the bones of the skull form a rigid cranial compartment that contains: brain tissue (80%)
CSF (10%)
blood volume (10%)
the pressure of _____ must remain _____ to maintain a normal _____ brain tissues, CSF, and blood volume;
balanced;
intracranial pressure (ICP)
intracranial pressu...
NUR 376 Exam 3 Study Questions with
Answers
the bones of the skull form a rigid cranial compartment that contains: ✅brain tissue
(80%)
CSF (10%)
blood volume (10%)
the pressure of _____ must remain _____ to maintain a normal _____ ✅brain tissues,
CSF, and blood volume;
balanced;
intracranial pressure (ICP)
intracranial pressure (ICP) ✅the pressure inside the skull, brain tissue, and CSF
normal ICP for a resting, supine adult ✅5-15 mmHg
what causes change in ICP? ✅volume changes in:
brain tissue
cerebral blood flow
CSF
what is the monroe-kellie hypothesis? ✅an increase in the volume of one component
must be compensated by a decrease in the volume of another
EX: A slow-growing brain tumor increases the volume of brain tissue. What happens?
✅The CSF production is slowed to compensate and maintain normal ICP.
What happens once the volume of the brain tumor exceeds the volume of the CSF
reduction? ✅ICP increases
when the compensating mechanisms are totally exhausted.... ✅ICP will increase
ICP is maintained until _____ ✅a maximum point is reached
what is a major cause of increased ICP? ✅cerebral edema
,what are major causes of cerebral edema? ✅trauma
hemorrhage
tumor inflammation
ischemia
types of cerebral edema ✅vasogenic
cytotoxic
what causes vasogenic cerebral edema? ✅trauma that causes a shearing stress on
the brain
what happens to the brain with vasogenic cerebral edema? ✅the pore's of the brain's
capillaries open wide and allow proteins/fluids to leak from blood to tissues
what causes cytotoxic cerebral edema? ✅cerebral ischemia or hypoxia
if cytotoxic cerebral edema is not reversed, what happens? ✅brain cell death
ischemia in the brain causes... ✅ion pumps to fail which leads to cellular swelling
cellular swelling causes _____ which causes _____ ✅an increase in the volume of
brain tissue; increased ICP
low oxygen levels (hypoxia) or high carbon dioxide levels in the brain cause...
✅reflexive cerebral vasodilation
reflexive cerebral vasodilation causes _____ which causes _____ ✅an increase in the
volume of the brain's blood; increased ICP
decreasing the volume of brain tissue, CSF, or circulation will cause... ✅decreased
ICP
what leads to decreased ICP? ✅external drainage of CSF via catheter
low blood volume from lowering BP
hypertonic solution infusion (mannitol)
low CO2
removing brain tissue
,decompressive craniectomy
how does infusion of a hypertonic solution affect the brain pressure? ✅rapidly
decreases intracellular pressure
lowers cerebral edema
how does low CO2 affect brain pressure? ✅causes vasoconstriction of cerebral
arteries which reduces the volume of blood delivered to the brain
how does a lobectomy affect ICP? ✅removing brain tissue decreases volume which
decreases ICP
how does a decompressive craniectomy decrease ICP? ✅a section of the skull
removed creates an opening in the closed space of the skull and allows for expansion of
the brain without compressing brain tissue
types of strokes ✅ischemic
hemorrhagic
transient ischemic attack (TIA)
a stroke is a ______ whereby a disruption in cerebral circulation triggers ______ that
are _____ ✅clinical syndrome;
abrupt neurological deficits;
permanent
ischemic stroke ✅caused by a thrombus or embolus that lodges in a cerebral artery
and blocks blood flow to brain tissue
ischemia of brain tissue leads to.... ✅cerebral infarction
(death of brain cells)
mechanisms commonly seen in ischemia stroke ✅cerebral ateriosclerosis
atrial fibrillation
carotid stenosis
, hemorrhagic stroke ✅caused by a rupture and hemorrhage of a cerebral artery that
leads to compression and toxicity of brain cells
hemorrhagic stroke leads to... ✅loss of cerebral blood flow
_____ of strokes are ischemic where as _____ are hemorrhagic ✅85%; 15%
what happens when a cerebral artery ruptures? ✅cerebral edema
tissue destruction
cerebral microhemorrhages are seen in _____ of older individuals and are associated
with ______ ✅5-23%;
hypertension, uncontrolled diabetes mellitus, and cigarette smoking
subarachnoid hemorrhage (SAH) ✅rupture of arterial branch of subarachnoid space
SAH can lead to ______ ✅anoxic encephalopathy
most common sites for cerebral aneurysm... ✅arteries that make up the circle of Willis
within the subarachnoid space
transient ischemic attack ✅disruption of cerebral circulation with neurological deficits
that are reversible and last for less than 24 hours
in TIA, the body _____ resulting in a ______ and no ______ ✅naturally dissolves the
clot that cause ischemia;
return of circulation;
permanent neurological injury
TIA is often a... ✅warning sign of future stroke
TIA often result in... ✅lacunar infarcts
lacunar infarcts are often associated with... ✅hypertension
smoking
uncontrolled diabetes
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