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Sharing today 1.
Anatomy of the brain 2.
Comparison of cerebrospinal fluid and plasma components CSF plasma protein is low, high, glucose, low, high Na+, high and low, Mg2+, high, low, K+, low, high HCO3-, low, high, Ca2+, low and high.
A similar barrier can limit the free exchange of substances between the blood and brain tissue, becoming the blood-brain barrier
.
High permeability and low fat-soluble substances such as O2, CO2, some anesthetics and ethanol, sucrose, glucose, mannitol, amino acids, acetylcholine, norepinephrine, dopamine, and glycine, but under special circumstances, the permeability of the blood-brain barrier is enhanced.
Condition? 1.
In the periventricular organs around the third ventricle of the hypothalamus and the posterior border of the medulla, the blood-brain barrier is relatively weak, and the permeability of the capillary wall to many substances is higher than that of other parts of the brain
.
When the brain tissue is hypoxic, damaged, and at the site of a brain tumor, the permeability of the capillary wall increases
.
4.
Intracranial pressure and influencing factors Generally, the normal value of adult intracranial pressure is 5.
3-13.
5mmHg, (70-200mmH2O), and if it exceeds 13.
5mmHg, intracranial pressure is increased
.
5.
Physiological dysfunction caused by increased intracranial pressure 6.
Cerebral blood flow and its regulation Normal brain weight accounts for about 2%-3% of body weight, but cerebral blood flow is about 750-1000ml per minute, accounting for 15% of cardiac output.
%-20%, the distribution of cerebral blood flow is uneven, the average is 54 (45-60) ml/(100g.
min)
.
7.
Brain metabolism and its monitoring 1.
Brain metabolic energy accounts for 20% of the whole body metabolic energy
.
The energy needs of the brain are provided by glucose
.
2.
Monitoring of brain metabolism
.
(1) Internal jugular vein oxygen saturation monitoring
.
The normal value is 55%-71%.
When the oxygen saturation of the internal jugular vein is lower than 50%, it indicates cerebral ischemia and hypoxia
.
In patients with severe cerebral congestion, decreased cerebral oxygen metabolism rate, and brain death, the increased oxygen saturation in the internal jugular vein may be related to the decreased cerebral oxygen metabolism and arteriovenous shunt
.
The internal jugular vein oxygen saturation reflects the oxygen saturation of the mixed venous blood in the whole brain
.
(2) Near-infrared spectrometer monitoring
.
The normal value of cerebral blood oxygen saturation is 64%+-3.
4%, and less than 55% indicates abnormality
.
(3) Brain tissue oxygen partial pressure monitoring
.
The normal value range is 16-40mmHg
.
10-15mmHg indicates mild hypoxia, and less than 10mmHg indicates severe hypoxia
.
8.
Effects of anesthetics on cerebral blood flow, cerebral metabolism and intracranial pressure
Anatomy of the brain 2.
Comparison of cerebrospinal fluid and plasma components CSF plasma protein is low, high, glucose, low, high Na+, high and low, Mg2+, high, low, K+, low, high HCO3-, low, high, Ca2+, low and high.
A similar barrier can limit the free exchange of substances between the blood and brain tissue, becoming the blood-brain barrier
.
High permeability and low fat-soluble substances such as O2, CO2, some anesthetics and ethanol, sucrose, glucose, mannitol, amino acids, acetylcholine, norepinephrine, dopamine, and glycine, but under special circumstances, the permeability of the blood-brain barrier is enhanced.
Condition? 1.
In the periventricular organs around the third ventricle of the hypothalamus and the posterior border of the medulla, the blood-brain barrier is relatively weak, and the permeability of the capillary wall to many substances is higher than that of other parts of the brain
.
When the brain tissue is hypoxic, damaged, and at the site of a brain tumor, the permeability of the capillary wall increases
.
4.
Intracranial pressure and influencing factors Generally, the normal value of adult intracranial pressure is 5.
3-13.
5mmHg, (70-200mmH2O), and if it exceeds 13.
5mmHg, intracranial pressure is increased
.
5.
Physiological dysfunction caused by increased intracranial pressure 6.
Cerebral blood flow and its regulation Normal brain weight accounts for about 2%-3% of body weight, but cerebral blood flow is about 750-1000ml per minute, accounting for 15% of cardiac output.
%-20%, the distribution of cerebral blood flow is uneven, the average is 54 (45-60) ml/(100g.
min)
.
7.
Brain metabolism and its monitoring 1.
Brain metabolic energy accounts for 20% of the whole body metabolic energy
.
The energy needs of the brain are provided by glucose
.
2.
Monitoring of brain metabolism
.
(1) Internal jugular vein oxygen saturation monitoring
.
The normal value is 55%-71%.
When the oxygen saturation of the internal jugular vein is lower than 50%, it indicates cerebral ischemia and hypoxia
.
In patients with severe cerebral congestion, decreased cerebral oxygen metabolism rate, and brain death, the increased oxygen saturation in the internal jugular vein may be related to the decreased cerebral oxygen metabolism and arteriovenous shunt
.
The internal jugular vein oxygen saturation reflects the oxygen saturation of the mixed venous blood in the whole brain
.
(2) Near-infrared spectrometer monitoring
.
The normal value of cerebral blood oxygen saturation is 64%+-3.
4%, and less than 55% indicates abnormality
.
(3) Brain tissue oxygen partial pressure monitoring
.
The normal value range is 16-40mmHg
.
10-15mmHg indicates mild hypoxia, and less than 10mmHg indicates severe hypoxia
.
8.
Effects of anesthetics on cerebral blood flow, cerebral metabolism and intracranial pressure
