NUR 239 Lecture Notes - Lecture 22: Cerebral Perfusion Pressure, Transient Ischemic Attack, Internal Carotid Artery
21 May 2018
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NUR 239/Pathophysiology and Pharmacotherapeutics in Nursing I
Unit 4/Porth Chapters 37 (p. 930 – 940) and Frandsen 9
Complete the following study guide and submit on Reggie Net by the due date on the Course Calendar
1
Key Terms (Porth Chapter 37 [p. 930-940]) – Disorders of Brain Function - define the following terms:
▪ Cerebral Autoregulation of blood flow: ability of the brain to maintain relatively constant blood flow
despite changes in perfusion pressure
▪ Ischemic Stroke: result of an obstruction within a blood vessel supplying blood to the brain
▪ Hemorrhagic Stroke: weakened blood vessel leak or brain aneurysm burst, blood spills into or around the
brain and creates swelling and pressure, damaging cells and tissue in the brain
▪ TIA (Transient Ischemic Attack): temporary blockage of blood flow to the brain
▪ Penumbra: a rim of mild to moderately ischemic tissue lying between tissue that is normally perfused and
the area in which infarction is evolving
▪ tPA (tissue plasminogen activator): treats ischemic type of strokes, a protein involved in the breakdown of
blood clots, can reduce long-term effects
Key Learning Objectives - Answer the follow questions ((Porth Chapter 37 [p. 930-940]) – Disorders of Brain
Function):
• List the disorder that are considered part of cerebrovascular disease.
o Strokes- TIA, ischemic, hemorrhagic
• How does blood get to the brain?
o Blood delivers fuel and nourishment to the brain through a complex system of blood vessels that
reaches every neighborhood of the brain. The carotid arteries, which run up the left and right sides
of the neck, are especially important, supplying blood to the front of the brain and the cerebral
cortex
o Supplied by the two internal carotid arteries anteriorly and vertebral arteries posteriorly
• Describe the venous system leaving the brain.
o Internal jugular veins
• Do the intracranial veins have valves? How does drainage occur?
o No, it is a bidirectional flow in the cerebral veins. Internal jugular veins collect blood from deep
face and neck vein sinuses.
• Describe the regulation of cerebral blood flow.
o Cerebral pressure autoregulation. Cerebral arteries (arterioles) maintain constant blood flow (CBF)
in the face of changing cerebral perfusion pressure (CPP)
• What metabolic factors affect cerebral blood flow? Causing vasodilation or constriction?
o pH level changes, hyper/hypoventilation
• Describe the effect of the sympathetic nervous system on blood flow to the brain.
o Causes vasoconstriction of most blood vessels
• Describe the types of stokes. Which type is most common? Which is more likely to be fatal?
o Ischemic, hemorrhagic, TIA
o Ischemic as the most common
o Hemorrhagic is more fatal
• Describe the importance of returning blood flow to the penumbra.
o Blood flow greater than 20mL/100g/min will start the metabolic pumps
• Describe the causes of a TIA.
o brief interruption of blood flow or lack of blood flow to part of the brain that causes temporary
stroke-like symptoms
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Document Summary
Key terms (porth chapter 37 [p. 930-940]) disorders of brain function - define the following terms: cerebral autoregulation of blood flow: ability of the brain to maintain relatively constant blood flow despite changes in perfusion pressure. Key learning objectives - answer the follow questions ((porth chapter 37 [p. 930-940]) disorders of brain. How does drainage occur: no, it is a bidirectional flow in the cerebral veins. Internal jugular veins collect blood from deep face and neck vein sinuses: describe the regulation of cerebral blood flow, cerebral pressure autoregulation. Causing vasodilation or constriction: ph level changes, hyper/hypoventilation, describe the effect of the sympathetic nervous system on blood flow to the brain, causes vasoconstriction of most blood vessels, describe the types of stokes. Complete the following study guide and submit on reggie net by the due date on the course calendar: describe the steps necessary to diagnose the type of stroke.
