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Patho Exam 3 2026 – Brain Injury, Increased Intracranial Pressure, and Neurological Assessment

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This document covers essential pathophysiology and neurological nursing concepts related to brain injury, cerebral perfusion, intracranial pressure, and neurologic assessment. Topics include primary and secondary brain injuries, ischemia, hypoxia, cerebral edema, autoregulation, cerebral perfusion pressure, increased ICP, Cushing’s triad, brain herniation, Glasgow Coma Scale scoring, posturing, cranial nerve assessment, and brainstem reflex testing. The study guide also reviews neurologic complications, oculovestibular reflexes, cold caloric testing, pupil assessment, and mechanisms of altered consciousness in a concise question-and-answer format for nursing and pathophysiology exam preparation. Keywords Pathophysiology Brain injury Primary brain injury Secondary brain injury Ischemia Hypoxia Hypoxemia Cerebral edema Reperfusion injury ATP depletion Autoregulation Intracranial pressure ICP Cerebral perfusion pressure CPP Mean arterial pressure MAP Glasgow Coma Scale Level of consciousness Coma Cushings triad Brain herniation Subfalcine herniation Tentorial herniation Uncal herniation Tonsillar herniation Monro Kellie hypothesis Compliance Decorticate posturing Decerebrate posturing Brainstem assessment Pupil reactivity Oculovestibular reflex Dolls eyes test Cold calorics Nystagmus Cranial nerves Neurological assessment Brainstem dysfunction Neuro nursing NCLEX preparation Nursing exam review

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Patho Exam 3 2026 Exam
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Primary brain injury - ANSWER ✔✔occurs as a direct result of the

initial insult, immediately at the onset of brain injury


Secondary brain injury - ANSWER ✔✔progressive damage resulting

from the body's physiologic response to the initial insult, occurs hours to

days after the initial trauma


Most common cause of secondary brain injury - ANSWER

✔✔Ischemia

, Critical factor in determining neural cell fate after injury - ANSWER

✔✔Degree of ATP Depletion


Common secondary injury - ANSWER ✔✔Cerebral edema


Secondary injury that occurs after re-establishing blood flow -

ANSWER ✔✔Reperfusion injury


Hypoxemia - ANSWER ✔✔Decreased oxygen in the blood


Ischemia - ANSWER ✔✔Decreased blood flow


_________ + __________ usually occur together - ANSWER

✔✔ISCHEMIA + HYPOXIA usually occur together


Hypoxia - ANSWER ✔✔Decreased oxygen at the cellular level


Why is the brain so sensitive to oxygen depletion? - ANSWER

✔✔Because of high ATP requirements and limited capacity for anaerobic

metabolism


How long can brain tolerate ATP loss? - ANSWER ✔✔Several

minutes (only takes ~5-10 for permanent damage)


Blood flow through brain is controlled by __________ - ANSWER

✔✔Blood flow through brain is controlled by AUTOREGULATION

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