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Organic & Neurogenic Comm Disorders > Stroke > Flashcards

Flashcards in Stroke Deck (38)
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1

Cerebrovascular accident (CVA)




– loss of blood supply to a focal area of the brain

2

Ischemic

arterial blockage
-complete or partial

Atherosclerosis can cause arteries to thicken blocking blood flow

Thrombosis- blockage or occlusion of an artery

Embolism- a thrombosis or blood clot that has traveled
-Embolic stroke

3

Hemorrhagic

– arterial bleed

Brain damage everywhere blood touches
Brian swells when blood touces it

2 types of hemorrhages: intracerebral & extracerebral (in meninges)

4

Transient ischemic attack (TIA)

– “mini stroke” causes temporarily loss of blood to the brain (CDC, 2014)

5

Adult Risk Factors

TIA
High blood pressure
High cholesterol
Heart disease
Atherosclerosis
Diabetes
Sickle cell disease
Smoking
Obesity

6

Child Risk Factors

Heart disease
Hemorrhage
Sickle cell disease
Vascular malformations

7

Vascular System

Carries blood to and from the heart

Arteries- carry blood away from the heart

Veins- carry blood to the heart

Capillaries- connect arteries and veins

Blood- supplies the brain with oxygen and glucose
BUT- blood and brain DO NOT mix

8

Cerebrovascular system

- network of arteries, veins, and capillaries that supply blood to the brain

9

Arteries

2 common carotid arteries- supplies the front of the brain
-Branches into the internal carotid arteries at the base of the skull
-Internal carotid arteries divide into smaller arteries that supply specific portions of the brain

Anterior cerebral arteries

Middle cerebral arteries

2 vertebral arteries- supplies the back of the brain
-Fuse to form the basilar artery

10

Circle of Willis

Carotid and vertebral arteries- come together to form a circle of arteries at the base of the brain.

Circle- redundant system that has some back-up if there is a blockage

Blockage or damage to an artery above the Circle of Willis may cause focal brain damage

11

aneurism

weakness in artery wall

causes a bulge that is susceptible to bursting

12

Ischemic stroke improvement:

Often occurs within a few weeks

Within first 3 months see significant recovery as blood reduces and brain swelling decreases

After 3-6 months recovery slows

If brain tissue dies - infarct



13

Hemorrhagic stroke improvement:

Rapid recovery over first few months

Better long-term outcomes

14

CNS

- brain and spinal cord

Spinal cord- carries neural messages from the brain to structures outside of the brain (peripheral structures)

15

Brainstem

Cranial nerves extend from the brainstem and then travel to other parts of the body (head, neck, face, ear, etc.)

Medulla, pons, and midbrain

Medulla has cranial nerves for tongue, laryngeal and diaphragmatic movement
Pons has cranial nerves for eye, facial, and hearing

16

Cerebrum


- Two brain hemispheres
Contain white and grey matter
White matter directly below the cerebral cortex
Contains fiber tracts that send information through pathways to different parts of the brain
Grey matter structures (e.g. thalamus & basal ganglia) are connected by the white matter pathways

17

Lateralization


- “one hemisphere is dominant for a particular function”(Bloom, 1997, p.146)
Language lateralized to left hemisphere
Nonverbal, visuo-spatial perceptual information

18

Brain Damage

Damage to a brain results in a specific pattern of deficits
Damage to language areas results in aphasia
Brain may not be as compartmentalized as we thought
Brain is a network of connections

19

Lateralization


- “one hemisphere is dominant for a particular function”(Bloom, 1997, p.146)

Language lateralized to left hemisphere

Nonverbal, visuo-spatial perceptual information

20

Localization

- one area of brain is responsible for a certain function

Broca’s area responsible for speech execution

21

Brain Damage

Damage to a brain results in a specific pattern of deficits

Damage to language areas results in aphasia

Brain may not be as compartmentalized as we thought

Brain is a network of connections

22

Aphasia

An acquired language disorder

Can be caused by stroke, TBI, tumor, or disease (damage to the brain)

categorized as fluent or nonfluent

Diagnosis is made based on standardized and nonstandardized test results
Discourse has to be analyzed

23

Fluent aphasias

- caused by damage to the posterior temporal lobe

Speak a lot but it doesn’t make sense, have normal articulation and syntax

24

Nonfluent aphasias

- caused by damage to the frontal lobe

Speaking short phrases or single words with reduced prosody, have syntax errors, misarticulate, and may repeat words or phrases (perseverate)

Often have weakness or paralysis on the right side of their body

25

Broca’s aphasia:

Non-Fluent

Damage- cortical and subcortical areas in the lower left frontal lobe
Including the precentral gyrus

Characteristics-
-Apraxia
-Agrammatic- short utterances that contain only content words
-Mildly impaired naming abilities
-Repetitions of sentences are agrammatic
-Oral reading and writing deficits


26

Transcortical motor aphasia:

Non-Fluent

Damage- frontal lobe in the area that connects Broca’s and the supplementary motor cortex

Broca’s area is NOT damaged

Characteristics-
-Articulation is intact
-Sentences contain syntactic errors
-Can repeat sentences
-Auditory comprehension is relatively good
-Reading and writing deficits are similar to Broca’s aphasia

27

Global aphasia:

Non-Fluent

Damage- large lesion affecting Broca’s and Wernicke’s areas
Including white matter deep to these structures

Characteristics-
-Limited verbal speech- meaningless or repetitions
Severe naming and sentence repetition -deficits
-May have some automatic speech
-Severely impaired auditory comprehension
-May be able to answer some yes/no questions and respond to basic commands
-Reading and writing severely impaired
-May have no functional reading

28

Wernicke’s

Fluent

Damage- posterior 1/3 of the superior temporal gyrus

Characteristics-
-Talks a lot and fast- without articulation errors
-Language can be empty or vague
-Neologistic jargon
-Paragrammatic-small grammar mistakes
-Auditory comprehension is severely impaired (hallmark)
-Naming and repetition are severely impaired
Reading and writing skills are variable, but impaired

29

Anomic

Fluent

Damage- Angular gyrus or the second temporal gyrus

Characteristics-
-Mild-moderate auditory comprehension deficits
-Severe word finding deficits- makes conversational speech appear empty (hallmark)
-Reading and writing
-Angular gyrus damage-severe impairments
-Second temporal gyrus- mild deficits similar to those heard in their speech

30

Conduction:

Fluent

Damage-Arcuate fasciculus

Characteristics-
-Mild word finding deficits
-Mild auditory comprehension deficits
-Severe repetition impairment (hallmark)
-Writing may have syntactic and spelling errors