Clinical care
NURSING OF THE CRITICALLY ILL
(KENT STATE UNIVERSITY)
Exam III Study Guide
CEREBRAL VASCULATURE EDEMA
, Critical Care Exam III Study Guide
**Subarachnoid space is between Arachnoid Mater & Pia Mater, location of CSF**
**Frontal horn of Lateral Ventricle (non-dominant side) is the location of cannulation for ICP
monitoring or CSF shunt**
**Intracranial blood supplied by internal carotids and vertebral basilar system**
** Cushing’s Triad: Increased Sys. BP, Decreased HR, Irregular Respirations**
**Caring for neuro patients involves comparing neuro exam to baseline, concepts of ICP, and
medication strategies**
**Assess cervical spine for injuries with all head injuries**
● Skull/Cranium/Cranial Vault: Inside superior surfaces are smooth and basilar surfaces
contain folds and ridges with sharp edges
● Meninges: 3 layers that protect the CNS
Dura mater (Tough)→ drains venous blood from intracranial and meningeal
veins into internal jugular veins and is supplied by the middle meningeal artery.
Rupture results in epidural hematoma.
Arachnoid Mater (Delicate)→ Spongy, weblike structure that contains the
cerebral vasculature and connects to the pia mater forming the subarachnoid space
where CSF circulates freely. Arachnoid villi, or small protrusions in the arachnoid mater
absorb CSF for removal via venous system.
Pia Mater (Final) → supplies arterial blood to CNS and follows tufts and
convolutions of brain’s surface.
● Ventricular System:
Lateral Ventricles→ Two largest, located within the hemispheres of the cerebral
cortex, extend to form the frontal horns located in the frontal lobe (horns are
location of monitoring devices).
Choroid Plexus→ within the ventricles, produce CSF, 500 mL/day or 25
mL/hour.
3rd & 4th Ventricles→ boring af
Hydrocephalus→ Communicating: arachnoid villi cannot reabsorb CSF
→ Non-Communicating: blockage of CSF flow within ventricles
caused by dilation of ventricles
● CSF Cerebrospinal Fluid: clear, colorless fluid that flows in the ventricular system & in the
subarachnoid space of the brain & spinal cord.
→ Shock absorption
→ Protection from bony brain structures
→ Produced by choroid plexus and reabsorbed by arachnoid villi
→ Similar to plasma w/o hemoglobin
→ Poorly oxygenated
→ Contains: glucose, amino acids, nutrients
● Cerebral Vasculature: 20% of cardiac output, two major sets of vessels
NURSING OF THE CRITICALLY ILL
(KENT STATE UNIVERSITY)
Exam III Study Guide
CEREBRAL VASCULATURE EDEMA
, Critical Care Exam III Study Guide
**Subarachnoid space is between Arachnoid Mater & Pia Mater, location of CSF**
**Frontal horn of Lateral Ventricle (non-dominant side) is the location of cannulation for ICP
monitoring or CSF shunt**
**Intracranial blood supplied by internal carotids and vertebral basilar system**
** Cushing’s Triad: Increased Sys. BP, Decreased HR, Irregular Respirations**
**Caring for neuro patients involves comparing neuro exam to baseline, concepts of ICP, and
medication strategies**
**Assess cervical spine for injuries with all head injuries**
● Skull/Cranium/Cranial Vault: Inside superior surfaces are smooth and basilar surfaces
contain folds and ridges with sharp edges
● Meninges: 3 layers that protect the CNS
Dura mater (Tough)→ drains venous blood from intracranial and meningeal
veins into internal jugular veins and is supplied by the middle meningeal artery.
Rupture results in epidural hematoma.
Arachnoid Mater (Delicate)→ Spongy, weblike structure that contains the
cerebral vasculature and connects to the pia mater forming the subarachnoid space
where CSF circulates freely. Arachnoid villi, or small protrusions in the arachnoid mater
absorb CSF for removal via venous system.
Pia Mater (Final) → supplies arterial blood to CNS and follows tufts and
convolutions of brain’s surface.
● Ventricular System:
Lateral Ventricles→ Two largest, located within the hemispheres of the cerebral
cortex, extend to form the frontal horns located in the frontal lobe (horns are
location of monitoring devices).
Choroid Plexus→ within the ventricles, produce CSF, 500 mL/day or 25
mL/hour.
3rd & 4th Ventricles→ boring af
Hydrocephalus→ Communicating: arachnoid villi cannot reabsorb CSF
→ Non-Communicating: blockage of CSF flow within ventricles
caused by dilation of ventricles
● CSF Cerebrospinal Fluid: clear, colorless fluid that flows in the ventricular system & in the
subarachnoid space of the brain & spinal cord.
→ Shock absorption
→ Protection from bony brain structures
→ Produced by choroid plexus and reabsorbed by arachnoid villi
→ Similar to plasma w/o hemoglobin
→ Poorly oxygenated
→ Contains: glucose, amino acids, nutrients
● Cerebral Vasculature: 20% of cardiac output, two major sets of vessels
