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ICP - 🧠 ANSWER ✔✔intracranial pressure = balance of pressure of the
brain tissue, blood, and CSF.
(normal pressure is 5 to 15 mm Hg)
Changes to ICP - 🧠 ANSWER ✔✔brain tissue, cerebral blood flow
(hypertension), or CSF
Monroe-Kellie hypothesis* - 🧠 ANSWER ✔✔increase in one compartment
of the brain is compensated by a decrease in the other compartments of
the brain
,Increased ICP patho - 🧠 ANSWER ✔✔initially compressing blood vessels in
the brian = less blood = less O2 = cerebral hypoxia
If ICP continues to increase and cause more pressure on the brain stem,
Cushing's triad- hypertension with wide pulse pressure, low HR
(bradycardia), and low RR (bradypnea)
early clinical manifestations pt suspected increased ICP* - 🧠 ANSWER
✔✔reduced LOC (irritability or restlessness), decreased mental status*-
earliest sign, sleepiness, flat affect & drowsiness
moderate signs pt suspected increased ICP - 🧠 ANSWER ✔✔headache-
constant (patho: stretching of meninges), sudden vomiting "emisis) without
nausea!- report (patho- pressure on medulla)
late- clinical manifestations pt suspected increased ICP* - 🧠 ANSWER
✔✔Brain stem affected: extra pressure on the brian, eventually squashing
the brian stem which controls breathing & heart = kills pt
Eyes: pupils fixed & dilated (8 mm, normal 2-6mm) , sometimes unequal-
pressure on cranial nerve 3 (oculomotor nerve)
,We want dolls eyes- meaning the eyes move in opposite direct of head
movement = brain stem is in tact!!
Papilledema- swelling around the optic disk caused by increased pressure
of CSF
lungs: irregular respirations, cheyne stroke respirations (apnea)
Neck: nuchal rigidity (stiff neck)- can not FLEX chin towards chest
crushing triad
Cushing's triad - 🧠 ANSWER ✔✔hypertension with wide pulse pressure,
slowed heart rate (bradycardia), and slowed respirations (bradypnea)
Intracranial hypertension* - 🧠 ANSWER ✔✔increased ICP)- Mechanisms
that increase the volume of one or more of three compartments—
circulation, brain tissue, and CSF—will increase ICP
Mechanisms that decrease ICP* - 🧠 ANSWER ✔✔decreasing volume of
any one of the three compartments- brain tissue, CSF, or circulation- will
decrease the ICP
Causes:
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, -Externally draining CSF via a catheter placed in the ventricles will lower
ICP.
-Blood volume can also be reduced by lowering blood pressure
-Infusing a hypertonic solution such as IV mannitol can rapidly decrease
intracellular pressure and lower cerebral edema.
-A low carbon dioxide level will vasoconstrict cerebral arteries, reducing the
volume of blood delivered to the brain.
-Removing brain tissue, such as occurs in a lobectomy, will likewise
decrease volume and ICP.
decompressive craniectomy, in which a section of the skull is removed,
creating an opening in the closed space of the skull and allowing expansion
of the brain.
-This allows the ICP to increase without the danger of compressing brain
tissue
what is a stroke? - 🧠 ANSWER ✔✔inability of O2 rich blood to reach the
brain due to blockage or bleeding in a vessel
Types of stroke - 🧠 ANSWER ✔✔ischemic, transient ischemic, and
hemorrhagic