RNSG 1412 (Ob/Pedi) - Exam 3, PPT & Learning Guide:
PEDI NEURO dx|Comprehensive Pediatric Neurology and
CNS Assessment: Brain, Spinal Cord, Meninges,
Myelinization, Cranial Nerves, Autoregulation, Intracranial
Pressure, Hydrocephalus, Spina Bifida, Myelomeningocele,
Cerebral Palsy, Head Injuries, Seizure Disorders, Epilepsy,
Febrile Seizures, Status Epilepticus, EEG, CT/MRI, Lumbar
Puncture, Meningitis, Encephalitis, Reye Syndrome,
Botulism, Tetanus, Neurogenic Bladder, CSF Dynamics,
Glasgow Coma Scale, Decorticate/Decerebrate Posturing,
Cushing Response, FOC Monitoring, Cranial Sutures,
Neurologic Nursing Interventions Exam Questions Verified
and Provided with Complete A+ Graded Rationales Latest
Updated 2026
Review of the Central Nervous System (CNS)
•Composed of the brain and spinal cord
•Myelinization of the nerves begins in the 3rd month of gestation and is completed by adolescence.
•The axial skeleton protects the underlying structure of the CNS.
•The brain and spinal cord are covered by the meninges.
The Brain
•Cerebrospinal fluid (CSF) surrounds the brain and spinal cord
.
•The brain consists of three sections.
•Cerebrum
,•Cerebellum
•Brainstem = most important of the 3 parts for sustaining life
Cranial Nerves
•12 pairs of cranial nerves
•Arise from the brain and the brainstem
•Testing of the nerves can indicate location and degree of CNS injury.
Autoregulation
regulates brains normal ICP
•Also known as self-regulation
•This process allows cerebral arteries to change diameter in response to changes in cerebral perfusion
pressure.
•Autoregulation may be impaired by trauma, ischemia, increased intracranial pressure (ICP).
Increased Intracranial Pressure •Pathophysiology
•Disturbance in the auto-regulation of the pressure exerted by the blood, brain, cerebrospinal fluid, and
other space-occupying fluid/mass within the central nervous system.
,•Increased ICP is defined as pressure sustained at 20 mm Hg or higher. (for 5 minutes or longer)
Normal ICP ranges from:
0-12 mm Hg in children
Increased Intracranial Pressure - causes
•Overproduction or malabsorption of CSF
•Space occupying lesion - tumor, hematoma
•Swelling of brain
intrauterine = placental abruption, prolonged cord comp., shoulder distocia during birth, anything
causing hypoxia
infant/child = infection in brain, anything causing swelling....trauma to head
Increased Intracranial Pressure: Clinical Manifestations (know for exam)
•Infant (they have more room to compensate - suture lines/fontanels, they fuse/close by age 2-3)
•Poor feeding
•Irritability or restlessness
•Bulging fontanel
, •High pitched cry
**Increased FOC (frontal occipital circumference)
•Eye deviation downward (aka-sunset eyes)
•Child
•Headache
•Double vision (Diplopia)
•Slurred speech
•Papilledema (optic nerve swelling from pressure)
•Alteration in LOC
•Early morning n/v = because they've been sleeping, when they get up and change position, pressure
increases causing N/V
ICP - Clinical Manifestations - severe (also know for exam)
severe = brain stem is dying
•Cushing’s Response
PEDI NEURO dx|Comprehensive Pediatric Neurology and
CNS Assessment: Brain, Spinal Cord, Meninges,
Myelinization, Cranial Nerves, Autoregulation, Intracranial
Pressure, Hydrocephalus, Spina Bifida, Myelomeningocele,
Cerebral Palsy, Head Injuries, Seizure Disorders, Epilepsy,
Febrile Seizures, Status Epilepticus, EEG, CT/MRI, Lumbar
Puncture, Meningitis, Encephalitis, Reye Syndrome,
Botulism, Tetanus, Neurogenic Bladder, CSF Dynamics,
Glasgow Coma Scale, Decorticate/Decerebrate Posturing,
Cushing Response, FOC Monitoring, Cranial Sutures,
Neurologic Nursing Interventions Exam Questions Verified
and Provided with Complete A+ Graded Rationales Latest
Updated 2026
Review of the Central Nervous System (CNS)
•Composed of the brain and spinal cord
•Myelinization of the nerves begins in the 3rd month of gestation and is completed by adolescence.
•The axial skeleton protects the underlying structure of the CNS.
•The brain and spinal cord are covered by the meninges.
The Brain
•Cerebrospinal fluid (CSF) surrounds the brain and spinal cord
.
•The brain consists of three sections.
•Cerebrum
,•Cerebellum
•Brainstem = most important of the 3 parts for sustaining life
Cranial Nerves
•12 pairs of cranial nerves
•Arise from the brain and the brainstem
•Testing of the nerves can indicate location and degree of CNS injury.
Autoregulation
regulates brains normal ICP
•Also known as self-regulation
•This process allows cerebral arteries to change diameter in response to changes in cerebral perfusion
pressure.
•Autoregulation may be impaired by trauma, ischemia, increased intracranial pressure (ICP).
Increased Intracranial Pressure •Pathophysiology
•Disturbance in the auto-regulation of the pressure exerted by the blood, brain, cerebrospinal fluid, and
other space-occupying fluid/mass within the central nervous system.
,•Increased ICP is defined as pressure sustained at 20 mm Hg or higher. (for 5 minutes or longer)
Normal ICP ranges from:
0-12 mm Hg in children
Increased Intracranial Pressure - causes
•Overproduction or malabsorption of CSF
•Space occupying lesion - tumor, hematoma
•Swelling of brain
intrauterine = placental abruption, prolonged cord comp., shoulder distocia during birth, anything
causing hypoxia
infant/child = infection in brain, anything causing swelling....trauma to head
Increased Intracranial Pressure: Clinical Manifestations (know for exam)
•Infant (they have more room to compensate - suture lines/fontanels, they fuse/close by age 2-3)
•Poor feeding
•Irritability or restlessness
•Bulging fontanel
, •High pitched cry
**Increased FOC (frontal occipital circumference)
•Eye deviation downward (aka-sunset eyes)
•Child
•Headache
•Double vision (Diplopia)
•Slurred speech
•Papilledema (optic nerve swelling from pressure)
•Alteration in LOC
•Early morning n/v = because they've been sleeping, when they get up and change position, pressure
increases causing N/V
ICP - Clinical Manifestations - severe (also know for exam)
severe = brain stem is dying
•Cushing’s Response
