UTA NURS 3366 Pathophysiology Exam 4 - Questions & Verified Answers
Maintenance of effective cerebral blood flow is dependent Cerebral Perfusion Pressure (CPP)-the pressure of blood going into the brain &
on keeping what 2 forces in balance? Intracranial Pressure (ICP)-the pressure in the intracranial cavity
Cerebral Perfusion Pressure (CPP) pressure required to get oxygenated blood into the brain to perfuse the cells of the
brain
If Cerebral Perfusion Pressure (CPP) is EITHER too low Cerebral edema and increased Intracranial Pressure (ICP)
OR too high it can lead to
Intracranial Pressure (ICP) totality of pressures in the brain:
arterial &venous pressures (blood) + CSF pressure + Brain (tissue)
The main culprit in causing IICP & loss of balance between cerebral edema
ICP & CPP is
Examples of CPP disturbances HTN, Hypotension, Blockage of arterial flow into brain
Examples of ICP disturbances -Head injury
-Brain Tumor
-Brain Attack (stroke)
-Infections
-Acid/base imbalance
-Hypoxemia from Respiratory Disorders
-Meningitis
Brain Attack the process of any interruption of the normal blood supply to a part of the brain or
the entire brain, resulting in damaged brain tissue
Brain attacks are most commonly called strokes or CVAs (cerebrovascular accidents)
Most common underlying etiologies of Brain Attacks (BS) -atherosclerosis of cerebral arteries (w/in the brain) and/or of incoming arteries
are (3) (carotid & vertebral arteries)
-HTN
-other: brain aneurysms, heart problems
The risk factors for BA are same for all atherosclerotic -preexisting hx of atherosclerosis in any part of body
disorders and include (6): -preexisting hx of HTN
-older age
-fam hx
-diabetes (3x more likely to have strokes)
-lifestyle changes such as smoking (increases risk by 50%) & high fat diets
What are the 2 main broad categories of BAs based on Ischemic and Hemorrhagic
their underlying mechanism?
Stuvia | Academic Year (2026-2027)
, UTA NURS 3366 Pathophysiology Exam 4 - Questions & Verified Answers
No matter if the BA is ischemic or hemorrhagic, ultimately cerebral edema & IICP
the actual negative effects of a stroke are still
S&S of a stroke does not depend on if it's ischemic or Treatment
hemorrhagic but what does depend on knowing which kind
is occurring?
How is a stroke determined to be ischemic or CAT scan or MRI of the brain
hemorrhagic?
What is the cause of an Ischemic BA? usually the narrowing or blockage of arteries supplying brain (carotid or vertebral
arteries) OR intracranial arteries themselves
Patho of an Ischemic BA diminished perfusion to brain tissue>cellular ischemia which may lead to infarction
(death of cell)>inflammatory process>swelling, cerebral edema>increased
ICP>further decrease in perfusion
Ischemic BA's can be either Thrombotic or Embolic in nature
Thrombotic Stroke occurs from a clot or plaque that blocks off the artery in which it has developed &
causes ischemia distally
Embolic Stroke when fragments that break from an arterial thrombus travel "downstream" until they
get stuck in a smaller artery and cause ischemic to brain distally
Atrial Fibrillation Thrombotic/Embolic Example atrial fibrillation (5-fold increase in risk for stroke)>disorganized motion of the LA
allows some incoming blood to pool & promotes stasis>small clots develop in
portion of atria>break off>travel to brain via carotids>lodge in cerebral
artery>ischemia/infarct to distal tissue
Atherosclerosis of Carotids Thrombotic/Embolic Example atherosclerosis of carotids>common place for thrombi to develop; small clots can
break off from these & travel downstream
Stuvia | Academic Year (2026-2027)
, UTA NURS 3366 Pathophysiology Exam 4 - Questions & Verified Answers
Other specific potential Thrombotic/Embolic Events -air emboli (usually iatrogenic)
-clots around mitral/aortic valve prosthesis or vegetation from around infected valve
-intracranial artery plaque can develop in the circle of Willis; if breaks free can lodge
in smaller arteries
Transient Ischemic Attack (TIA) can happen in either thrombotic or embolic situation & czs the same S&S as a fully
evolved stroke but does not damage brain tissue because it is transient
(temporary) resolves itself quickly
S&S from a TIA only last <24 hrs & have no lasting neurological deficit (last between 10 minutes to <24
hrs)
TIAs are often a warning that a more serious, fully-evolved stroke can occur at a later date (w/o tx, 80% pts
w/TIAs have full strokes later)
Hemorrhagic BA usually czd by the effx of blood that leaks out directly onto brain tissue
Hemorrhagic BA Example: Intracerebral Aneurysm an intracerebral aneurysm begins to leak blood onto brain tissue>blood irritates the
