotation, adduction, toes down, wrists flexed
decerebrate - brainstem - midbrain - arms adducts, extended wrist, hyperpronated, legs stiff, toes down |
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dolls eyes
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absent if eyes remain midline/move with head
absent - eyes go opposite way head is turned |
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brain death testing
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ice water calorics
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herniation syndromes
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supratentorial (above tentorium) - into brainstem
uncal (unilateral) central (mideline) infratentorial (lethal) upward trasntentorial herniation - cerebellum and midbrainup downward cerrebellar - cerebellum into foramen magnum |
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blunt trauma types
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acceleration
deceleration rotational coup contra coup |
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basilar skull fx sx
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battle sign
racoon's eyes rhinorrhea/otorrhea facial paralysis, tinnitus, vertigo |