According to the Monroe-Kellie doctrine, which of the following statements is true regarding the three essential components of the skull (brain tissue, blood, and CSF)?
The three components must remain at a relatively constant volume within the closed skull.
The three components of the skull can vary in volume without affecting brain function
The three components of the skull can expand indefinitely
The three components of the skull are not interconnected
The Correct Answer is A
A. According to the Monroe-Kellie doctrine, the skull is a closed compartment, and the total volume of brain tissue, blood, and cerebrospinal fluid (CSF) must remain constant. If one component increases, the others must decrease to maintain normal intracranial pressure (ICP).
B. Even small changes in volume can affect ICP and brain function if compensation mechanisms are exceeded.
C. The skull is rigid and does not expand, so any volume increase without compensation leads to increased ICP.
D. The components are interrelated and changes in one directly affect the others due to the closed nature of the intracranial space.
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Correct Answer is D
Explanation
A. In stage four, the brain tissue no longer remains stable; it shifts due to high pressure.
B. CSF levels may decrease initially in compensation but are not the hallmark of stage four.
C. Cerebral blood flow decreases due to increased pressure, leading to ischemia.
D. Stage four is marked by brain herniation, where increased intracranial pressure causes brain tissue to shift from high-pressure areas to lower-pressure areas, which can be life-threatening.
Correct Answer is B
Explanation
A. Rejuvenation –. This is not a physiological term used in the context of ICP or brain compensation.
B. Autoregulation –This is the brain’s ability to maintain consistent cerebral blood flow (CBF) despite changes in systemic blood pressure. In early stages of increased ICP, autoregulation helps maintain oxygen and nutrient delivery to brain tissue by adjusting cerebral vessel diameter.
C. Percolation –This term is not relevant in neurophysiology or ICP management.
D. Demarcation –This refers more to distinguishing boundaries between tissues (e.g., in gangrene), not compensatory mechanisms for ICP.
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