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DIAG 2740 Exam 1 Study Guide - Chapter 5 Cranium Ventricles...

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Chapter 5- Cranium, Ventricles and Meninges 3 fossa- ant, middle, posterior 3 layers of meninges- dura arachnoid, pia 3 spaces-epidural, subdural, sub arachnoid Ventricles: Ependymal cells: filter CSF out of blood. CSF: protects brain and NS pH balance, mechanical cushion, gravity/flotation, nutrient/waste exchange Lateral 3 rd 4 th then resorption in spinal cord. Volume is 150cc. 20cc per hour Headaches - Common neurological symptom. Benign and may be bad. Brain has no nociceptors. Sensory nerves are V IX X and C1-C3. Type Subtype Signs Gender Location Time Vascular Migraine: Classic Severe throbbing, intolerance to noise and light, aura association Young women unilateral hours Vascular Migraine: complicated Same as classic but also neurological defects Same as classic Same as classic Same as classic Vascular Cluster Intense, stabbing, tearing, stress or alcohol related Mid-age men Behind one eye minutes Tension Cervicogenic/ subluxation Most common , squeezing Hat band , bilateral Many units Other Intracranial pressure or inflammation Meningitis, subarachnoid hemorrhage Others Acute trauma, hemorrhage, infarct, artery dissection, venous thrombosis, hydrocephalus, low CSF pressure, toxic/metabolic, meningitis, abscess, tumor, disorder of eye, scalp, teeth, ears, sinuses (CN V) Temporal Arteritis (Giant cell) aka Circumnodule Arteritis Elderly, inflammation of temporal arteries (enlarge and firm) and other arteries. Classic sign is superficial scalp pain . Treatment prevents vision loss (ophthalmic artery) . It’s a Chronic Granulomatous Inflammation. Increased intracranial pressure - Causes neurological deficits due to compression, destruction, herniation. Signs and Symptoms Cushing’s triad (increase BP, decreased HR, arrhythmia/respiratory abnormality) Focal symptoms Direct translation from findings Global symptoms Involves the whole brain (Cushing’s triad, headaches, changes in consciousness, papilledema) Contracoup Brain injury on opposite side of impact Trauma Concussion- post concussive syndrome Contusion- leaking blood into the brain, permanent neurological deficits Laceration- tissue is torn, permanent deficits Intracranial hemmorage : Type Location Time Signs Epidural Meningeal artery Sev. Hours later From whiplash trauma Subdural Bridging veins Days to months Sheer force, Trivial forgotten injury Subarachnoid Basilar or ant, mid, post cerebral artery Immediate Lucid intervals, worst headache ever (explosive) intracerebral Tiny distal brain arteries Chronic HBP, berry aneurysm
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Hydrocephalus : obstructs CSF flow. Symptoms: general, increase in intracranial pressure, change in consciousness, Papilledema. Infants Big head , tense fontanels, setting sun sign (eyes roll down), high pitched scream, transilumination, UMNL signs Adults Increased intracranial pressure, herniation, Arnold Chiari malformation (cerebellar tonsil herniation) Intracranial tumors : - increased intracranial pressure. Focal deficit. Long standing and progressively worsens Tumor Type
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