"Medicine does make sense when explained properly" Seriously man, out of all the textbooks, websites, and professor explanations none of them could explain it well enough that it made sense and yet, you managed to explain it so well, thank you. Earned yourself a new follower for sure!
CPP Normal Range : 70-100 mmHg, ICP Normal Range: 5-15 mmHg, B-Brandypnea, and A- CT scan of the head. CPP = Mean Arterial Pressure (MAP) - Intracranial Pressure (ICP). MAP = (Diastolic BP x 2) + Systolic BP / 3. Thank you.
@@WizKidNas In general, X-rays shows bones well, but aren’t very good at finding soft tissue problems. Specifically, for this patient: elevated BP + bradycardia in a patient with a positional headache...Medicosis is telling us that there is Cushing Signs in the setting of what could be a brain bleed (or something sloshing around in his head). That’s bad. And likely a brain problem, not a skull problem. CT better for soft tissue (and actually fantastic at picking up acute bleeds)
Have been going through your work for the last couple of days. It's amazing how detailed your lectures are, and how deep you go in elucidating subjects. I just want to tell you my sheer appreciation for the amazing job you do despite it probably not paying you back enough. I hope you will continue doing this!
Just came across this video while studying for Step 1. Simple, effective, fun explanation. Teachers like you make studying pleasant. Needless to say you have gained me as a subscriber. Thank you. P. S. I love your voice and accent.
Can't fast forward or skip this video Everything explained so perfectly and your sense of humour ofcourse is amazing 😂😂 Time well spent watching this video ❤❤❤
Wow I just discovered this channel while studying for my exams and looking for a better explanation. Everything makes so much sense, 1000x better than all my lectures!! Also the crying joke 😂😂😂👌 New subscriber here 🙌
Amazing lecture. thanks for putting your valuable time and effort to help others. All the best wishes for every aspect of your life. Love from Bangladesh.
Q1: normal cerebral perfusion pressure is 60-80 mm Hg Q2: normal intracranial pressure is 5-10 mm HG Q3. none of these are expected in the physical exam findings Q4: This patient needs STAT CT scan of head
Good explanation But no need to cry when you see cushing reflex...try to give mannitol Intubate paralyse and ventilate and transfer to a nerosurgicalcenter as soon as possible....
Awesome video, and you have a good sense of humor. My 36 year-old son has been diagnosed with first mold toxicity, but his lowered immune system let a diagnosis of Lyme, Babesia, and anaplasmosis. Then, he got Covid after Christmas in Jan. 2022, and his head pressure went through the roof. He’s still in horrible pain, and it’s 8 months later. He’s seeing 4 different types of specialist doctors, and is being treated for these infections, but no one can figure out what, exactly is causing this excruciating pain. He sleeps with ice packs, has lost a lot weight, and barely gets up. He does have forward head posture, and I’m not sure if that’s keeping the pressure in his brain, but he complains all day long when he doesn’t sleep. He also has horrible nightmares, hallucinations (cut back his meds), delusions, paranoia, depression, anxiety, and I’m going nuts, as his mother! He’s had meningitis at age 7, several severe TBIs, and now this. I was told it was either the mold or the Babesia, but I also think, by his neck placement, it could be cervical instability. He won’t go back to the upper cervical chiropractor I was taking him to, although his neck felt better, but maybe I should try it again. He’s going for neurofeedback and hypnosis, but I’m not sure these will work if there’s a physical problem. Can ANYONE tell me what this could be? He’s ready to jump off a bridge and can’t stay by himself for more than an hour. He’s scared to death! I am too!
I suggest that you put the link to the answer of the questions in the description box, because I can't search for a Facebook post from 2018 in 2021 lol Thank you for the video, it is so helpfull
The only video on youtube which ist explaining why and how heartfrequence, Vasoconstriction occures and you even mention those important receptores! great work ym friend. Btw: are you studying medicine?
I really like it as well,,,his sense of joke a good one to keep the learners more focus ,,,please calm down and wait ,,,, if you fail after this explanation blame yourself ..lol
What a great yet simple presentation that you gave in discussing about this cns ischemic response .....plus adding a joke *which i laughed at it a little* kinda a good way of making this more interesting ... Hope to see more vids from you, sir ♥♥♥♥ loves from medical student, Malaysia
This is fantastic. Could you talk a little about the timeline of this process? For example I’m guessing stomach ulcers take time to form so can a person have Cushing signs but still be alert and orientated? For example , the question at the end has a person experiencing a Cushing a triad but a gcs 15 and has been suffering this for 3 weeks . I’m a uk paramedic and we tend to associate these symptoms only with acute onset and greatly reduced gcs patients. Thank you
Tachycardia....oh wait you said bradycardia...calm down good things happen to those who wait. 😂 Funny tone. Nice video. Thankyou so much. Explained well!
at 4:28, he says CN6 palsy, but this is supposed to be CN3 palsy (oculomotor n.) due to compression against the clivus bone at the base of the skull; this results in ipsilateral dilated and nonreactive pupil and later the "down and out position" of the eye (parasympathetic fibers surround the motor fibers in the nerve and thus are affected first).
