61 year-old male with long history of alcohol abuse suffers a stoke and can't speak, use right hand and arm or walk without assistance
Anatomy
Upstream
Upstream
Physiology
Anatomy of the brain
4 main regions
Limbic system
Amygdala
Septal nuclei
Gyrus
Mammillary bodies
Limbic lobe
Olfactory bulbs
Governs emotional aspects of behavior
Is a rim of cerebral cortex
Cingulate gyrus
Composed of several groups of neurons
Located within the septal area formed by the region under the corpus callous and the paraterminal gyrus
Two round masses close to the midline near the cerebral peduncles
Flattened bodies of the olfactory pathway that rest on the cribriform plate
Brainstem
Cerebellum
Cerebrum
Diencephalon
Major transportation route, connects to spinal cord, and controls respiratory (life support)
Pons
Midbrain
Medulla oblongata
Thalamus
Hypothalamus
Epithalamus
Contain pineal gland
Contains habenular nuclei
Motor control and sends sensory information
Regulates body temperature
Autonomic nervous system
Endocrine system
Releases adrenaline (fight or flight)
Largest part of the brain, divided into tow hemispheres, memory, emotion, and consciousness are the result of cerebral function
Prefrontal cortex
Primary somatosensory cortex
Central sulcus
Somatosensory association
Longitudinal (sagittal) fissure
Primary visual cortex
Visual association cortex
Primary auditory cortex
Gustatory and olfactory area
Lobes of cerebral cortex
Parietal lobe
Occipital lobe
Frontal lobe
Temporal lobe
Insula
Cannot be seen at the surface
Problem solving
Central sulcus separates the frontal lobe from the parietal lobe
Anterior to central sulcus
Associated with movement
Located posterior to central sulcus
Associated with visual processing
Separates parietal lobes from occipital lobe
Associated with perception and recognition auditory stimuli, memory and speech
Lateral cerebral sulcus the frontal lobe from the temporal lobe
Premotor cortex
Touch sense
Understanding what you're touching
Helps make sense of what your are seeing
Taste and smelling sense
Wernicke's
Brocua's
Hearing
Language/speaking part
Reading and hearing language
Stores motor movement
Muscle memory
Function of the brain
4 main regions
Brainstem
Major transportation route, connects to spinal cord, and controls respiratory (life support)
Pons
Midbrain
Medulla oblongata
Swallowing
Coughing
Vasomotor
Regulated blood pressure
Sneezing
Primary respiratory
Regulates normal breathing
Vomiting center
Cardiac
Control center that regulated heart
Cerebellum
Stores motor movement
Muscle memory
Cerebrum
Largest part of the brain, divided into tow hemispheres, memory, emotion, and consciousness are the result of cerebral function
Premotor cortex
Prefrontal cortex
Emotions and moods and decision making; higher thinking process; personality
Primary motor cortex
Use for stimulation making muscles start working
Primary somatosensory cortex
Touch sense
Central sulcus
A shallow grove such as the between the convolutions on the brain surface
Somatosensory association
Understanding what you're touching
Longitudinal (sagittal) fissure
A narrow cleft that separates the parts, such as the lobes of the cerebrum
Primary visual cortex
Visual association cortex
Helps make sense of what your are seeing
Primary auditory cortex
Hearing
Gustatory and olfactory area
Taste and smelling sense
Wernicke's
Reading and hearing language
Brocua's
Language/speaking part
Lobes of cerebral cortex
Parietal lobe
Associated with movement, orientation recognition, perception of stimulation
Postcentral gyrus, located posterior to central sulcus, contains the primary somatosensory area of the cerebral cortex
Occipital lobe
Associated with visual processing
Parieto-occipital sulcus, separates parietal lobes from occipital lobe
Frontal lobe
Associated with reasoning, planning, emotion and problem solving
Central sulcus separates the frontal lobe from the parietal lobe
Precentral gyrus, located immediately anterior to central sulcus
Temporal lobe
Associated with perception and recognition auditory stimuli, memory and speech
Lateral cerebral sulcus the frontal lobe from the temporal lobe
Insula
Within the lateral cerebral sulcus, deep to the parietal frontal, and temporal bones, cannot be seen at the surface
Diencephalon
Thalamus
Motor control and sends sensory information to other parts of brain where information is processed
Hypothalamus
Regulates body temperature
Autonomic nervous system
Endocrine system
Releases adrenaline (fight or flight)
Epithalamus
Contain pineal gland, which produces melatonin
Contains habenular nuclei to help relay signals from limbic system
Stroke
