NSG 3280 - Exam 3 (Neuro) Questions with 100% Correct Answers

What is ischemia? Cell death. What is hypoxia? Decreased oxygen leading to mitochondrial failure and cell damage. What is the main CNS neurotransmitter? Glutamate. What effect does ischemia have on glutamate? Ischemia increases glutamate release. What happens to nerve tissue during ischemia? Nerve tissue struggles with anaerobic metabolism and is very sensitive to decreased oxygen. What are the effects of too much glutamate? Increased calcium and water enter the cell, causing calcium overload and cytotoxic edema. What does excessive glutamate production lead to? Increased production of nitrous oxide, free radical formation, and cell death. What is the normal range for intracranial pressure (ICP)? 0-15 mmHg At what ICP level does brain impairment occur? 22 mmHg for 5 minutes What are the three main components of the cranial cavity according to the Monroe-Kellie doctrine? Brain, Cerebrospinal Fluid (CSF), Blood What is intracranial compliance? The ability of the cranial components to adjust to changes in volume to minimize impact on ICP. Name an everyday activity that can cause slight changes in ICP. Sneeze, cough, bending, laugh What is interstitial edema? Swelling caused by fluid, electrolytes, and proteins forced into the intercellular space due to vessel damage or increased pressure. What causes intracellular edema? Global ischemia leading to cellular energy failure and Na+ accumulation, attracting water into the cell. What is the most sensitive clinical manifestation of increased ICP? Change in level of consciousness (LOC), often increased drowsiness. What are common symptoms of increased ICP? Headache, nausea/vomiting, blurred vision, slow pupillary response. What does a decrease in the Glasgow Coma Scale (GCS) score indicate? A potential decrease in consciousness or brain function. What is the maximum score for eye opening on the Glasgow Coma Scale? 4 for spontaneous eye opening. What is the maximum score for verbal response on the Glasgow Coma Scale? 5 for oriented verbal response. What is the maximum score for motor response on the Glasgow Coma Scale? 6 for following commands. What is Cushing's Triad? A late sign of increased ICP characterized by ↑BP, ↓HR, and respiratory changes. What does decreased pupil response indicate? Increased intracranial pressure (ICP). What is the normal response in the Doll's Eyes Test? Eyes move in the opposite direction of head movement. What does an absent response in the Cold Calorics test indicate? No eye movement, suggesting potential brain dysfunction. What is the normal response of the corneal reflex? Blinking when a cotton swab touches the cornea. What does fixed and dilated pupils indicate? Poor brain perfusion. Focal (Coup) Injury localized to the site of impact Polar (Coup-countercoup) Injury at site of impact and on opposite side of the brain (due to brain's forward-backward movement within the skull) What does small (pinpoint) pupils suggest? Possible pons issue or drug effects. Diffuse Widespread damage of the brain Multiple movements of brain within the skull Results in shifting and rotational forces causes stretching and shearing of white matter Primary vs secondary injury Primary - original injury; Secondary - complications that form due to the bodies response to the primary injury Examples of secondary injury Cerebral edema, vessel rebleed or spasm, CSF blockage, seizures Epidural Hematoma Location: between inner skull and dura mater