OPPAT 62101 Pathophysiology for O&P Session 8: Nervous System Disorders Part 1 - CVA

Practice flashcards covering central nervous system anatomy, stroke epidemiology, stroke syndromes, hemorrhage types, and rehabilitation interventions.

Cerebrovascular Accident (CVA)

Sudden onset, rapidly developing clinical signs of focal or global neurological disturbance lasting $>24$ hrs or leading to death with no apparent cause other than of vascular origin.

Transient Ischemic Attack (TIA)

A precursor of stroke where neurologic deficits last $< 24$ hrs and are caused by a temporary interruption of blood flow to the brain.

Central Nervous System (CNS)

The division of the nervous system consisting of the brain (cerebrum) and the spinal cord.

Peripheral Nervous System (PNS)

The division of the nervous system consisting of the Somatic (voluntary) and Autonomic (automatic) systems.

Frontal Lobe

Part of the cerebrum responsible for executive functions (judgment, behavior, personality, emotion), motor function (body movement), and expressive language.

Parietal Lobe

Part of the cerebrum responsible for sensory function (body sensation), taste, and visual/spatial perception.

Temporal Lobe

Part of the cerebrum responsible for hearing, smell, language comprehension, and memory.

Occipital Lobe

Part of the cerebrum responsible for vision.

Cerebellum

The brain structure responsible for balance, posture, and coordination of body movement.

Brainstem

Consists of the Midbrain, Pons, and Medulla Oblongata; it controls basic, vital functions like breathing and cardiac rhythm.

Homunculus

Latin for "Little man," it is a neurological map of both sensory and motor functions for different parts of the body located between the frontal and parietal lobes.

Muscle Spindles

Sensory organs buried within skeletal muscle that constantly sense muscle length.

Golgi Tendon Organ (GTO)

Sensory organs within the tendon region of a muscle-tendon unit that sense muscle tension or force.

Acetylcholine

A neurotransmitter that is decreased in Alzheimer’s disease, Myasthenia Gravis, and Lambert-Eaton’s Syndrome.

Dopamine

A catecholamine neurotransmitter that is decreased in Parkinson’s Disease and TBI, and increased in Schizophrenia.

Gamma-Aminobutyric Acid (GABA)

An inhibitory amino acid neurotransmitter included in medications that decrease seizure activity and neuropathic pain.

Glutamate

An excitatory amino acid neurotransmitter that is increased in degenerative neurologic diseases and acute injuries like TBI, stroke, and spinal cord injury.

Proprioception

The sense of body position in space.

Ischemic Stroke

A type of stroke accounting for $87 \%$ of cases, caused by an obstruction blocking blood flow to part of the brain.

Hemorrhagic Stroke

A type of stroke accounting for $13 \%$ of cases, caused by a weakened vessel wall rupturing and causing bleeding in the brain.

Stroke Belt

A geographical region in the Southeast U.S. having the highest incidence and mortality of stroke.

Hypertension (HTN)

The most important modifiable risk factor for both ischemic and hemorrhagic stroke, increasing risk by $700 \%$. (Chronic HTN is defined as BP $> 140/90$).

Middle Cerebral Artery (MCA) Syndrome

A stroke syndrome characterized by contralateral hemiplegia and hemianesthesia (face and arm $>$ leg), and global aphasia if the dominant hemisphere is involved.

Anterior Cerebral Artery (ACA) Syndrome

A stroke syndrome primarily affecting the frontal and parietal lobes, characterized by motor weakness in the legs (distal $>$ proximal).

Aphasia

An impairment of language, affecting the production or comprehension of speech and the ability to read or write.

Apraxia

Poor motor planning where a person is unable to carry out a sequence of tasks despite having adequate strength.

Posterior Cerebral Artery (PCA) Syndrome

A stroke syndrome that can present with memory problems, visual field cuts, cortical blindness, and agnosia.

Agnosia

The inability to recognize or identify objects.

Prosopagnosia

The inability to recognize familiar faces.

Computed Tomography (CT)

A diagnostic imaging tool that combines multiple x-ray measurements to create detailed cross-section images of bones, blood vessels, and soft tissues; used emergently for acute bleeds.

Magnetic Resonance Imaging (MRI)

An imaging method using strong magnetic fields and radio waves to create detailed images of organs and soft tissues; used for chronic bleeds or posterior brain imaging.

Intracerebral Hemorrhage (ICH)

Bleeding from an artery within the brain tissue, most commonly caused by Hypertension.

Subarachnoid Hemorrhage (SAH)

Bleeding into the subarachnoid space between the arachnoid and pia mater, often caused by the rupture of a Berry Aneurysm.

Arteriovenous Malformation (AVM)

A congenital conglomerate of blood vessels where arteries are directly connected to veins without a capillary bed.

Subdural Hematoma (SDH)

Bleeding between the dura mater and arachnoid mater, usually caused by the tearing of bridging veins; common in the elderly following minor trauma.

Epidural Hemorrhage (EDH)

Bleeding between the skull and dura mater, often caused by a skull fracture rupturing the middle meningeal artery and characterized by a "lucid interval."

Spasticity

An abnormal velocity-dependent increase in muscle tone (tonic stretch reflexes) and exaggerated tendon jerks (phasic stretch reflexes).

Baclofen (Lioresal)

A GABA-B agonist medication used for the pharmacologic management of generalized spasticity.

Chemodenervation

The use of local injections like Botulinum toxin (Botox) to block the release of Acetylcholine from motor nerves to reduce localized spasticity.

Ankle-Foot Orthosis (AFO)

The most commonly prescribed lower extremity orthoses for stroke survivors to provide stability, safety, and efficiency while walking.