tissue>inflammatory process>swelling, cerebral edema>increased ICP>cellular
ischemia, injury, and/or infarction of the surrounding area
Causes of a Hemorrhagic BA -pressure of HTN
-weakened arterial walls from atherosclerosis
-aneurysms
-congenital vascular malformations
-bleeding into a tumor
-coagulation disorders
The 3 general areas of brain tissue are -brain stem
-cerebellum
-right or left hemisphere of the cerebrum
The Vertebral Artery merges with the Basilar Artery and brain stem and cerebellum
supplies blood to the
Stuvia | Academic Year (2026-2027)
, UTA NURS 3366 Pathophysiology Exam 4 - Questions & Verified Answers
The Right and Left Internal Carotid Arteries forms the right right or left hemisphere of cerebrum
and left middle cerebral artery (MCA) which supplies blood
to the
Mini Concept Map of assessing patient for S&S of various #1. assess pt's autonomic status (LOC & mental status)
kinds of BA #2. assess sensorimotor system above(2a) and below (2b) the shoulders
#3. assess reflexes
#1 assess pt's autonomic status includes involuntary controlled neuro functions such as BP, HR, RR, temp
#1 assess pt's LOC & mental status, expected LOC -being alert/easily arousable to alertness if asleep
includes -being oriented x 4(self, time, place, events)
-following commands appropriately
-having normal speech (speech centers in brain okay)
-conversing appropriately (cognition, mental status okay)
Abnormals of LOC include -not being alert: lethargic to inability to awaken the pt at all (coma)
-not oriented to some or all of self, time, place, events
-doesn't follow commands
-speech may be garbled or no speech at all
-verbal responses/conversational efforts show inappropriate /dysfunctional mental
status (confusion or behavioral changes such as withdrawal/aggression)
What is often the FIRST sign of a neurologic event or Changes in LOC
worsening of an existing neurologic illness?
Sensorimotor encompasses the fact the movement & sensation are intricately related
#2 assess pt's sensorimotor findings 1. normal sensation, muscle tone, & movement THAT IS ALSO
2. symmetric (bilaterial)
Abnormalities of CN VII (facial nerve) controls facial movement and expression
If there is a focal cerebral edema around the RIGHT CN facial drooping on the left side of the mouth
VII, you would expect to see
Abnormalities of CN II (optic nerve) responsible for transmitting visual images to the brain
Stuvia | Academic Year (2026-2027)
Maintenance of effective cerebral blood flow is dependent Cerebral Perfusion Pressure (CPP)-the pressure of blood going into the brain &
on keeping what 2 forces in balance? Intracranial Pressure (ICP)-the pressure in the intracranial cavity
Cerebral Perfusion Pressure (CPP) pressure required to get oxygenated blood into the brain to perfuse the cells of the
brain
If Cerebral Perfusion Pressure (CPP) is EITHER too low Cerebral edema and increased Intracranial Pressure (ICP)
OR too high it can lead to
Intracranial Pressure (ICP) totality of pressures in the brain:
arterial &venous pressures (blood) + CSF pressure + Brain (tissue)
The main culprit in causing IICP & loss of balance between cerebral edema
ICP & CPP is
Examples of CPP disturbances HTN, Hypotension, Blockage of arterial flow into brain
Examples of ICP disturbances -Head injury
-Brain Tumor
-Brain Attack (stroke)
-Infections
-Acid/base imbalance
-Hypoxemia from Respiratory Disorders
-Meningitis
Brain Attack the process of any interruption of the normal blood supply to a part of the brain or
the entire brain, resulting in damaged brain tissue
Brain attacks are most commonly called strokes or CVAs (cerebrovascular accidents)
Most common underlying etiologies of Brain Attacks (BS) -atherosclerosis of cerebral arteries (w/in the brain) and/or of incoming arteries
are (3) (carotid & vertebral arteries)
-HTN
-other: brain aneurysms, heart problems
The risk factors for BA are same for all atherosclerotic -preexisting hx of atherosclerosis in any part of body
disorders and include (6): -preexisting hx of HTN
-older age
-fam hx
-diabetes (3x more likely to have strokes)
-lifestyle changes such as smoking (increases risk by 50%) & high fat diets
What are the 2 main broad categories of BAs based on Ischemic and Hemorrhagic
their underlying mechanism?
Stuvia | Academic Year (2026-2027)
, UTA NURS 3366 Pathophysiology Exam 4 - Questions & Verified Answers
No matter if the BA is ischemic or hemorrhagic, ultimately cerebral edema & IICP
the actual negative effects of a stroke are still
S&S of a stroke does not depend on if it's ischemic or Treatment
hemorrhagic but what does depend on knowing which kind
is occurring?
