Neuro checkpoint

thrombosis

stationary blockage

larger arteries

deficits occur gradually

50% preceded by TIA

atherosclerosis

embolism

traveling clot

deficits occur immediately

Transient Ischemic Attack (TIA)

small ischemia within the brain

resolves within 24 hours

WARNING SIGNS

subarachnoid

bleed

between pia and arachnoid matter

headache

intracerebral

bursts within vessel

thalamus, basal ganglia, pons, cerebellum

HTN

most lethal

aneurysm

balloon burst

what are the 3 types of strokes

Hemorrhagic

Ischemic

TIA

what causes aphasia

stroke

TBI

Medication

Infection

brain tumor

surgery

what causes a stroke

interruption of blood flow to the brain

stroke risk factors

obesity, high BP, smoking, drinking, exercise levels (lack of exercise), stress, medications, diet

what are the warning signs of a stroke?

Balance

Eyes blurred vision

Face drooping

Arm or leg weakness

Speech difficulty

Time (call immediately)

spontaneous recovery

concerned with the organism’s reaction to insult

associated with rapid improvement of physical, mental, speech/language status

reperfusion

reperfusion

restoration of blood flow to the brain occurs across three phases (acute, subacute, chronic)

Ischemic recovery

rapid in the first few days and weeks but gradually slows

hemorrhagic recovery

slow in first 4-8 weeks with a period of rapid recovery that slows and stablaizes

sever thunder pounding headache precedes this type of stroke

subarachnoid

most lethal type of stroke that occurs when a blood vessel bursts within the brain itself

intracerebral

occurs when a blood vessel supplying blood flow to the brain becomes occluded

thrombosis

an abnormal widening or ballooning of a portion of an artery due to weakness of blood vessels that develops in the circle of willis

aneurysm

often atherosclerosis causes a stationary blockage of an artery leading to its gradual occlusion

thrombosis

warning sighs for larger, more destructive stroke

TIA

a piece of plaque breaks off the artery and travels from larger arteries to smaller arteries where it eventually lodges and blocks blood flow

embolism

modifiable risk factors

smoking

medication

obesity

stress

heart disease

diabetes

physical inactivity

high blood pressure

alcohol

high blood cholesterolo

non-modifiable risk factors

genetics, sex, ethnicity

(age is not really considered one anymore)

how can diabetes lead to a stroke

high blood sugar can break down the blood vessel walls

plaque build up decreases circulation

hypertension, high cholesterol, atherosclerosis, obesity

time effects of ischemic stroke

neurons die → tissues swell → neuronal degeneration → diaschisis

over time cerebral swelling decreases, cerebral blood flow is restored, and new neural connections emerge

prognostic predictions are unreliable until temporary effects have diminished

after a month, if recovery is limited = substantial brain damage = severe impairments

lesion size

amount of neurological structures that lost blood supply

lesion site

integrity of angular gyrus, supramarginal gyrus, areas within the temporal lobe and temporoparietal junction

recovery with spontaneous speech is related to integrity of subcortical white matter areas

prognosis personal factors

age (does not contribute significantly to recovery but some studies suggest younger recover better)

gender (females tend to recover better)

handedness (not supported)

premorbid education (related to recovery due to cognitive reserve)

arteriosclerosis is common in which type of stroke

ischemic thrombotic

hematoma

accumulation of blood outside of the vascular system

subdural hematoma

accumulation of blood below dura matter

dura matter

tough, outer layer

separates neural tissue from bone

arachnoid matter

beneath dura matter, blood vessels pass

cerebrospinal fluid runs through

pia matter

holds all of the sulci and gyri

contains the major blood vessels that serve the surface of the cerebrum (nutrients)

infarct

death of cerebral tissue due to ischemia

atherosclerosis

build up of lipids (fatty acids and cholesterol)

penumbra

area surrounding the damaged area which can also be affected by lack of oxygen

aphasia

acquired (not developmental)

language modalities (not a problem of intellect)

damage to the brain

cognition

the ability to think and acquire and process the knowledge around the world

ideation

desire to do something

purpose and goal for action

how do you communicate functionally?

interactive, multimodal, common ground

4 steps of oral communication

ideation

linguistic planning

motor planning

execution

apraxia of speech

a sensorimotor speech disorder resulting from brain damage causing deficits in motor planning and programming (not due to muscular weakness)

dysarthria

motor speech disorder caused by brain damage resulting in articulation deficits due to muscular weakness

right hemisphere communication disorder

communication deficits (perception, cognition) that appear following damage to the right hemisphere

traumatic brain injury

cognitive deficits limit the ability to attend selectively, to discriminate, to organize thoughts, to remember, analyze, integrate, and synthesize information

dementia

a group of symptoms caused by various diseases and conditions that affect the brain which leads to a progressive decline in cognition, language, and personality

axial

the brain cut through horizontally

sagittal

view from the side

coronal

view from behind

transverse

cuts the body in half horizontally

frontal

cuts the body in half separating front and back

sagittal

cuts the body in half vertically

glial cells

supports neurons

produce myelin

regulate fluid levels in brain tissue

remove waste

participate in brain metabolism

nerve cells

a neuron is the smallest functional unit of the nervous system

neurons are the nervous system cells responsible for transmitting and processing information

neuron

responsible for communicating with each other and transmitting important nerve impulses via an electrochemical system of cellular communication (action potential)

cerebrum

made up gray matter and white matter

gray matter

unmyelinate cell bodies of the neurons

where the processing and regulating of information occurs in the CNS

white matter

myelinated axons

transmit information over long distances within the body such as from one area of the brain to another or between the brain and the body

white matter tracts

corpus callosum

a group of fibers that provides communication between the two hemispheres

left hemisphere

right hand control

writing

language

scientific skills

mathematics

lists

logic

right hemishphere

left hand control

emotional expression

spatial awareness

music

creativity

imagination

dimension

gestalt (whole picture)

broca’s area

responsible for the production of speech

Wernicke’s area

responsible for language processing and understanding

dorsocentral prefrontal cortex

abstract thinking, judgement, planning

obitofrontal

decision making for reward related behaviors

premotor strip

skilled voluntary movement

primary motir strip

voluntary movement/speech motor execution

primary sensory strip

process sensations of touch, pressure, and position

supramarginal gyrus

phonology

heshls gyrus

primary auditory cortex

angular gyrus

reading and writing

visual cortex

vision

superior longitudinal fasciculus (SLN)

connects frontal region with temporal, parietal, and occipital regions

inferior longitudinal fasciculus (ILF)

links anterior temporal regions with tempero-occipital and occipital areas

arcuate fasciculus (AF)

connects inferior frontal gyrus to posterior superior temporal gyrus

uncinate fasciculus (UF)

connects inferior frontal and anterior temporal regions

Inferior fronto-occipital fasciculus (IFOF)

connects frontal lobe to temporal, occipital, and superior parietal areas

cingulate gyrus

assesses sensory input and modifies cortical activity related to painful or fearful stimuli

what 4 arteries supply blood to the brain

right vertebral artery

left vertebral artery

right cerebral artery

left cerebral artery

What major cerebral arteries supply blood to the brain that come from the circle of willis

middle cerebral artery

anterior cerebral artery

posterior cerebral artery

anastomosis

allows for collateral circulation

collateral circulation

ability of blood from separate brain arteries to redistribute to other areas of the brain

occurs when blockage is below the circle of willis

ACA

supplies blood to the anterior surface (frontal and parietal lobes)

MCA

supplies blood to the lateral surface (parts of frontal, parietal, and temporal lobes)

PCA

supplies blood to the posterior surface (occipital and parts of the temporal lobe)