MedSurg Exam 2
What are the components of ICP? - ✅✅-brain
spinal cord
blood
Monroe Kelli Hypothesis - ✅✅ -Brain +CSF+blood
keeping normal ICp in brain
increasing volume of one will decrease volume of others
What do neurons need? And how we provide them that? - ✅✅-oxygen and
glucose
through maintaining a necessary blood flow
✅✅
If you have too much CSF, what condition will that cause? -
-hydrocephalus
What is CSF made of? - ✅✅
-water, bit of sugar, salt
NO PROTEIN, WBCs, RBCs
communicating hydrocephalus - ✅✅-all avenues working but absorptions is
disrupted by villi and pus
What are causes of communicating hydrocephalus? - ✅✅-meningitis
subarachnoid hemorrhage
noncommunicating hydrocephalus - ✅✅-movement of fluid is blocked
What are causes of noncommunicating hydrocephalus? - ✅✅-clot
tumor
abnormal neural tumor
cerebral herniation - ✅✅-pressure increase skull and brain forced across
cerebelli
✅✅
If someone is experiencing a cerebral herniation, what symptoms may you
see? - -pupillary changes
posturing changes
,Define the following terms that relate to cerebral herniation and the parts of
the brain they affect:
✅✅
supratentorial
infratentorial - -Supratentorial: affecting cerebrum, above tentorial notch
Infratentorial: affecting cerebellum
primary injury v. secondary injury - ✅✅
-Primary: occurs at the initial injury
Secondary: occurs as autoregulatory processes decrease
✅✅
What are symptoms of a secondary head injury occurred? -
-HYPOTENSION
HYPOXIA
ischemia
edema
increased ICP
hypercarbia
hyperemia
intracranial pressure - ✅✅-overall pressure exerted by the contents of the
skull
too high of an ICP will cause... - ✅✅-herniation! usually over 40-60
normal ICP - ✅✅-0-15
How is ICP controlled? - ✅✅-compensation
autoregulation
compliance
Controls on ICP: compensation - ✅✅
-shunting CSF-->decreases CSF
production and increasing CSF absorption
decreasing blood flow
-This goes back to the Monroe Kelli hypothesis, since ICP is increasing you
need to accommodate by decreasing the blood and CSF and blood volume in
the brain
Controls on ICP: autoregulation - ✅✅-altering MAP-->again Monroe Kelli
Hypothesis, altering MAP will alter how much blood is brought to brain and the
overall pressure of the brain
altering in CO2-->has a strong affect on the cerebral arteries
, -If more CO2, cerebral arteries will dilate and decrease MAP and visa versa
-Also if someone has HTN, their cerebral arteries will be more constricted
which will make overall MAP higher
Controls on ICP: compliance - ✅✅-overall idea of the ability of the brain to
accommodate changes
✅✅
When you are trying to decrease cerebral edema and stimulate the cerebral
venous system, what is a priority action? - -positioning them about 15-30
as it will make it easier to get blood out of the head and a manual way of
helping to decrease ICP
As perfusion decreases, blood vessels - ✅✅-dilate
to get more blood flow to the brain
cerebral perfusion pressure - ✅✅ -CPP = MAP - ICP
what blood pressure has to overcome to oxygenate the brain
What happens if ICP is greater than MAP? - ✅✅-syncope
✅✅
As CPP decreases, what happens to the cerebral vessels? -
-autoregulation kicks on and vasodilates to normal cerebral blood flow
and cerebral oxygenation
✅✅
If a patient has increased ICP, what will you see on the patient's assessment?
- --decreased LOC
-decreased BV
-weakness/palsy
-paralysis
-pupils and eye movements
-swallow issues
-decreased HR
-irregular respirations
-widened pulse pressure
-vomiting
-abnormal movement/reflexes
How can you monitor ICP? - ✅✅--detect ICP before symptoms
-CSF drainage (halo)
What are the components of ICP? - ✅✅-brain
spinal cord
blood
Monroe Kelli Hypothesis - ✅✅ -Brain +CSF+blood
keeping normal ICp in brain
increasing volume of one will decrease volume of others
What do neurons need? And how we provide them that? - ✅✅-oxygen and
glucose
through maintaining a necessary blood flow
✅✅
If you have too much CSF, what condition will that cause? -
-hydrocephalus
What is CSF made of? - ✅✅
-water, bit of sugar, salt
NO PROTEIN, WBCs, RBCs
communicating hydrocephalus - ✅✅-all avenues working but absorptions is
disrupted by villi and pus
What are causes of communicating hydrocephalus? - ✅✅-meningitis
subarachnoid hemorrhage
noncommunicating hydrocephalus - ✅✅-movement of fluid is blocked
What are causes of noncommunicating hydrocephalus? - ✅✅-clot
tumor
abnormal neural tumor
cerebral herniation - ✅✅-pressure increase skull and brain forced across
cerebelli
✅✅
If someone is experiencing a cerebral herniation, what symptoms may you
see? - -pupillary changes
posturing changes
,Define the following terms that relate to cerebral herniation and the parts of
the brain they affect:
✅✅
supratentorial
infratentorial - -Supratentorial: affecting cerebrum, above tentorial notch
Infratentorial: affecting cerebellum
primary injury v. secondary injury - ✅✅
-Primary: occurs at the initial injury
Secondary: occurs as autoregulatory processes decrease
✅✅
What are symptoms of a secondary head injury occurred? -
-HYPOTENSION
HYPOXIA
ischemia
edema
increased ICP
hypercarbia
hyperemia
intracranial pressure - ✅✅-overall pressure exerted by the contents of the
skull
too high of an ICP will cause... - ✅✅-herniation! usually over 40-60
normal ICP - ✅✅-0-15
How is ICP controlled? - ✅✅-compensation
autoregulation
compliance
Controls on ICP: compensation - ✅✅
-shunting CSF-->decreases CSF
production and increasing CSF absorption
decreasing blood flow
-This goes back to the Monroe Kelli hypothesis, since ICP is increasing you
need to accommodate by decreasing the blood and CSF and blood volume in
the brain
Controls on ICP: autoregulation - ✅✅-altering MAP-->again Monroe Kelli
Hypothesis, altering MAP will alter how much blood is brought to brain and the
overall pressure of the brain
altering in CO2-->has a strong affect on the cerebral arteries
, -If more CO2, cerebral arteries will dilate and decrease MAP and visa versa
-Also if someone has HTN, their cerebral arteries will be more constricted
which will make overall MAP higher
Controls on ICP: compliance - ✅✅-overall idea of the ability of the brain to
accommodate changes
✅✅
When you are trying to decrease cerebral edema and stimulate the cerebral
venous system, what is a priority action? - -positioning them about 15-30
as it will make it easier to get blood out of the head and a manual way of
helping to decrease ICP
As perfusion decreases, blood vessels - ✅✅-dilate
to get more blood flow to the brain
cerebral perfusion pressure - ✅✅ -CPP = MAP - ICP
what blood pressure has to overcome to oxygenate the brain
What happens if ICP is greater than MAP? - ✅✅-syncope
✅✅
As CPP decreases, what happens to the cerebral vessels? -
-autoregulation kicks on and vasodilates to normal cerebral blood flow
and cerebral oxygenation
✅✅
If a patient has increased ICP, what will you see on the patient's assessment?
- --decreased LOC
-decreased BV
-weakness/palsy
-paralysis
-pupils and eye movements
-swallow issues
-decreased HR
-irregular respirations
-widened pulse pressure
-vomiting
-abnormal movement/reflexes
How can you monitor ICP? - ✅✅--detect ICP before symptoms
-CSF drainage (halo)
