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NUR 376 Exam 3 Study Questions with Answers

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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...

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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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