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61 year-old piano teacher suffered a stoke (Background (Brain (cerebral…
61 year-old piano teacher suffered a stoke
Background
Brain
cerebral hemispheres
motor areas- voluntary movement
broca's area
anterior to the inferior region of the premotor area
in left hemisphere only
special motor speech area
speech production
Frontal Eye Field
anterior to the premotor cortex and superior to Brocas area
voluntary movement of the eyes
primary motor cortex
frontal lobe
pyramidal cells
movement of skeletal muscles
premotor cortex
anterior to precentral gyrus
plan movement
according to sensory feedback
Sensory Areas
primary somatosensory Cortex
in postcentral gyrus of parietal lobe
receive information from general sensory receptors
somatosensory association cortex
posterior to the primary somatosensory cortex
integrate sensory inputs
visual areas
primary visual cortex
receives visual information that originates on retina of eye
posterior tip of the occipital lobe
visual association area
surround primary visual cortex
interpret visual stimuli
auditory areas
primary auditory cortex
superior margin of temporal lobe next to lateral sulcus
auditory association area
perception of sound stimulus
vestibular cortex
posterior part of insula and adjacent parietall cortex
responsible for conscious awareness of balance
olfactory cortex
medical aspect of the temporal lobe
piriform lobe
conscious awareness of different odors
gustatory cortex
in the insula just deep to the temporal lobe
perceiving taste stimuli
visceral sensory area
cortex of the insula, posterior to the gustatory cortex
conscious perception of visceral sensation
upset stomach
full bladder
Multimodal association areas
anterior association area
frontal lobe
intellect, complex learning abilities
posterior association area
temporal, parietal, and occipital lobe
recognizing patterns and faces
awareness of the entire scene
limbic association area
cingulate gyrus, parahippocampul gyrus, hippocampus
emotional impact of a scene
Cerebral White Matter-reponsible for communication
association fibers
connect different parts of same hemisphere
commissural fibers
connect corresponding gray areas of the two hemispheres
two hemispheres work in cordination
projection fibers
in cerebral cortex, low brain
sensory information
Basal Nuclei
deep in white matter
control of movement
diencephalon
thalamus
bilateral egg-shape nuclei
80% of the diencephalon
relay station for information coming in
hypothalamus
below thalamus
important for homeostasis
control the autonomic nervous system
initiate physical responses to emotions
regulate body temperature
regulate food intake
regulate water balance and thirst
regulate sleep-wake cycles
control endocrine system functions
epithalamus
dorsal portion of diencephalon
pineal gland
secretes melatonin
Brain stem
midbrain
between diencephalon and pons
contains the cerebral aqueduct
corpora quadrigemina
superior colliculi
inferior colliculi
pons
between midbrain and medulla oblongata
composed of conduction tracts
deep projection fibers
superficial ventral fibers
medulla oblongata
inferior part of brain stem
functions
autonomic reflex center
cardiovascular center
respiratory center
Cerebellum- adjust output, coordination and balance
functions
adjust motor output
ensures coordination
balance
cognitive functions
thinking
language
emotion
anatomy
symmetrical
apple-sized cerebellar hemispheres
lobes
anterior
posterior
flocculonodular
cortex
outer
grey matter
internal
white matter
cerebellar peduncles
superior cerebellar peduncles
connect cerebellum and midbrain
middle cerebellar peduncles
carry away communications from the pons to cerebellum
advising on voluntary movement
inferior cerebellar peduncles
connect medulla and cerebellum
interconnected structures of the brain
language
involves all association cortex on left side
important areas
Brocas area
speaking
Wernickes area
understanding language
Memory
kinds of memories
declarative
fact
names, faces, words, dates
stages
short-term memory
last seconds
long-term memory
stored for years
procedural
skills
playing piano
motor
riding a bike
emotional
how your heart reacts to something
factors that influence memory
emotional state
rehearsal
association
automatic memory
brain waves
alpha waves
8-13 Hz (awake but relaxed)
regular, rhythmic, low amplitude, synchronous
beta waves
14-30 Hz (awake, alert)
rhythmic, less regular than alpha and higher frequency
theta waves
4-7 Hz ( common in children)
more irregular
delta waves
4 Hz or less (deep sleep)
high amplitude waves
consciousness
encompasses perception
sensation
voluntary initiation
control movement
higher mental process
grades of consciousness
alertness
drowsiness
stupor
coma
sleep and sleep-wake cycles
