INTRACRANIAL PROBLEMS CALCULATION OF CEREBRAL PERFUSION PRESSURE CPP = MAP ICP (does not consider effect of CVR, generated

d by arterioles) CPP = Flow x Resistance (considers CVR) Compliance =

Example Systemic BP = 122/84 MAP = 97 ICP = 12 CPP = 85

On old Olympuss towering tops, a Finn and German viewed some hops. Cranial Nerve Memory Jogger Olfactory Optic Oculomotor Trochlear Trigeninal Adbucens Facial Acoustic Glossopharengeal Vagus Spinal accessory Hypoglossal CN 1 CN 2 CN3 CN 4 CN 5 CN 6 CN 7 CN 8 CN 9 CN 10 CN 11 CN 12

***A nurse is assessing a clients extra-ocular eye movement as part of the neurologic exam. Which CN is the nurse assessing? (Select all that apply) 1. 2. 3. 4. 5. 6. CN 2 CN 3 CN 4 CN 5 CN 6 CN 8

Answer: 2,3,5. CN 3 (oculomotor) , 4 (Trochlear), and 6 (Abducens). Oculomotor originates in the brain stem and control s the movement of the eyeball UP, DOWN, and INWARD: raises the eyelid and constricts the pupil. Trochlear nerve rotates the eyeball DOWNWARD and OUTWARD.

INTRACRANIAL PROBLEMS Abducens originates in the pons and rotates the eyeball LATERALLY. Optic evaluates vision Trigeminal has three branches, corneal reflex assessment (ophthalmic branch). Sensation of skin of cheek, upper jaw, teeth, lips, hard palate, maxillary sinus, nasal mucosa (maxillary branch). Sensation of lower lip, chin, ear, mucous membrane, teeth of the lower jaw, and tongue (mandibular branch). Acoustic assess hearing (cochlear)and balance (vestibular)

LOC: Assessment 1. Eye opening (spontaneous eye opening) 2. Motor response (Obeying motor commands) 3. Verbal stimuli (A&O x 3) Highest score is? 15.

ICP Waveforms P1 Percussion wave P2 Rebound wave or tidal wave

P3 Dicrotic Wave

Meaning Represents arterial pulsations; normally the highest of the 3 waveforms Reflects intracranial compliance or relative brain volume. When p2 is higher than p1, intracranial compliance is compromised Follows dicrotic notch; represents venous pulsations; normally the lowest waveform.