@@MedicosisPerfectionalis I wouldn't say "commonly" as it is a rarer symptom of IIH. CN 6 is most commonly affected in IIH, but IIH in and of itself is a rare disease that usually affects young overweight females, and it is usually chronic or subacute, not an acute emergency as your video says. Thus, you don't really see the Cushing reflex in IIH. There are other more common causes of emergent intracranial hypertension that affect a larger number of people and include a wider variety of patients. In these cases, brain herniation is the biggest threat, and the most commonly seen cranial nerve involvement is CN3 for the reasons I stated before.
I work in the icu and my patient last night was this im not a neuro icu but more cardiac and well i watched this patient do all these things narrow pulse pressure but initially hypotensive then hypertensive and then the first code they just brady down to nothing came back but now pupils are both blown fixed no reflexes whatsoever !
Why do people describe Cushing reflex as having a 'widening pulse pressure'? I understand why the systolic increases with increase HR, but why would the diastolic not follow?
Wow! I remember describing periods of not breathing when lying in bed at night to my physicians on my diagnosis. Nothing more was mentioned about it. Thanks for the information!
Stage 2 : there is a stimulation of parasympathetic ➡️: bradycardia so why there is no vasodilation (because of parasympathetic) so there is mo more ⬆️HTN
Can Anyone explain how the widening pulse pressure makes sense with bradycardia and HTN? Is it because the vessels are so squeezed that it depletes the vessels of fluid during diastole? I'm just a little confused.
What do these things mean? I’m a mom with a son who has had horrible intracranial head pressure for 8 months! I’m desperately trying to find out why my son is suffering so badly. He has Lyme and Babesia.
What do u mean" HTN will press on your respiratory center"? The pressure is exerted on the blood vessels from the inside. Or do blood vessels just next tho the resp center expand due to HTN and craete mass effect?
Normal value of CCP = 60-80mmhg Normal value of ICP= 7-15mmhg - we will expect a bradypnea ( to complete the triade of Cushing reflex then going to cry where nobody can see u :) ) ..next step is CT scan? Btw. They said to us to propose a MRI because it's better for showing the cerebral lesions..
💊 👨🏫 Antibiotics Lectures: www.medicosisperfectionalis.com/products/courses/antibiotics/
"Medicine does make sense when explained properly" Seriously man, out of all the textbooks, websites, and professor explanations none of them could explain it well enough that it made sense and yet, you managed to explain it so well, thank you. Earned yourself a new follower for sure!
I appreciate you so much!
medicine = everything makes sense once explained correctly. oh goodness this is so true
The best comment ever...You made my day!
Hahaha 😁 ...Thanks!
CPP Normal Range : 70-100 mmHg, ICP Normal Range: 5-15 mmHg, B-Brandypnea, and A- CT scan of the head. CPP = Mean Arterial Pressure (MAP) - Intracranial Pressure (ICP). MAP = (Diastolic BP x 2) + Systolic BP / 3. Thank you.
Nursing student here! Why CT over Xray? (probably a dumb question)
CT over x-ray for which condition?
@@MedicosisPerfectionalis In your case study example at the end (last two questions).
@@WizKidNas In general, X-rays shows bones well, but aren’t very good at finding soft tissue problems.
Specifically, for this patient: elevated BP + bradycardia in a patient with a positional headache...Medicosis is telling us that there is Cushing Signs in the setting of what could be a brain bleed (or something sloshing around in his head). That’s bad. And likely a brain problem, not a skull problem. CT better for soft tissue (and actually fantastic at picking up acute bleeds)
CPP
Have been going through your work for the last couple of days. It's amazing how detailed your lectures are, and how deep you go in elucidating subjects. I just want to tell you my sheer appreciation for the amazing job you do despite it probably not paying you back enough. I hope you will continue doing this!
Sure! Thank you so much...What a great comment 😊
It's incredible when you understand something you thought was very difficult, almost impossible. Thanks for the lecture! From Brazil here! :)
Wow 🤩
That’s awesome 👏
Thank you so much for watching!
