1|Page
EXAM 4 RRD( RRD# 10, 11, 12) NURS 3366 Questions and
Answers with 100% Complete Solutions
forces of cerebral blood flow
CPP (Cerebral Perfusion Pressure)
ICP (Intracranial Pressure)
Cerebral Perfusion Pressure
pressure required to get oxygenated blood into the brain to
perfuse to brain cells
if too low --> ineffective perfusion --> ischemia to brain --
>cellular hypoxia--> cell injury & death--> loss of cell membrane
integrity--> water and other cells are released (pressure too
high)--> results in cerebral edema and increased ICP --> loss of
effective perfusion
Too high or too low--> cerebral edema and increased ICP
hyper/hypotension and blockage of flow into brain disrupts
balance
Intracranial Pressure
1
,2|Page
total of pressures in brain= blood pressure (arterial & venous) +
CSF pressure + Brain tissue
increase ICP (IICP)--> decreased brain fxn (decreased LOC,
impaired sensorimotor fxn) --> cerebral edema
ex: inschemia from blockage of an artery (plaque, tumor,
injuries, aneurysms, irritants like infex or acidosis) in brain or
going to brain (like carotid) --> cells become hypoxic --> swell,
increased vascular permeability--> edema--> increased ICP -->
decreased CPP --> further brain ischemia
brain attack
the process of any interruption of the normal blood supply to a
part of or entire brain --> damaged brain tissue
etiologies: atherosclerosis of cerebral arteries (either within
and/or leading into), hypertension, other (brain aneurysms,
heart problems)
categories of brain attack
ischemic and hemorrhagic (both still lead to cerebral edema
and IICP)
ischemic brain attack
caused by narrowing or blockage of arteries supplying brain or
intracranial arteries (same process as plaques forming in
coronary arteries)
2
,3|Page
usually related to atherosclerosis
patho: diminished perfusion to brain tissue --> cellular ischemia
(could lead to cell death) --> inflammatory process--> swelling,
cerebral edema --> IICP --> further decrease in perfusion
can be thrombotic or embolic
examples of potential thrombotic/embolic events that can lead
to brain attack
atrial fibrilation --> disorganized motion of the LA--> allows
some incoming blood to pool --> promotes stasis --> small clot
develop in portion of atria --> break off --> travel to brain via
carotids --> lodge in cerebral artery --> inschemia/ infarct distal
tissue
atherosclerosis of carotids--> common place for thrombi to
develop; small clots can break off from these and travel
downstream
air emboli
clots around mitral or aortic valve prothesis or vegetation from
around infected valve
3
, 4|Page
intracranial artery plaque can develop in the circle of willis; if it
breaks free it can lodge into smaller arteries
transient ischemic attack
S/S only last 24 hours and have no lasting neurologic deficit
hemorrhagic brain attack
caused by effect of blood that leaks directly onto brain
causes: pressure of hypertension, weakened arterial walls from
atherosclerosis, aneuryms, congenital vascular malformations,
bleeding into a tumor, coagulation disorders, "worst headache
ever", neck pain, light intolerance, N&V
ex: intracerebral aneurysms begins to leak blood into brain
tissue --> blood irritates the tissue --> inflammatory process -->
swelling, cerebral edema--> IICP--> cellular ischeia, injury and/
or infarction of the surrounding area
higher mortality rate
Where brain attacks most commonly occur
Brain stem (supplied by vertebral artery merging with basilar
artery, controls autonomic function)
cerebellum (supplied by vertebral artery merging with basilar
4
EXAM 4 RRD( RRD# 10, 11, 12) NURS 3366 Questions and
Answers with 100% Complete Solutions
forces of cerebral blood flow
CPP (Cerebral Perfusion Pressure)
ICP (Intracranial Pressure)
Cerebral Perfusion Pressure
pressure required to get oxygenated blood into the brain to
perfuse to brain cells
if too low --> ineffective perfusion --> ischemia to brain --
>cellular hypoxia--> cell injury & death--> loss of cell membrane
integrity--> water and other cells are released (pressure too
high)--> results in cerebral edema and increased ICP --> loss of
effective perfusion
Too high or too low--> cerebral edema and increased ICP
hyper/hypotension and blockage of flow into brain disrupts
balance
Intracranial Pressure
1
,2|Page
total of pressures in brain= blood pressure (arterial & venous) +
CSF pressure + Brain tissue
increase ICP (IICP)--> decreased brain fxn (decreased LOC,
impaired sensorimotor fxn) --> cerebral edema
ex: inschemia from blockage of an artery (plaque, tumor,
injuries, aneurysms, irritants like infex or acidosis) in brain or
going to brain (like carotid) --> cells become hypoxic --> swell,
increased vascular permeability--> edema--> increased ICP -->
decreased CPP --> further brain ischemia
brain attack
the process of any interruption of the normal blood supply to a
part of or entire brain --> damaged brain tissue
etiologies: atherosclerosis of cerebral arteries (either within
and/or leading into), hypertension, other (brain aneurysms,
heart problems)
categories of brain attack
ischemic and hemorrhagic (both still lead to cerebral edema
and IICP)
ischemic brain attack
caused by narrowing or blockage of arteries supplying brain or
intracranial arteries (same process as plaques forming in
coronary arteries)
2
,3|Page
usually related to atherosclerosis
patho: diminished perfusion to brain tissue --> cellular ischemia
(could lead to cell death) --> inflammatory process--> swelling,
cerebral edema --> IICP --> further decrease in perfusion
can be thrombotic or embolic
examples of potential thrombotic/embolic events that can lead
to brain attack
atrial fibrilation --> disorganized motion of the LA--> allows
some incoming blood to pool --> promotes stasis --> small clot
develop in portion of atria --> break off --> travel to brain via
carotids --> lodge in cerebral artery --> inschemia/ infarct distal
tissue
atherosclerosis of carotids--> common place for thrombi to
develop; small clots can break off from these and travel
downstream
air emboli
clots around mitral or aortic valve prothesis or vegetation from
around infected valve
3
, 4|Page
intracranial artery plaque can develop in the circle of willis; if it
breaks free it can lodge into smaller arteries
transient ischemic attack
S/S only last 24 hours and have no lasting neurologic deficit
hemorrhagic brain attack
caused by effect of blood that leaks directly onto brain
causes: pressure of hypertension, weakened arterial walls from
atherosclerosis, aneuryms, congenital vascular malformations,
bleeding into a tumor, coagulation disorders, "worst headache
ever", neck pain, light intolerance, N&V
ex: intracerebral aneurysms begins to leak blood into brain
tissue --> blood irritates the tissue --> inflammatory process -->
swelling, cerebral edema--> IICP--> cellular ischeia, injury and/
or infarction of the surrounding area
higher mortality rate
Where brain attacks most commonly occur
Brain stem (supplied by vertebral artery merging with basilar
artery, controls autonomic function)
cerebellum (supplied by vertebral artery merging with basilar
4
