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A 61 year-old piano male teacher is suffering from post-stroke symptoms…

- - - - Condition caused by brain blood vessels
      - Types of stroke:
        
        Ischemic stroke
        
        Arteries that supply blood are blocked due to
        
        Blood clot or debris carried by the blood
        
        Blocked flow of oxygen & nutrients
        
        Symptoms
        
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        Affecting patients
        
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        Most common
        
        Hemorrhagic stroke
        
        Uncontrolled high blood pressure
        
        Hypertension
        
        Anticoagulant
        
        Weak spot in blood vessel walls
        
        Lifestyle factors
        
        Diet
        
        Physical activity
        
        Smoking
        
        Alcohol consumption
        
        Medical conditions
        
        High cholesterol
        
        High blood pressure
        
        Diabetes
    - - Blocks chemical signals between brain cells (neurons)
        
        lead to
        
        Immediate symptoms of intoxication
        
        Poor memory
        
        Slurred speech
        
        Impulsive behavior
        
        Slowed reflexes
        
        Brain adapts to blocked signals
        
        then responds to neurotransmitters
        
        After alcohol leaves the system
        
        Brain continue to over activate
        
        Neurotransmitters
        
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    - - Sensory areas
        
        Primary somatosensory cortex
        
        Receive information from
        
        General sensory receptors in skin
        
        Proprioceptors found in
        
        Skeletal muscle
        
        Joints
        
        Tendons
        
        Somatosensory association cortex
        
        Integrate sensory input
        
        Temperature & pressure
        
        Understanding of objects felt
        
        Size, texture, relationships
      - Visual areas
        
        Primary visual cortex
        
        Receive information from Retina
        
        Visual association area
        
        Use past visual experience to interpret visual stimuli
      - Motor areas
        
        Premotor cortex
        
        Plan movement
        
        Coordinate movement
        
        Control voluntary actions
        
        Broca's area
        
        Voluntary motor activities
        
        Motor speech
        
        Frontal eye field
        
        Voluntary movement of eye
      - Auditory areas
        
        Primary auditory cortex
        
        Sound interpreted as pitch, loudness, location.
        
        Auditory association area
        
        Permits perception of sound stimulus
        
        Vestibular cortex
        
        Awareness of balance
      - Olfactory cortex
        
        Primary olfactory cortex
        
        Conscious awareness of different odors
      - Gustatory cortex
        
        Perceive taste stimuli
      - Visceral sensory area
        
        Conscious perception of visceral sensation
      - Multimodal association area
        
        Sensation, thoughts, emotions
        
        Divided into:
        
        Anterior association area
        
        Intellect
        
        Learning & recall
        
        Personality
        
        Posterior association area
        
        Recognizing patterns & faces
        
        Awareness
        
        Limbic association area
        
        Emotional impact
        
        Includes:
        
        Hippocampus
        
        Memory
        
        Amygdala
        
        Emotion center (fear & anger)
        
        Cingulate gyrus
      - Wernicke's area
        
        Hearing & reading
  - - - 4 Regions of the brain
        
        2 Cerebral hemispheres
        
        Frontal lobe
        
        Motor activities
        
        Temporal lobe
        
        Hearing
        
        Occipital lobe
        
        Vision
        
        Parietal lobe
        
        General sensation
        
        Function
        
        40% of brain mass
        
        Conscious mind & awareness
        
        40% of brain mass
        
        Sensation & communication
        
        Distinct features
        
        Gyri
        
        Elevated ridges
        
        Fissures
        
        Shallow grooves
        
        Longitudinal fissure
        
        Separate cerebral hemispheres
        
        Transverse cerebral fissure
        
        Separate cerebral hemispheres from cerebellum
        
        Sulci
        
        Deeper grooves
        
        Each hemisphere has
        
        Cerebral cortex of gray matter
        
        Short, non-myelinated neurons & neuron cell bodies
        
        Internal white matter
        
        Myelinated axons
        
        Basal nuclei
        
        (deep white matter)
        
        Association fibers
        
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        Commissural fibers
        
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        Projection fibers
        
        Insula
        
        Interpretation of taste (gustatory)
        
        Diencephalon
        
        Hypothalamus
        
        Connect to
        
        Pituitary gland
        
        via
        
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        Thalamus
        
        Epithalamus
        
        Function
        
        80% of brain mass
        
        Relay station to cortex
        
        Mediate sensation
        
        Mediate motor activities
        
        Mediate cortical arousal
        
        Mediate learning & memory
        
        Brain-stem
        
        Pons
        
        Medulla oblongata
        
        Midbrain
        
        Function
        
        2.5% of brain mass
        
        Control breathing & regulate body
        
        Autonomic behaviors for survival
        
        Cerebellum
        
        Function
        
        11% of brain mass
        
        Process information from cerebral motor cortex
        
        Coordinate smooth muscle contraction
        
        Coordinate movement
      - Ventricles
        
        1 and 2 within the lateral ventricle
        
        3 & 4 connected by
        
        Cerebral aqueduct
        
        Filled with cerebrospinal fluid
        
        Ependymal cells
      - Cranial nerves
        
        Vestibulocochlear nerve (VIII)
        
        Innervates ear
        
        Sensory nerve
        
        Function
        
        Hearing and balance
        
        Glossopharyngeal nerve (IX)
        
        Innervates tongue & pharynx
        
        Sensory & motor nerve
        
        Function
        
        Taste and swallowing
        
        Vagus nerve (X)
        