Can you please help me by sharing?
“Start to cry and weep, just for a second because we don’t have time” 😅😅😅😂😂😂😂😅😂😅😂
Haha 😂
😂 😂 😂 😂
😂😂😂😂
😂😂😂😂
This made me laugh 🤣
انا هكتب بالمصري معلش علي النعمة بنعمة ربي انت عظيم انا بتابعك من مصر وعايز اقولك "عظمة علي عظمة يا ست " زي ما الجدع قالها لام كلثوم
How can I forget what he just taught with his great sense of humor. lol.
Thanks a lot!
My pleasure 😇
One of the best explanation i have ever heard. Straight to the point. Easy to understand. All the best. New subscriber here.
Thank you so much 😊
Welcome 🙏
🧠 Neuroanatomy Playlist: ua-cam.com/play/PLYcLrRDaR8_cBHy0sWaCaLmOlJb9gzmA2.html&si=lnnSJhJJTUcfKl5b
🥼 Clinical Neurology Playlist: ua-cam.com/play/PLYcLrRDaR8_cQG-7JbGaeXsXGgBpK-Yzl.html&si=Qoi97evsN9uz-9Te
💀 Anatomy Playlist: ua-cam.com/play/PLYcLrRDaR8_cxbxAwLSQSx9v28Ezv3gQB.html&si=jqigBoyauPcen27C
Just came across this video while studying for Step 1. Simple, effective, fun explanation. Teachers like you make studying pleasant. Needless to say you have gained me as a subscriber. Thank you.
P. S. I love your voice and accent.
I am honored!
As an EMT student, I didn't understand why bradycardia happened even with the extreme hypertension, this helped a ton. Thank you!
Glad it helped!
Thank you so much watching!
You are the one who make medicine makes sense
❤️❤️
Thank you 😊
🧠 Neurology playlist: ua-cam.com/play/PLYcLrRDaR8_cQG-7JbGaeXsXGgBpK-Yzl.html&si=hAKOlNyei9Zpc5A2
Can't fast forward or skip this video
Everything explained so perfectly and your sense of humour ofcourse is amazing 😂😂
Time well spent watching this video ❤❤❤
Love the way you are passionate about teaching and enjoying medicine....! Great
Thank you 🙏
Wow I just discovered this channel while studying for my exams and looking for a better explanation. Everything makes so much sense, 1000x better than all my lectures!! Also the crying joke 😂😂😂👌 New subscriber here 🙌
Thank you!
Incredible work as always , thank you from the deep cerebral arteries medicosis!
You’re always welcome!
New grad in the ICU here! Great video much needed! :)))
Thank you so much 😊
Amazing lecture. thanks for putting your valuable time and effort to help others.
All the best wishes for every aspect of your life.
Love from Bangladesh.
Thank you!! Laughed when you said to cry a little LOL
Thank you ☺️
Good video,,now I understood why HR is reduced…Bravo!👏
I just discovered your channel, your explanation is just PERFECT thank you 👌🏻❤️
My pleasure 😇
As a medical student from Belguim, I gotta say thanks xD
My pleasure!
Q1: normal cerebral perfusion pressure is 60-80 mm Hg
Q2: normal intracranial pressure is 5-10 mm HG
Q3. none of these are expected in the physical exam findings
Q4: This patient needs STAT CT scan of head
Thank you Dr. Elaine
Thanks for this video! This was entertaining and I understood it very well! I laughed at “start to cry and weep for seconds” so much 🤣
Haha 😂
i'm studying for my post grad after doing mbbs. this was helpful. thank you.
My pleasure 😇
Good luck with your career 👍
Its my favvv channel
Thank you 🙏
"good things happen to those who wait". - medicosis perfectionalis 2018
Haha 😂
you are the best...true medicine becomes easy when it s well explained ,,thx a lot ,,BRAVO
Thank you so much 😊
CPP: 50-70 mmHg
ICP: 5-15 mmHg
Really good videos, sir! You explain everything so well, and in not very lengthy videos to leave one bored...love the jokes in between! :)
Excellent! Thanks for letting me know! 😊
1 billion thanks 🙏🙏
the best explanation ever, thank you for all your effort 🙏🙏🙏
My pleasure 😇
Good explanation
But no need to cry when you see cushing reflex...try to give mannitol
Intubate paralyse and ventilate and transfer to a nerosurgicalcenter as soon as possible....
Very well explained! Learned this in physiopathology class last week
Cool! Keep slaying it!
you mean pathophysiology.....
Thank you ! You explained it so beautifully
You’re very welcome ☺️
Cushing reflex seems intimately tied with TBI/GCS ... I want to hear more on the subject. I spent years working on this.
