Week 3
Intracranial Regulation
and
Level of Consciousness
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.
Definitions:
Intra:
Within, or inside.
Cranial:
Relating to, involving, or
located in the skull,
especially the part covering
the brain.
Intracranial Regulation:
The ability of the cranial contents
(brain, blood, cerebral spinal fluid)
to maintain normal intracranial pressure.
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.
Our soft brain is protected
by a hard skull…
Soft brain, hard skull:
Intracranial regulation
involves:
Central Nervous SystemBrain and spinal cord
Peripheral Nervous SystemCranial and spinal nerves
Remember that the two
systems work together to
receive an impulse, interpret
it, and initiate a response…
A threat to any aspect of
neurologic function is a threat
to the whole person!
Intracranial Pressure:
Why is it so important?
Normal Intracranial pressure:
5-10 mmHg, measured with the
patient lying at 30 degrees
(Semi-Fowler’s Position).
If there is an increase in
intracranial pressure, what
happens?
(Remember ‘soft brain’, ‘hard skull’…)
Extreme Tumor
What are some
examples you can
think of that alter the
function of the
central nervous
system?
Hmmmmmmmmmmmm, let’s
see…
Well,
let’s consider:
Anesthesia, tumor, bleeding,
many drugs, low blood sugar,
illness, alcohol, lack of
oxygen…
Those are all examples of
ways in which the function
of the central nervous
system can be altered…
For an assessment, what are
the ‘norms’ YOU should be
looking for?
Awake:
Is the patient awake?
Or, is the patient other than awake?
Alert:
Is the patient alert?
Or, is the patient other than alert…
Oriented:
Is the patient oriented to
person (who they are), place
(where they are), and time
(day, month, and year)?
A.A.O. x 3:
Awake, Alert, and Oriented to
person, place and time
End of Week 3