week 9 flash part 1

Question 1

what is a normal ICP

Answer 1

under 15mmHg
higher than 20 = ischemia and brain damage

Question 2

whats the difference between a primary and secondary brain injury

Answer 2

primary injury: time of injury (initial ouch)
secondary injury: several hours to days after injury

Question 3

what is a normal CPP

Answer 3

60-80

Question 4

how do you calculate CPP

Answer 4

BP - ICP

Question 5

what should you keep SBP at to increase CPP

Answer 5

160

Question 6

what is an external ventricular drain (EVD)

Answer 6

ICP monitor

Question 7

what are the three ways the body compensates for IICP

Answer 7

brain tissue: dura becomes distended and compresses the tissue
blood: cerebral vessels vasoconstriction which decreases perfusion to the brain
CSF: production slows down and some is displaced onto the spinal column

Question 8

why does IICP increase H+ concentration

Answer 8

because lactic acid will be released due to PaCO2 (to dilate vessels so more O2 can enter the brain)
- lactic acid makes the body super acidic

Question 9

what do you need to monitor CO2 and O2 levels in a patient

Answer 9

you need and ABG

Question 10

what is cushings triad and what does it mean

Answer 10

• wide pulse pressure
• Bradycardia
• irregular reps

medical emergency, means compression on the brain stem

Question 11

why would you see changes in temp with cushings triad

Answer 11

because the hypothalamus will be compressed

Question 12

what is an epidural hematoma

Answer 12

bleeding outside the dura

Question 13

what is a subdural hematoma

Answer 13

bleeding inside the dura

Question 14

which diagnostic test will confirm cerebral edema or a re bleed in a brain trauma patient

Answer 14

CT

Question 15

what diagnostic test checks for aneurism and stroke

Answer 15

angio

Question 16

which diagnostic test determines a seizure

Answer 16

EEG

Question 17

with LP, where in the spine does the needle go

Answer 17

L3/L4

Question 18

what are some signs of complication with a LP

Answer 18

shooting pain/tingling, headache that doesn’t improve

Question 19

what does a trans cranial doppler look for

Answer 19

backflow/vasospasm in intracerebral arteries

Question 20

when would you use corticosteroids for the brain

Answer 20

only for brain tumours, not for diffuse cerebral edema

Question 21

why is it bad if an IICP patient has decreased O2

Answer 21

it could result in vasodilation and increase ICP

Question 22

what is the frontal lobe responsible for

Answer 22

intellect, personality, decision making

Question 23

what is the parietal lobe responsible for

Answer 23

motor activities, motor speech, sensory discrimination

Question 24

what is the occipital lobe responsible for

Answer 24

eyes to opposite side, body awareness, writing, visual reception

Question 25

what are the main things you do at the scene of a brain trauma accident

Answer 25

- maintain airway - stabilize spine apply pressure to external bleeding and warm blankets

Question 26

what is the temporal lobe responsible for

Answer 26

reading, memory, hearing, smelling, taste

Question 27

what do you assess for in an initial accident of a brain trauma patient

Answer 27

- rhinnorhea - ottorrhea - scalp wounds

Question 28

what does a nurse do with a neuro trauma patient once theyre at the hospital

Answer 28

- O2 - establish 2 large bore IV - warm blankets - frequent VS and neurochecks - monitor

Question 29

what is port auricular ecchymosis

Answer 29

battle sign, bruising behind ears can mean basilar skull fracture

Question 30

what is bilateral periorbital ecchymosis

Answer 30

raccoon eyes, bruising around the eyes

Question 31

what is the main complication of skull fracture

Answer 31

Dural tear (CSF leak) increases risk of meningitis

Question 32

how can you tell if nasal drainage is CSF

Answer 32

halo sign

Question 33

what is a brain contusion

Answer 33

bruising of the brain within one focal area (right where skull is fractured)

Question 34

what causes a diffuse axonal injury

Answer 34

coup-contra-coup injury

Question 35

what is a diffuse axonal injury

Answer 35

Brain shaking like jello, tears all axons in half

Question 36

what is the main complication of a DAI

Answer 36

90% of people with a DAI remain in a vegetative state

Question 37

whats the difference between an epidural hematoma and a subdural hematoma

Answer 37

epidural: usually arterial so it bleeds fast, medical emergency subdural: usually venous, slower onset

Question 38

what is the main thing we do to manage hydrocephalus

Answer 38

use shunt from ventricle into perineal cavity which releases fluid into the body to be reabsorbed

Question 39

what is a burr hole usually used for

Answer 39

a subdural hematoma

Question 40

what is stereotactic radio surgery

Answer 40

radiation used to destroy brain tumour, patients head held still by stereotactic frame - uses high dose radiation to pinpoint exact spot where tumour is