NU 327 - Pathophysiology - Final Exam
Normal RBC Count - ANS-Female = 4.2-5.4
Male = 4.5-6.2
Normal WBC Count - ANS-Female = 4,500-11,000
Male = 5,000-10,000
Normal Hematocrit - ANS-Female = 37-47%
Male = 42-52%
Normal Hemoglobin - ANS-Female = 12-16
Male = 14-18
Normal Sodium (Na+) - ANS-Adults = 135-145 mEq/L
Normal Potassium (K+) - ANS-Adults = 3.5-5.0 mEq/L
Normal Total Cholesterol - ANS-<200 mg/dL
Normal HDLs - ANS-Female >55 mg/dL
Male >45 mg/dL
(these are protective levels)
Normal LDLs - ANS-Beneficial <100 mg/dL
Harmful >160 mg/dL
Normal Troponin - ANS-<0.01 ng/mL
Normal BNP - ANS-<100 indicates no Heart Failure
Normal Ejection Fraction (EF) - ANS-60-80%
Normal Creatinine - ANS-Female = 0.5-1.1 mg/dL
Male = 0.6-1.2 mg/dL
(reflects GFR for renal function)
Normal Blood Urea Nitrogen (BUN) - ANS-10-20 mg/dL
(indirect measure of overall hydration)
Normal pH Range - ANS-7.35-7.45
,Absolute pH - ANS-7.4
Normal PaCO2 Range - ANS-35-45 mmHg
(acid)
Normal HCO3- Range (Bicarb.) - ANS-22-26 mEq/L
(base)
Normal PaO2 Range - ANS-80-100 mmHg
Normal SaO2 Range - ANS-95-100%
Normal Blood Pressure Range - ANS-120/80-140/90
Normal V/Q Ratio - ANS-V = 4 L/min
Q = 5 L/min
V/Q = 0.8
Central Nervous System (CNS)
Components & Functions - ANS-- composed of brain + spinal cord bathed in cerebrospinal fluid
(CSF)
- receives and processes sensory information and creates responses to be relayed to
muscles/glands
- the site of emotion, memory, cognition, learning
- protected by the skull & vertebrae, CSF, blood-brain barrier, meninges (dura mater, arachnoid
mater, pia mater)
Cerebrum - ANS-- largest part of the brain
- sensory & motor activities
- motor coordination
- R & L hemispheres
- 4 lobes (frontal, parietal, temporal, occipital)
Cerebellum - ANS-- beneath the cerebrum, base of the brain
- coordinates muscle movements
- controls posture
- maintains equilibrium
Brain Stem - ANS-- composed of the midbrain, pons, and medulla
- pupillary reflexes and eye movements
- respirations
- cardiac, vasomotor functions
Spinal Cord - ANS-- extends from the brain to second lumbar vertebrae
,- 2-way conduction between brain and PNS
- gray matter - neuron cell bodies
- white matter - nerve tracts
Peripheral Nervous System (PNS)
Composition & Functions - ANS-- messages transmitted through the spinal cord reach their
target organs through the PNS
- 31 pairs of spinal nerves
- 12 pairs of cranial nerves
Autonomic Nervous System (ANS)
Composition & Functions - ANS-- composed of the Sympathetic NS and the Parasympathetic
NS
- digestion, respirations, cardiovascular, supports homeostasis
Sympathetic Nervous System
Functions & Effects - ANS-- speeds up
- adrenergic catecholamines norepinephrine
- dilates pupil
- inhibits flow of saliva
- accelerates heartbeat
- dilates bronchi
- inhibits peristalsis and secretion
- conversion of glycogen to glucose
- secretion of adrenaline and noradrenaline
- inhibits bladder contraction
Parasympathetic Nervous System
Functions & Effects - ANS-- slows down
- cholinergic neurohormone acetylcholine
- constricts pupil
- stimulates flow of saliva
- slows heartbeat
- constricts bronchi
- stimulates peristalsis and secretion
- stimulates release of bile
- contracts bladder
Primary Brain Injury - ANS-- occurs immediately at the onset of brain injury
- little can be done to reverse
- sudden damage to tissue
Secondary Brain Injury - ANS-- development of further neurological damage
- day-weeks after initial injury
, - delayed cell death may involve necrosis
Hypoxia - ANS-- an O2 deficiency at the cellular level
Hypoxemia - ANS-- an O2 deficiency in the blood
Ischemia - ANS-- occurs when the deliver of oxygenated blood is below the level needed to
meet metabolic demands
- cellular energy failure
- excitatory amino acids
- reperfusion injury
- abnormal autoregulation
Cellular Energy Failure (R/T Ischemia) - ANS-- neuronal tissue highly sensitive to O2
deprivation b/c of great ATP reuirements and very limited capacity for anaerobic metabolism
during ischemia
- normal brain recieves 15% of total CO
- gathers 20% of body's O2 consumption
- brain is only 2% of total body weight
- 5-10 mins of ATP loss is necessary for irreversible brain damage
Excitatory Amino Acids (R/T Ischemia) - ANS-- XS release of excitatory amino acids is thought
to contribute to Ca2+ overload during acute brain injury
- Ca2+ is a critical event leading to cell dysfunction, cell necrosis, membrane damage
Reperfusion Injury (R/T Ischemia) - ANS-- reestablishing perfusion is URGENT!
- longer period of ischemia = greater extent of necrosis
- occurs when blood flow is reintroduced to previously ischemic but viable cells
- the return of O2 allows inflammatory cells to invade area
- the inflammatory response contributes to brain inflammation
- inflammation promotes platelet aggregation in cerebral vessels w/subsequent reduction in
perfusion and worsening of ischemia
Abnormal Autoregulation (R/T Ischemia) - ANS-- autoregulation of cerebral blood flow achieves
appropriate flow to meet metabolic needs in spite of BP & metabolism changes
- hypoxia & high PaCO2 - dilation of cerebral vessels
- hyperventilation & low PaCO2 - constriction of cerebral vessels
- effective when MAP = 50-150 mmHg
- hypotension - predisposes to ischemia
- hypertension - vascular damage and brain edema
Increased Intracranial Pressure (ICP) - ANS-- pressure exerted by the contents of the cranium
[NORMAL ICP - 0.15 mmHg]
- volume of the cranium is made of CSF, blood, and brain tissue
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