How is a stroke determined to be ischemic or CAT scan or MRI of the brain
hemorrhagic?
What is the cause of an Ischemic BA? usually the narrowing or blockage of arteries supplying brain (carotid or vertebral
arteries) OR intracranial arteries themselves
Patho of an Ischemic BA diminished perfusion to brain tissue>cellular ischemia which may lead to infarction
(death of cell)>inflammatory process>swelling, cerebral edema>increased
ICP>further decrease in perfusion
Ischemic BA's can be either Thrombotic or Embolic in nature
Thrombotic Stroke occurs from a clot or plaque that blocks off the artery in which it has developed &
causes ischemia distally
Embolic Stroke when fragments that break from an arterial thrombus travel "downstream" until they
get stuck in a smaller artery and cause ischemic to brain distally
Atrial Fibrillation Thrombotic/Embolic Example atrial fibrillation (5-fold increase in risk for stroke)>disorganized motion of the LA
allows some incoming blood to pool & promotes stasis>small clots develop in
portion of atria>break off>travel to brain via carotids>lodge in cerebral
artery>ischemia/infarct to distal tissue
Atherosclerosis of Carotids Thrombotic/Embolic Example atherosclerosis of carotids>common place for thrombi to develop; small clots can
break off from these & travel downstream
Stuvia | Academic Year (2026-2027)
, UTA NURS 3366 Pathophysiology Exam 4 - Questions & Verified Answers
Other specific potential Thrombotic/Embolic Events -air emboli (usually iatrogenic)
-clots around mitral/aortic valve prosthesis or vegetation from around infected valve
-intracranial artery plaque can develop in the circle of Willis; if breaks free can lodge
in smaller arteries
Transient Ischemic Attack (TIA) can happen in either thrombotic or embolic situation & czs the same S&S as a fully
evolved stroke but does not damage brain tissue because it is transient
(temporary) resolves itself quickly
S&S from a TIA only last <24 hrs & have no lasting neurological deficit (last between 10 minutes to <24
hrs)
TIAs are often a warning that a more serious, fully-evolved stroke can occur at a later date (w/o tx, 80% pts
w/TIAs have full strokes later)
Hemorrhagic BA usually czd by the effx of blood that leaks out directly onto brain tissue
Hemorrhagic BA Example: Intracerebral Aneurysm an intracerebral aneurysm begins to leak blood onto brain tissue>blood irritates the
tissue>inflammatory process>swelling, cerebral edema>increased ICP>cellular
ischemia, injury, and/or infarction of the surrounding area
Causes of a Hemorrhagic BA -pressure of HTN
-weakened arterial walls from atherosclerosis
-aneurysms
-congenital vascular malformations
-bleeding into a tumor
-coagulation disorders
The 3 general areas of brain tissue are -brain stem
-cerebellum
-right or left hemisphere of the cerebrum
The Vertebral Artery merges with the Basilar Artery and brain stem and cerebellum
supplies blood to the
Stuvia | Academic Year (2026-2027)
, UTA NURS 3366 Pathophysiology Exam 4 - Questions & Verified Answers
The Right and Left Internal Carotid Arteries forms the right right or left hemisphere of cerebrum
and left middle cerebral artery (MCA) which supplies blood
to the
Mini Concept Map of assessing patient for S&S of various #1. assess pt's autonomic status (LOC & mental status)
kinds of BA #2. assess sensorimotor system above(2a) and below (2b) the shoulders
#3. assess reflexes
#1 assess pt's autonomic status includes involuntary controlled neuro functions such as BP, HR, RR, temp
#1 assess pt's LOC & mental status, expected LOC -being alert/easily arousable to alertness if asleep
includes -being oriented x 4(self, time, place, events)
-following commands appropriately
-having normal speech (speech centers in brain okay)
-conversing appropriately (cognition, mental status okay)
Abnormals of LOC include -not being alert: lethargic to inability to awaken the pt at all (coma)
-not oriented to some or all of self, time, place, events
-doesn't follow commands
-speech may be garbled or no speech at all
-verbal responses/conversational efforts show inappropriate /dysfunctional mental
status (confusion or behavioral changes such as withdrawal/aggression)
What is often the FIRST sign of a neurologic event or Changes in LOC
worsening of an existing neurologic illness?
Sensorimotor encompasses the fact the movement & sensation are intricately related
#2 assess pt's sensorimotor findings 1. normal sensation, muscle tone, & movement THAT IS ALSO
2. symmetric (bilaterial)
Abnormalities of CN VII (facial nerve) controls facial movement and expression
If there is a focal cerebral edema around the RIGHT CN facial drooping on the left side of the mouth
VII, you would expect to see
Abnormalities of CN II (optic nerve) responsible for transmitting visual images to the brain
Stuvia | Academic Year (2026-2027)