Very well explained Med. You the best!
Thank you 🙏
Awesome video, and you have a good sense of humor. My 36 year-old son has been diagnosed with first mold toxicity, but his lowered immune system let a diagnosis of Lyme, Babesia, and anaplasmosis. Then, he got Covid after Christmas in Jan. 2022, and his head pressure went through the roof. He’s still in horrible pain, and it’s 8 months later. He’s seeing 4 different types of specialist doctors, and is being treated for these infections, but no one can figure out what, exactly is causing this excruciating pain. He sleeps with ice packs, has lost a lot weight, and barely gets up. He does have forward head posture, and I’m not sure if that’s keeping the pressure in his brain, but he complains all day long when he doesn’t sleep. He also has horrible nightmares, hallucinations (cut back his meds), delusions, paranoia, depression, anxiety, and I’m going nuts, as his mother! He’s had meningitis at age 7, several severe TBIs, and now this. I was told it was either the mold or the Babesia, but I also think, by his neck placement, it could be cervical instability. He won’t go back to the upper cervical chiropractor I was taking him to, although his neck felt better, but maybe I should try it again.
He’s going for neurofeedback and hypnosis, but I’m not sure these will work if there’s a physical problem.
Can ANYONE tell me what this could be? He’s ready to jump off a bridge and can’t stay by himself for more than an hour. He’s scared to death! I am too!
dont go to a chiropractor, im a doctor and they cause serious damage, sometimes fatal. chiropractors are not doctors but pretend to be.
Dude, you are natural
😃 Thanks
Your videos are life saving ❤
I suggest that you put the link to the answer of the questions in the description box, because I can't search for a Facebook post from 2018 in 2021 lol
Thank you for the video, it is so helpfull
You are amazing, best teacher ever! Thank you so much, you are helping me a lottttttttttt!! from Brazil :D
I love the way this is presented -
Thank you 🙏
المصري معروف بقوته وبجبروته 😂
والله يا دكتوربنحبك ❤
Thank you, Sir!
only you make medicine easy ,many thanks
That "good things happen to those who wait" is nice😂👍
:)
The only video on youtube which ist explaining why and how heartfrequence, Vasoconstriction occures and you even mention those important receptores! great work ym friend.
Btw: are you studying medicine?
Yup! I am a medical student...and I can’t thank you enough for your great words and encouragement...You made my day! Good luck with everything 🍀
"please calm down and wait"
😃😃
I really like it as well,,,his sense of joke a good one to keep the learners more focus ,,,please calm down and wait ,,,, if you fail after this explanation blame yourself ..lol
I have Brachycardia of 49 BPM and pre-hypertension and history of traumatic brain injury with suspected CTE
Cerebral blood flow(CBF)=Cerebral perfusion pressure (CPP)/cerebral vasculature resistance(CVR)
CPP=Mean arterial pressure - ICP
Great video,Thanks 👍🏻
You’re always a life saver. Do you have a video on the treatment?
Thank you…I’ve talked about the treatment of intracranial hypertension in my Emergency Medicine Course: www.medicosisperfectionalis.com/
I like your sense of humour. Very well explained. Thanks.
HaHa! Thank you 😊
Beautifully explained...thanku so much for making this so easy
My pleasure 😇
CPP - 80 to 100 mmHg
ICP - 5 to 10 mmHg
Case of the day answers 1)b because there will be irregular breathing as well
2)a to rule out the cause of increased icp
Which anti-hypertensive drug is the most appropriate and which to avoid for this type of condition?
What a great yet simple presentation that you gave in discussing about this cns ischemic response .....plus adding a joke *which i laughed at it a little* kinda a good way of making this more interesting ... Hope to see more vids from you, sir ♥♥♥♥ loves from medical student, Malaysia
Same love and respect to the great people of Malaysia...Thank you so much :)
Super explanation 👏👏
Thank you so much 😊
ICP normal range 4 to 15 mm/HG
Cerebral perfusion pressure= MAP -ICP
85MM/HG =100-15
Pressure on respiratory centrum - > irregular breathing, but how exactly does it work? What is the mechanism?
This is fantastic. Could you talk a little about the timeline of this process? For example I’m guessing stomach ulcers take time to form so can a person have Cushing signs but still be alert and orientated? For example , the question at the end has a person experiencing a Cushing a triad but a gcs 15 and has been suffering this for 3 weeks . I’m a uk paramedic and we tend to associate these symptoms only with acute onset and greatly reduced gcs patients.
Thank you
Aah you've made this so easy!
