Editing Anatomy and Physiology – RN Flashcards (section)

== Neurologic ==

;State the Monro-Kellie doctrine.
:The skull is a rigid container holding brain tissue, blood, and cerebrospinal fluid at a fixed total volume. An increase in any component must be offset by a decrease in another, or intracranial pressure rises. Normal adult intracranial pressure is about 5 to 15 mmHg.

;What is the earliest and most sensitive sign of increasing intracranial pressure, and what is the late triad?
:The earliest sign is a change in level of consciousness. The late finding is the Cushing triad: widening pulse pressure with rising systolic pressure, bradycardia, and irregular respirations, which indicates brainstem compression.

;Which cranial nerves must be intact for safe swallowing?
:IX (glossopharyngeal) and X (vagus) for the gag reflex and pharyngeal phase, and XII (hypoglossal) for tongue control of the bolus. Impairment of any of these creates aspiration risk.

;Describe autonomic dysreflexia and the first nursing action.
:An exaggerated sympathetic response to a noxious stimulus below a spinal cord injury at or above T6, causing severe hypertension, pounding headache, bradycardia, flushing above the lesion, and pallor below it. The first action is to sit the patient upright, then find and remove the trigger, most often bladder distention or fecal impaction.