1. Week 3 Intracranial Regulation and Level of Consciousness

2. Learning Objectives 1. Identify awake/asleep, alert, orientation to person, place and time as norms, vs. abnormal findings. 2. Explain how intracranial regulation controls level of consciousness and vital signs. 3. Identify key normal neurologic assessment techniques and findings with consideration for variations across the lifespan.

3. Definitions: Intra: Within, or inside. Cranial: Relating to, involving, or located in the skull, especially the part covering the brain.

4. Intracranial Regulation: The ability of the cranial contents (brain, blood, cerebral spinal fluid) to maintain normal intracranial pressure.

5. What does the brain do? The brain is made up of many specialized areas that work together. The skull (cranium) helps protect the brain from injury.

6. Our soft brain is protected by a hard skull…

7. Soft brain, hard skull:

8. Intracranial regulation involves: Central Nervous System- Brain and spinal cord Peripheral Nervous System- Cranial and spinal nerves

9. Remember that the two systems work together to receive an impulse, interpret it, and initiate a response…

10. A threat to any aspect of neurologic function is a threat to the whole person!

11. Intracranial Pressure: Why is it so important?

13. Normal Intracranial pressure: 5-10 mmHg, measured with the patient lying at 30 degrees (Semi-Fowler’s Position).

14. If there is an increase in intracranial pressure, what happens? (Remember ‘soft brain’, ‘hard skull’…)

15. Extreme Tumor

16. What are some examples you can think of that alter the function of the central nervous system?

17. Hmmmmmmmmmmmm, let’s see…

18. Well, let’s consider: Anesthesia, tumor, bleeding, many drugs, low blood sugar, illness, alcohol, lack of oxygen…

19. Those are all examples of ways in which the function of the central nervous system can be altered…

20. For an assessment, what are the ‘norms’ YOU should be looking for?

21. Awake: Is the patient awake? Or, is the patient other than awake?

22. Alert: Is the patient alert? Or, is the patient other than alert…

23. Oriented: Is the patient oriented to person (who they are), place (where they are), and time (day, month, and year)?

24. A.A.O. x 3: Awake, Alert, and Oriented to person, place and time

25. End of Week 3