Normal ICP 5-15mmHg
Normal CPP 60-100mmHg
Excellent and concise explanation. Thank you so much!
This saved my life
Awesome 👏
I am honored!
Great explanation. Love from Bangladesh.
Thank you so much 😊
NICE explanation sir from India
Thanks 🙏
Quality channel
Thanks 🙏
Tachycardia....oh wait you said bradycardia...calm down good things happen to those who wait. 😂 Funny tone. Nice video. Thankyou so much. Explained well!
thank you so much.
Last two
1-b
2-a
at 4:28, he says CN6 palsy, but this is supposed to be CN3 palsy (oculomotor n.) due to compression against the clivus bone at the base of the skull; this results in ipsilateral dilated and nonreactive pupil and later the "down and out position" of the eye (parasympathetic fibers surround the motor fibers in the nerve and thus are affected first).
Then why do we commonly see CN VI palsy in cases of idiopathic intracranial hypertension?
@@MedicosisPerfectionalis I wouldn't say "commonly" as it is a rarer symptom of IIH. CN 6 is most commonly affected in IIH, but IIH in and of itself is a rare disease that usually affects young overweight females, and it is usually chronic or subacute, not an acute emergency as your video says. Thus, you don't really see the Cushing reflex in IIH. There are other more common causes of emergent intracranial hypertension that affect a larger number of people and include a wider variety of patients. In these cases, brain herniation is the biggest threat, and the most commonly seen cranial nerve involvement is CN3 for the reasons I stated before.
What causes the systolic and diastolic be widened? Why the widened pulse pressure?
You are doing great job , love and support from pakistan ❤️
Thank you sir
Easy to understand and straight to the point
My pleasure 😇
I work in the icu and my patient last night was this im not a neuro icu but more cardiac and well i watched this patient do all these things narrow pulse pressure but initially hypotensive then hypertensive and then the first code they just brady down to nothing came back but now pupils are both blown fixed no reflexes whatsoever !
you gained a subscriber ! congratsss
Thanks, dear :)
Why does this only happen in this occasion and say not any situation that elevates blood pressure??
Great video, you make medicine easy.
Thanks a ton for your encouragement :)
Why do people describe Cushing reflex as having a 'widening pulse pressure'? I understand why the systolic increases with increase HR, but why would the diastolic not follow?
The best explaination thank u sir☝👆👋👏👐👌✌✋✋👍👍👍👍👍❤❤❤❤
Thank you 🙏
"...Good tings happen to people that wait..."👍😂😂😂
:)
Wow! I remember describing periods of not breathing when lying in bed at night to my physicians on my diagnosis. Nothing more was mentioned about it. Thanks for the information!
You’re welcome!
Please talk to your doctor.
Really amazing thank you so much
Thanks from Atbara 🌼🌼
My pleasure 😇
AMAZING! THANK YOU!
My pleasure 😇
Cpp= map (50 to 150 mmhg) - icp (5 to 15 mmhg)
Stage 2 : there is a stimulation of parasympathetic ➡️: bradycardia so why there is no vasodilation (because of parasympathetic) so there is mo more ⬆️HTN
CPP 50mmHg
ICP 60-15mmHg
But how can the patient maintain a high BP when brady occours?
- emt student
3:47 Mechanism of Cushing Reflex ❤️
Can Anyone explain how the widening pulse pressure makes sense with bradycardia and HTN? Is it because the vessels are so squeezed that it depletes the vessels of fluid during diastole? I'm just a little confused.
wow. you are really amazing , this is the first time i see your page and it`s awesome. thanks a lot for all these videos. keep it up
Thank you for your kind words...I wish you all the best!
1) 60_80mmHg
2)15mmHg
3)Bradypnea
4)CT scan brain
What do these things mean? I’m a mom with a son who has had horrible intracranial head pressure for 8 months! I’m desperately trying to find out why my son is suffering so badly. He has Lyme and Babesia.
Really good video, thanks for the help.
My pleasure 😇
ICP= 7-15mmhg
CPP= 60-80 mmhg
What do u mean" HTN will press on your respiratory center"? The pressure is exerted on the blood vessels from the inside. Or do blood vessels just next tho the resp center expand due to HTN and craete mass effect?
Normal value of CCP = 60-80mmhg
Normal value of ICP= 7-15mmhg
- we will expect a bradypnea ( to complete the triade of Cushing reflex then going to cry where nobody can see u :) )
..next step is CT scan?
Btw. They said to us to propose a MRI because it's better for showing the cerebral lesions..
you are amazing, thank you!
My pleasure 😇