partial unconsciousness
can be aroused by stimulation
types of sleep
Non-rapid eye movement
rapid eye movement
slow-wave sleep
Brain protection
meninges
3 connective tissue membranes
dura mater
arachnoid mater
pia mater
cover and protect CNS
protect blood vessels and enclose venous sinuses
contain cerebrospinal fluid
form partitions in the skull
cerebrospinal fluid
liquid cushion
Blood brain barrier
maintain the brain stable environment
development
neural tube
primary brain vesicles
prosencephalon
telencephalon
cerebrum
lateral ventricles
diencephalon
thalamus, hypothalamus, epithalamus
third ventricles
mesencephalon
brain stem: midbrain
central aqueduct
rhombencephalon
metencephalon
brain stem: pons
fourth ventricle
myelencephalon
brain stem: medulla oblongata
fourth ventricle
Stroke
symptoms
trouble speaking/ understanding speech
confusion, slur words
paralysis or numbness of the face, arms or leg
problem seeing in one or both eyes
blurred or blackened vision
headache
accompained with
vomiting, dizziness
trouble walking
outcomes
paralysis
difficulty swallowing or talking
balance problems
dizziness
memory loss
difficulty controlling emotions
depression
pain
changes in behavior
blood supply to part of brain is interrupted or reduced
prevent brain from getting oxygen and nutrients
brain cells begin to die in minutes
causes
blocked artery
ischemic stroke
leaking or bursting of blood vessel
hemorrhagic stroke
uncontrolled high blood pressure
overtreatment with blood thinners
bulges at weak spot in blood vessel walls
trauma
factors
lifestyle
physical inactivity
heavy drinking
use of drugs
overweight or obese
medical
high blood pressure
high cholesterol
diabetes
cardiovascular disease
Effects of alcohol on brain
blocks chemical signals between brain cells
impulsive behavior
slurred speech
poor memory
slowed reflexes
drinking for long period of time
brain adapt to blocked signals
responds more dramatically to certain transmitters
after alcohol leaves the body
brain continues to over activating neurotransmitters
causing painful and potential dangerous withdrawal simptoms
damage
neurotoxicity
neurons over react to neurotransmitters
neurons can burn out
pathway damage
noticeable slowing down in reactions
brain shrinkage
reduce volume
gray matter
white matter
other factors
how much and how often a person drinks
at what age the person began drinking
persons age
family history of alcoholism
general health status
impact on cognitive ability
occasional and moderate drinkers
memory impairment
blackout
recklessness
impaired decision making
heavy and chronic drinkers
inability to think abstractly
loss of visuospatial abilities
wernicke-korsakoff syndrome
memory loss
loss of attention span
Upstream
causes
direct
lifestyle
alcohol abuse
increase triglycerides levels
affect blood pressure
irregular heartbeat
blood clots
heart attack
increase risk of stroke
no physical activity
weight
age
61
indirect
medical conditions
diabetes
blood pressure
high cholesterl
cardiovascular disease
family history
medications
symptoms
cant speak
left hemisphere
brocas area
speech production
can not use right hand and arm
left hemisphere
motor areas affected
frontal lobe
primary motor cortex
voluntary movement
premotor cortex
plan movement
according to feedback
can not walk
back of brain affected
cerebellum
coordination and fine muscle control
posture and equilibrium
Downstream
stroke
brain
effects
damage brain cells
can no longer work properly
damage cerebrum
movement and sensation
speech and language
eating and swallowing
vision
cognitive ability
perception and orientation
bowel and bladder control
sexual ability
mental faculties
patient should still be able to
pay attention
recognize things
hear or touch
aware of own body
factors
worsens condition
deep vein thrombosis
clots
pressure sores
skin
problems swallowing
pneumonia
malnutrition
dehydration
bowel and bladder problems
other medical conditions
diabetes
high blood pressure
blocked carotid arteries
atrial fibrillation
improves condition
physical activities
motor-skill exercises
improve muscle strength and cordination
mobility training
mobility aids
walker, canes, wheelchair
constraint-induced therapy
improve limb function
range of motion therapy
ease muscle tension
emotional activites
therapy for cognitive disorders
therapy for communication disorders
psychological treatment
medication
prescribe medications
blood thinners
blood pressure
diabetes medication
continous to drink
interfere with medications
to reduce stroke
exp: warfarin
increase risk
another stroke
parts of brain affected
motor area
movement
procedural memory
cerebellum
equilibrium
procedural memory
playing piano
patient most likely wont be able to play piano
motor area and cerebellum were affected
affecting procedural memory