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47 Cards in this Set
- Front
- Back
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Frontal Lobe functions
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Primary motor area “motor strip”
Personality (affective response to situation) Moral, ethical, and social values Abstract thought Long-term memory Broca’s speech center on dominant side Volunteer eye movement |
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Parietal Lobe functions
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Sensation, texture, size, shape, and spatial relationships
Three-dimensional (spatial) perception Singing, playing musical instruments, and processing nonverbal visual experiences. Perception of body parts and body position awareness Taste impulses for interpretation. |
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Temporal Lobe functions
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Time
Auditory center for sound interpretation Complicated memory patterns Wernicke’s area for speech |
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Occipital Lobe functions
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Vision
Visual recognition of objects Reading comprehension |
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Limbic System functions
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Self preservation (survival)
Primitive behavior Moods Visceral processes associated with emotions Learning and memory |
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Cerebral circulation includes
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internal carotid arteries (anterior circulation) and vertebral arteries (posterior circulation)
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Carotid arteries supply blood to
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frontal, parietal, and temporal lobes, the basal ganglia and part of the diencephalon (thalamus & hypothalamus)
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Vertebral arteries join to form _____ _________ and supply blood to
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Basilar Artery
Supply middle & lower part of temporal lobes, occipital lobes, cerebellum, brainstem & part of the dienchephalon |
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Anterior and posterior cerebral circulation connect at the ______ ___ _______
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circle of Willis
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The Middle Cerebral Artery leads bloodflow to about ___ % of the brain
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80
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Circle of Willis connects the
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forebrain and hindbrain
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Cerebral bloodflow is ____ - _____ ml/min or ____ % of cardiac output
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750-1,000ml/min
20% |
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When cerebral bloodflow stops, these things occur:
In 30 seconds .. 2 min .. 5 min .. |
neurologic metabolism alteration
neurological metabolism cessation cell death |
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Cerebral autoregulation maintins systolic BP between
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50 - 150 mm Hg
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Cerebral autoregulation is impaired with
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Cerebral ischemia
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Carbon Dioxide is a potent
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vasodilator
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Right brain functions
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Receives messages from left side of the body
Visual and spatial awareness Musical ability Ability to recognize others/parts of body Negative emotions |
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Left brain functions
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Receives message from right side of body
Logic Analytical thought, problem solving Mathematical ability Positive emotions |
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Risk factors for stroke
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Smoking, Hypertension, Obesity, Alcohol, Sedentary lifestyle, DM, High Cholesterol,
Hypertension, Heart Disease / Atrial Fibrillation / MI / Valve Disease / Cardiomyopathy, Diabetes Mellitus, Hyperlipidemia, Smoking Obesity / Physical Inactivity Oral Contraceptive use Additional Risk Factors Carotid artery stenosis Transient ischemic attack Transient monocular blindness Migraine, Hx of stroke, Hypercoagulability / Sickle Cell Disease, Alcohol and Drug use |
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AFib is the largest cause of
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embolic stroke
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Cerebral perfusion must fall to ____ of normal before brain does not receive adequate blood flow
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2/3
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Factors that affect blood flow to brain
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systemic blood pressure
cardiac output blood viscosity intracranial pressures collateral circulation Atherosclerosis |
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Facts about Atherosclerosis
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major cause of stroke
can lead to thrombus or emboli starts as infiltration of lipids into the intimal layer of a vessel (fatty streak) which then develops further into a plaque plaque cause increased turbulence of blood flow plaque can rupture or crack, platelet & fibrin stick to roughened area (thrombus) & move to become (emboli) |
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Describe the ischemic cascade
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Series of metabolic events that occur in response to ischemia
inadequate adenosine triphosphate (ATP) production loss of ion homeostasis release of excitatory amino acids (glutamate) free radical formation cell death Area around the ischemic / infarcted core tissue is potentially reversible if flow restored (< 3 hrs) |
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Describe a transient ischemic attack
