Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ESA 5 - Nervous System > Raised Intracranial Pressure > Flashcards

Raised Intracranial Pressure Flashcards

1
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the intracranial and spinal vault enclosed by?

A

Dura mater and bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What does the intracranial and spinal vault contain?

A
  • Neural tissue (brain and spinal cord)
  • Blood
  • CSF
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is intracranial pressure?

A

The pressure within the intracranial space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the normal ICP?

A

5-15mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What occupies the intracranial space?

A
  • CSF
  • Blood
  • Brain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How is blood flow to the brain regulated in an healthy individual?

A
  • Autoregulation
  • Chemoregulation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How does autoregulation of blood flow to the brain occur?

A
  • Vasoconstriction
  • Vasodilation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How does chemoregulation of blood flow to the brain occur?

A

Vasodilation in response to a low cerebral pH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the result of adaptation of the brain, blood, and CSF?

A

It can maintain ICP to a degree, even in disease states

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Describe the steps in the pathophysiology of a brain injury?

A
  1. Reduction in blood supply to brain cells, e.g. compression by intracranial tumour
  2. Cytotoxic cellular oedema
  3. Further swelling and compression, so further reduction in blood supply to brain cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the signs and symptoms of raised ICP?

A
  • Headache
  • Vomiting
  • Visual disturbances
  • Depression of conscious level
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the features of the headache caused by raised ICP?

A
  • Generalised ache
  • Worst on awakening in the morning
  • May awaken patient from sleep
  • Severity gradually progresses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Why is the headache from raised ICP worse in the morning?

A

As a result of hypoventilation during the sleeping hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What factors aggregate the headache caused by raised ICP?

A
  • Bending or snooping
  • Coughing or sneezing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe the vomiting caused by raised ICP

A

Nausea and vomiting that progresses to projective vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What visual disturbances might occur with raised ICP?

A
  • Blurring
  • Obscurations
  • Papilloedema
  • Retinal haemorrhages
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are obscurations?

A

Transient blindness upon bending or posture changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

When will raised ICP patients get retinal haemorrhages?

A

If the rise in ICP has been rapid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How might slowly increasing intracranial pressure present in infants?

A

As slowly increasing head size

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What happens if raised ICP is not treated, and continues to rise?

A

You get herniation through the foramen magnum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the clinical relavance of herniation through the foramen magnum?

A

It is a poor prognostic sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is Cushing’s reflex?

A

A last effort to perfuse the brain, whereby there is;

  • Increased blood pressure
  • Irregular breathing
  • Bradycardia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What causes the bradycardia in Cushing’s reflex?

A

Ischaemia at the medulla leads to sympathetic activation, which causes a rise in blood pressure and tachycardia. Baroreceptors react, causing bradycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What causes the low respiratory rate in the Cushing’s reflex?

A

Ischaemia at the respiratory centres in the pons/medulla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the categories of causes of raised intracranial pressure?

A
  • Increased cerebral blood volume
  • Cerebral oedema
  • Increased CSF
  • Space occupying lesion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What can cause an increased cerebral blood volume?

A
  • Venous outflow obstruction
  • Venous sinus thrombosis
28
Q

What can cause increased CSF?

A
  • Impaired absorption
  • Excessive secretion
29
Q

What can cause impaired absorption of CSF?

A
  • Hydrocephalus
  • Benign intracranial hypertension
30
Q

What can cause excessive secretion of CSF?

A

Choroid plexus papilloma

31
Q

What can cause cerebral oedema?

A
  • Meningitis
  • Encephalitis
  • Diffuse head injury
  • Infarction
32
Q

What space occupying lesions can cause raised ICP?

A
  • Abscess
  • Tumour
  • Haemorrhage/haemotoma
33
Q

What is the most common cause of raised ICP?

A

Traumatic brain injury

34
Q

What needs to be thought about in suspected raised ICP due to traumatic brain injury?

A
  • Epidural, subdural, and subarachnoid harmorrhages
  • Use of anticoagulants
35
Q

What might suggest severe meningitis encephalitis as the cause of raised ICP?