        Innervates thorax and abdomen
        
        Sensory & motor nerve
        
        Function
        
        Sensation and control of organs
        
        Accessory nerve (XI)
        
        Innervates trapezius and sternocleidomastoid
        
        Motor nerve
        
        Function
        
        Moves trapezius and sternocleidomastoid muscles
        
        Trigeminal (V)
        
        Innervates face & muscles of mastication
        
        Sensory & motor nerve
        
        Function
        
        Face sensation & chewing
        
        Abducens (VI)
        
        Innervates eyes
        
        Sensory & motor nerve
        
        Function
        
        Control extrinsic eye muscle (turns laterally)
        
        Facial nerve (VII)
        
        Innervates tongue & facial muscles
        
        Sensory & motor nerve
        
        Function
        
        Facial expression
        
        Trochlear nerve (IV)
        
        Innervates eyes
        
        Motor nerve
        
        Function
        
        Moves eyes
        
        Olfactory (I)
        
        Tiny sensory nerves
        
        Function
        
        Smell
        
        Innervates nose
        
        Optic (II)
        
        Sensory nerve
        
        Function
        
        Brain tract for vision
        
        Innervates eyes
        
        Oculomotor (III)
        
        Innervates eyes
        
        Function
        
        Supplies 4 of 6 muscles that moves the eyes in orbit
        
        Motor nerve
        
        Hypoglossal (XII)
        
        Innervates tongue
        
        Motor nerve
        
        Function
        
        Moves tongue
      - Limbic system
        
        Cingulate gyrus
        
        Septa nuclei
        
        Amygdaloid body
        
        Hippocampus
        
        Dentate gyrus
        
        Parahippocampal gyrus
      - Neurons
        
        Structural unit of the nervous system
        
        Dendrites
        
        Axons
      - Neuroglia
        
        Astrocytes
        
        Microglial cells
        
        Ependymal
        
        Oligodendrocytes
- - - - Inability for oxygen to reach
        
        Brain cells die
        
        Weakness
        
        Numbness
        
        Severe headache
        
        Vision problems
        
        Trouble walking or talking
        
        Slurred speech
      - Blood clots
      - Treatment:
        
        Thrombolytic therapy
        
        Dissolve clots in
        
        Blood vessels
        
        Arteries of lungs
        
        Treats
        
        Dialysis catheters
        
        Bypass grafts
        
        Veins that cause
        
        Deep vein thrombosis
        
        Legs
        
        Pelvic area
        
        Upper extremities
  - - - Premotor cortex
        
        Inability to walk without assistance
      - Broca's area
        
        Inability to speak
      - Left Primary cortex
        
        Inability to use right arm and hand
      - Primary somatosensory cortex
        
        Inability to use proprioceptors found in skin muscle & joints
        
        Inability to receive information
      - Somatosensory association area
        
        Lack of sensory feeling
    - - Wernicke-Korsakoff Syndrome
        
        Amnesia
        
        Coma (if untreated)
      - Loss of neurons
        
        Serious impairment in
        
        Language
        
        Memory
      - Raise blood pressure levels
        
        Increase risk for stroke
      - Increase levels of triglycerides
        
        Form fat in blood arteries
      - Damaging the liver
        
        Cirrhosis
        
        Alcoholic hepatitis
        
        Cellular mutation
        
        Liver cancer
        
        Liver failure
        
        Death
        
        Fat buildup (steatosis)
    - - Neuroplasticity
        
        Potentiation
        
        Factors that improve the patient's conditions:
        
        Patient's ability move his hand and arm
        
        Patient is able to feel objects with his hand & gain the sensory area of his brain
        
        Patient's ability to be able to speak again
        
        Regular practice using the injured parts of the brain
        
        Patient begins to walk again
        
        Strength of information increasing
        
        Neurons used often grows stronger
        
        synaptic
        
        More Action potentials
        
        Reach axon terminals
        
        Releases more neurotransmitters
        
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        Structural
        
        One neuron firing more action potentials
        
        to secondary neuron
        
        causing elongation of dendrites of secondary neuron
        
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        Increasing the number of axon terminals to the first neuron
        
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        Depression
        
        Signs of depression
        
        If patient completely loses ability to control the right side of his body
        
        Patient loses sensation of touch
        
        If the patient is unable to speak again
        
        If the patient is unable to move his right hands and arm
        
        Minimal or no practicing using the injured parts of the brain
        
        If patient feels fatigue & lightheadedness
        
        Strength of information decreasing
        
        Neurons that are used rarely grow weaker
        
        Structural
        
        One neuron firing less action potentials
        
        to secondary neuron
        
        causing shortening of dendrites of secondary neuron
        
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        Decreasing the number of axon terminals of first neuron
        
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        Synaptic
        
        Less action potential
        
        reaching axon terminals
        
        Release less neurotransmitters
        
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        The ability of the brain to form & reorganize synaptic connections following an injury
        
        Synaptic
        
        Chemical changes
        
        Structural
        
        Formation of connections
- - - - Raise blood pressure levels
        
        Stroke
      - Increase levels of triglycerides
        
        Form fat and blocks blood arteries
        
        Stroke
    - - Ischemic
      - Hemorrhagic
  - - - Damage to left primary cortex
    - - Damage to left primary cortex
    - - Damage to Broca's area
    - - Damage to premotor cortex
    - - Preventing the ability to receive information
        
        Due to damage in primary somatosensory cortex
    - - Due to damaged somatosensory association area
  - - - Smoking
      - Alcohol consumption
      - Physical activity
      - Diet