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Brief, reversible episodes of neurologic dysfunction usually caused by temporary, focal cerebral ischemia
Temporary focal loss of neurologic function caused by ischemia of one of the vascular territories of the brain May be due to microemboli that occlude vessel Warning sign of progressive cerebrovascular disease Neurologic deficits present with no residual effects. |
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Most TIA resolve within
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3 hours
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clinical manifestations of carotid TIA
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temporary loss of vision in one eye (amaurosis fugax),
transient hemiparesis -numbness or loss of sensation or sudden inability to speak |
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clinical menifestation of vertebralbasilar TIA
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tinnitus, vertigo, darkened or blurred vision, diplopia, ptosis,
dysarthria, dysphagia, ataxia, and unilateral or bilateral numbness or weakness |
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most important diagnostic test for TIA
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CT of brain without contrast
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Medications to prevent platelet aggregation
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aspirin
ticlopidine (Ticlid) clopidogrel (Plavix) dipyridamole (Persantine) warfarin |
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Define Ischemic stroke
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Inadequate blood flow to the brain from partial or complete occlusion of artery
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Ischemic strokes account for about ___ % of all strokes
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85%
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Define Penumbra
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Tissue around infracted area of CVA
Area of decreased blood flow Salvageable tissue |
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Penumbra can be salvaged by maintaining
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Oxygen > or = to 92% saturation
Blood pressure > 185/105 Glucose of 140 mg/dL |
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Types of ischemic stroke
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thrombotic
embolic |
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Describe Thrombotic stroke
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The formation of a blood clot or coagulation that results in the narrowing of the lumen of a blood vessel with eventual occlusion.
Most common cause of cerebral infarction. Associated with hypertension or diabetes partial stroke with permanent neurologic deficits Tend to develop during sleep or within one hour of arising |
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Thrombotic strokes are strongly associated with this chronic illness
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HTN
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Describe Embolic Stroke
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Occlusion of a cerebral artery by an embolus, resulting in necrosis & edema of the area supplied by the involved blood vessel.
2nd most common cause of stroke. Location of clot formation is usually the heart Rapid onset of severe symptoms No discernible time pattern, unrelated to activity Manifestations occur rapidly,-----within 10 - 30 seconds Usually remains conscious, has headache Often with NO warning May have rapid improvement Usually normotensive |
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Most common disorder causing stroke
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AFib
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Describe Hemmorhagic Stroke
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generally result from spontaneous bleeding into the brain tissue -
Either intracerebral or intraparenchymal hemorrhage OR into the subarachnoid space or the ventricles (subarachnoid hemorrhage) |
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Hemmorhagic strokes are commonly caused by
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HTN
Other causes of intracerebral hemorrhage include: brain tumor, trauma, thrombolytic drugs, ruptured aneurysms, anticoags and thrombotics |
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Describe intracerebral hemmorhage
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Bleeding within the brain caused by the rupture of a vessel
Hypertension is most important cause of ICH Sudden onset of symptoms with progression over minutes to hours Typically occurs during waking hours, during periods of activity |
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Clinical Manifestations of ICH
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Severe headache with nausea and vomiting
Hypertension and decreased LOC Rapid onset to complete hemiplegia Putamen [which is in the forebrain & involved with movement], internal capsule, central white matter hemorrhage weakness of one side, including the face, arm and leg, slurred speech & deviation of eyes. Rapid progression of symptoms r/t severe hemorrhage include hemiplegia, fixed & dilated pupils, abnormal body posturing, & coma. |
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Describe Thalamic hemmorhage
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hemiplegia with more sensory than motor loss
problems with vision and eye movement |
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Describe Cerebellar hemmorhage
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severe headache, vomiting, inability to walk, dysphagia, dysarthria, eye movement disturbances
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Describe Pons hemmorhage
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most serious, life functions affected (respiration)
hemiplegia leading to complete paralysis, coma, abnormal body positioning, fixed pupils, hyperthermia and death |
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Describe Subarachnoid hemmorhage
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Occurs when there is intracranial bleeding into the cerebrospinal fluid-filled space between the arachnoid and pia mater membranes on the surface of the brain
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