A
  • Signs/symptoms of meningitis
  • Immunosupression
  • Tb exposure
36
Q

What can severe meningitis encephalitis cause in the short term?

A

Brain oedema

37
Q

What can severe meningitis encephalitis cause in the long term?

A

Venous outflow obstruction

38
Q

What colour is normal CSF?

A

Clear and colourless

39
Q

Describe the composition of normal CSF

A
  • Very little protein - 15 to 45mg/dL
  • Little immunoglobulin
  • 1-5 cells per ml
40
Q

How are changes to CSF clinically important?

A

They are useful in diagnosis of a variety of disease processes

41
Q

What is accumulation of CSF thought to be due to?

A

Imbalance between production and absorption of CSF with subsequent enlargement of brain ventricles

42
Q

How common in hydrocephalus?

A

1 in 1000 births

43
Q

What are the classifications of hydrocephalus?

A
  • Non-communicating/obstructive
  • Communicating
44
Q

What is non-communicating/obstructive hydrocephalus?

A

CSF is obstructed within the ventricles, or between the ventricles and subarachnoid space

45
Q

What is non-communicating/obstructive hydrocephalus most commonly due to?

A

Aqueduct blockage

46
Q

Is non-communicating/obstructive hydrocephalus congential or acquired? her

A

Can be either

47
Q

Give an example of an acquired cause of hydrocephalus

A

Tumours, e.g. meningiomas

48
Q

What is communicating hydrocephalus?

A

When there is communication between the ventricles, or between the ventricles and subarachnoid space, and so the problem lies outside of the venticular system

49
Q

What problems with CSF might cause communicating hydrocephalus?

A
  • Reduced absorption or blockage of the venous drainage system
  • Increased CSF production
50
Q

What conditions might cause communicating hydrocephalus?

A
  • Post-meningitis, ​bacterial, fungal, or TB
  • Subarachnoid haemorrhage
  • Trauma
  • Neoplastic infiltration of subarachnoid space
  • Choroid plexus papilloma
51
Q

What is the incidence of brain tumours?

A

1 in 10,000

52
Q

Where are the age peaks for brain tumours?

A
  • Children
  • Late middle age
53
Q

How does the incidence of brain tumours in children differ to other childhood cancers?

A

Second most common childhood cancer after leukaemia

54
Q

What are the most common forms of paediatric brain tumours?

A
  • Astrocytomas from astrocytes
  • Medulloblastomas from neuroectoderm cells
55
Q

Where in the brain to brain tumours tend to effect?

A

Midline or posterior region

56
Q

What are the most common types of brain tumours in adults?

A
  • Gliomas
  • Meningiomas
  • Metastases from lung, breast, and kidney
57
Q

What is idiopathic intracranial hypertension?

A

Raised intracranial pressure without evidence of hydrocephalus or mass lesion

58
Q

What will be round on investigation with idiopathic intracranial hypertension?

A
  • Normal investigations, including imaging of the brain
  • Signs of raised ICP
59
Q

Who is idiopathic intracranial hypertension most commonly found in?

A

Obese young women

60
Q

What are the treatment options for idiopathic intracranial hypertension?

A
  • Weight loss
  • Medical management using drugs
  • CSF drainage and shunts
61
Q

Give an example of a drug that can be used to treat idiopathic intracranial hypertension

A

Carbonic anhydrase inhibitors

62
Q

How is ICP caused by increased cerebral blood volume treated?

A
  • Anticoagulation
  • Rarely, tenting of venous sinuses
63
Q

How is raised ICP caused by cerebral oedema treated?

A
  • Treat the cause
  • Mannitol
  • Hypertonic saline
64
Q

How is raised ICP caused by increased CSF treated?

A
  • Shunts
  • Tumour resection
  • Diuretics whilst awaiting intervention, e.g. furosemide, carbonic anhydrase inhibitors
65
Q

How is raised ICP caused by space occupying lesions treated?

A
  • Surgical resection, e.g. craniotomy
  • Steroids of high value for brain tumours

ESA 5 - Nervous System (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions