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Flashcards in Copy of CNS LECTURE FLASHCARDS Deck (57):
1

The afferent pathway refers to sensory or motor pathways?

Sensory-coming into the brain (A=arriving)

2

The efferent pathways deal with:

Effector/motor pathways-leaving the brain (E=exiting)

3

T or F: the CNS includes the brain and spinal cord.

TRUE

4

T or F: The PNS includes the brain, spinal cord, and peripheral nerves.

FALSE-peripheral nerves only.

5

The Monro-Kellie doctrine refers to:

The three components (brain tissue, IV blood, CSF) are equal within the vault (brain)

6

CPP stands for:

Cerebral perfusion pressure

7

T or F: CPP can't be knocked out of balance

FALSE- increases or decreases in blood flow or CSF can alter the CPP.

8

T or F: The skull can expand to accommodate changes in pressure/fluid

FALSE. The skull is a rigid vault that does not expand

9

What are 6 possible etiologies of brain injuries?

Trauma
Tumors
Strokes
Metabolic derangements
Degenerative disorders
Infections, inflammatory disease

10

Where does CSF flow in the brain?

Between the ARACHNOID layer and pia matter

11

CAD, HTN, PVD
Clotting disorders
Diabetes, Glucose, fluid and electrolyte
disorders are all:

Underlying conditions that are risk factors for brain injury

12

What are two examples of a degenerative disorder that can cause brain injuries?

Systemic lupis, Alzheimer's

13

What are 3 mechanisms of brain injury?

1. Ischemia/hypoxia
2. Cerebral edema and Cerebral
Pressure
3. Increased Intracranial Pressure
(IICP)

14

Define hypoxia:

Low cellular oxygen with or without blood flow

15

Define ischemia

interrupted, reduced blood flow causing hypoxia

16

Decreased ATP, severe anemia, and CO2 toxicity are all pathological effects of:

hypoxia and ischemia

17

If a patient is hypoxic or ischemic in the brain neurons are:

compensating with anaerobic metabolism, creating lactic acidosis

18

List 8 clinical signs/symptoms of ischemia/hypoxia

Euphoria, drowsiness
Level of consciousness
Seizures
Concentration, attention, problem
solving
Cerebral necrosis- coma and death

19

What is a treatment for ischemia in the brain?

Reperfuse brain tissue

20

How can one reperfuse the brain without a blood transfusion?

Give pt oxygen and fluids-to expand concentrated hemoglobin

21

If a patient has an increase work of breathing what should you do?

Decrease their metabolic needs through rest or sedation if necessary

22

Why would you give a pt glucose who is suffering from hypoxia/ischemia?

To increase their energy production and raise their metabolic functions

23

_________________is defined as increased tissue volume r/t abnormal accumulations

Cerebral edema

24

Interstitial edema is caused by:

Increased Na and H2O (white matter)

25

Vasogenic edema is due to:

Increased ECF

26

Cytoxic edema is due to

Actual swelling of cells

27

Cerebral Perfusion is dependent on:

Blood flow and ICP

28

The volume of the brain is made up by:

Tissue, CSF, blood

29

Define mean arterial pressure (MAP):

average arterial pressure during cardiac cycle

30

What is a normal MAP range?

70-100 mm Hg

31

For perfusion of vital organs we must maintain a pressure of:

> 60 mm Hg

32

What is the most valuable number for determining the cerebral pressure?

CPP

33

CPP=

MAP- ICP

34

CPP >

60mmHg

35

ICP =

0-15 mmHg

36

Why do we put brain injury patients in an induced coma?

To decrease O2 needs, metabolic needs so that brain can recover more quickly

37

T or F: The newest research shows HOB, Diuretics, and Steroids are the best form of treatment for a brain injury

FALSE. This is the classic mindset, new research shows that oxygenation of tissue is more important than immediately reducing ICP/edema

38

Define intracranial pressure:

is the pressure exerted by brain tissue, blood volume & cerebral spinal fluid (CSF) within the skull.

39

ICV =

Vbrain + Vblood + Vcsf

40

In cerebral edema, what is displaced first?

CSF

41

What is altered second in cerebral edema?

Cerebral blood flow

42

In an attempt to increase MAP and offset IICP ______________________ occurs first followed by _________________ to decrease the ICP (compensation)

Venous Vasoconstriction; arterial Vasoconstriction

44

T or F: An increased ICP results from an increased volume of brain tissue, blood, and / or CSF.

TRUE

45

What are the three main life threatening effects of IICP?

1. obstructs blood flow, 2. Destroys brain cells, 3. Displaces brain tissue- herniation

46

List the 5 most common clinical presentations of increased intracranial pressure:

Decreased level of consciousness, Bradycardia, Headache, Increased systolic blood pressure, Seizures

47

Decreased level of consciousness relates to an increase in ICP because:

Usually, the greater the decrease in LOC, the more serious the injury is.

48

Two clinical symptoms of ICP that show the body is attempting to compensate are:

Bradycardia and Increased systolic blood pressure

49

A person who can t think rapidly and clearly is:

Confused

50

A person who begins to loose consciousness and awareness to Time, place, and self is:

Disoriented

51

Define lethargy:

spontaneous speech and movement limited

52

Define obtundation:

arousal (awakeness) is reduced

53

A person in a deep sleep or unresponsive, but opens eyes to vigorous or repeated stimuli is in a:

Stupor

54

A person who responds to noxious stimuli only is in a:

Coma

55

A person who demonstrates Unresponsive coma, No reflexes (pupils, gag, corneal, cough), No spontaneous respiration, Dilated fixed pupils is most likely in:

Brain death

56

Acute CNS catastrophe, Exclusion of complicating medical condition, No drug intoxication or poisoning, Core temp >90F are all prerequisites for a diagnosis of:

Brain death

57

Define Acute Confusional States:

Acquired mental disorder characterized by deficits in attention and coherence of thoughts and action

58

T or F: delirium is defined as irreversible Decreased cognitive functions, while Dementia is defined as an Acute Confusional state.

FALSE. Delirium is an acute confusional state, vs dementia which is an irreversible alteration in cognitive function.