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Flashcards in Increased Intracranial Pressure Deck (23)
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1
Q

What is normal intracranial pressure?

A

5-15 mmHg

2
Q

What is the Monro-Kellie doctrine?

A

Thevolume of the three components of the cranial vault - brain tissue, CSF, and blood - must remain constant in order to maintain stable ICP.

3
Q

What are some common symptoms of increased ICP?

A

change in LoC (agitation, confusion), change in VS (Cushing’s Triad), ocular abnormalities - severe damage, headache, vomiting w/o nausea

4
Q

What diagnostic test should not be performed in E-ICP?

A

Lumbar puncture - creates pressure gradient that can cause brain stem herniation.

5
Q

How is E-ICP diagnosed?

A

CT / MRI / PET, EEG, cerebral angiography, ventriculostomy - pressure transducer “bolt”

6
Q

What is important to remember about positioning patients with E-ICP?

A

Keep head of bed elevated

7
Q

What is important to remember about positioning patients with a skull flap?

A

Do not roll them on to the side with the flap.

8
Q

What does nitrazine paper test for?

A

Presence of CSF.

9
Q

Why are hypertonics useful in E-ICP?

A

The pull fluid out of brain tissue.W

10
Q

What is a coup-countercoup injury?

A

Brain “whiplash” injury to both ends of the axis of impact.

11
Q

What is normal cerebral perfusion pressure?

A

60-100 mmHg

12
Q

How do you calculate MAP?

A

diastolic + 1/3 pulse pressure.

ex: 120/80 => 120 + (40/3) = 93 mmHg

13
Q

What is cushing’s triad?

A

Hypertension with widening pulse pressure (to maintain cerebral perfusion)

Bradycardia to compensate for hypertension

Irregular respiration due to pressure on the brain stem

14
Q

What are the four stages of E-ICP?

A
  1. total compensation
  2. reduced compensation
  3. failure to compensate (without herniation)
  4. herniation & death
15
Q

What are the three types of cerebral edema?

A

Vasogenic - most common, fluid moves from tissues to vasculature (M-KD: blood)

Cytotoxic - cell membrane dispruption moves fluid from vasulature into tissues (M-KD: tissue)

Interstitial - usually a result of hydrocephalus (ventricular enlargement from excess CSF produced or retained). (M-KD: CSF)

16
Q

What is decorticate posturing and what does it indicate?

A

arms in, feet in. suggests damage to areas above brain stem.

17
Q

What is decerebrate posturing and what does it indicate?

A

Arms down, feet pointed, head arched back. Suggests damage to brain stem.

18
Q

What are complications of E-ICP?

A

Inadequate cranial perfusion, brain stem herniation

19
Q

How is unconsciousness defined?

A

Abnormal state of complete or partial unawareness of self or environment

20
Q

What are the three locations for cranial hematomas?

A

Epidural, subdural, and subarachnoid

21
Q

Epidural hematomas are more often what kind of bleed?

A

Arterial

22
Q

Subdural hematomas are more often what kind of bleed?

A

Venous

23
Q

What is the official name for a “brain bolt”?

A

LICOX catheter