A stoke is an interruption in blood flow to the brain that results in the death of brain cells
Subjective signs and symptoms
Difficulty forming words
Difficulty swallowing
Sudden or gradual loss of movement of extremities on one side
Nausea, vomiting
Weakness or numbness
History of TIAs (Transient Ischemic Attack)
A temporary loss of neurologic function
Caused by focal brain, spinal cord or retinal ischemia
Direct
Indirect
Age
Family history
Prior Stroke
Stroke is most common on
Individuals with hypertension and diabetes
Individuals who smoke/drink
African Amerifcans
Can have consequences for movement, sensation or emotions
Can differ in patients based on
Gender
If patients have health problems
Age
Effects of alcohol on brain
Affects the cerebrum
Affects the medulla oblongata
After 1-4 drinks
Problem solving
Judgement
Speech
Inhibition is impaired
After 5-7 drinks
Perception
Attention span
Gross motor skills
Reaction time is affected
Uncoordinated
Blurred vision
Unbalanced
After 8+ drinks
Body temperature
Blinking
Heart rate/BP
Coma
Digestion
Death
Breathing
Alcohol shuts down central nervous system, a depressant
Affects hippocampus (forms and stores memories)
Affects hypothalamus and pituitary glands
Prevents memories from forming and causes loss of emotional control
Increase3s sexual arousal
Identifying a stroke
F.A.S.T
S: speech difficulty
T: time to call 911
A: arm weakness
F: face drooping
Lack of knowledge
Not understanding the effects of alcohol
The reasons why the patients has those specific symptoms
Primary motor cortex is affected
Can't be use for stimulation making muscles start working
Therefore, can't use his right hand and arm or can't walk without assistance
In the cerebrum brocua's is affected
Language/speaking part doesn't function as it should
Therefore, the patient can't speak
Cerebellum is affected
Can't store motor movement or muscle memory
Therefore, the patient can't remember which muscles to moves in order to use right hand and arm or walk without assistance
Alcohol abuse affects the risk of a stoke
Alcohol is absorbed
Directly into the bloodstream, primarily in the small intestines
Then concentrates in various organs in proportion to water content (brain has high water content)
Alcohol can increase in blood pressure, which leads to a heart attack or stroke
Immediate effects of a stoke in the brain
High level of triglycerides can form in the blood arteries which then causes a stroke
Tell the wife about her husband's mental faculties or ability to play the piano
Right brain damage affects motor function
Left side hemiplegia
Left side neglect, shoulder on affected side rotates internally and hip rotates externally
Mood is affected by left and right brain damage
Mood is affected by right brain damage
Impaired time concepts
Impaired judgment
Pmpulsivity = safety problems
Poor attention span
Rapid performance
Tends to deny/minimize problems
Mood is affected by left brain damage
Slow performance
Cautious
Aware of deficits
Depression
Impaired comprehension related to math and language
Primary motor cortex is affected
Can't be use for stimulation making muscles start working
Therefore, can't use his right hand and arm or can't walk without assistance
In the cerebrum brocua's is affected
Language/speaking part doesn't function as it should
Therefore, the patient can't speak
Cerebellum is affected
Can't store motor movement or muscle memory
Therefore, the patient can't remember which muscles to moves in order to use right hand and arm or walk without assistance
However can gain abilities back through therapy and practice (like having to relearn)
Factors that can determine if worsens or improves
Worsens
Improves
Stops drinking
Doesn't have anymore strokes
Doesn't stop drinking
Keeps having strokes
Continues drinking outcomes
Coma
Form fats in the arteries
Amnesia
Memory loss
Increase his risk for another stroke
Death
Reticular formation
Amygdala body
Recognizes angry or fearful facial expressions, assesses danger, and elicits fear response
Denate gyrus
Lies between the hippocampus and parahippocampus
Plays role in expressing emotion via gestures and resolves mental conflict
Hypothalamus plays a role in psychosomatic illnesses
Puts emotional responses to odors
Ex: skunks smell bad
Extends through central core of brain stem
Has three broad columns that run length of brain stem
Medial (large cell) group of nuclei
Lateral (small cell) group of nuclei
Raphe nuclei
Has an axonal connection with hypothalamus, thalamus, cerebral cortex, and cerebellum, and spinal cord
The connections allow it to govern brain arousal
Reticular activating system (RAS)
Inhibited by sleep centers, alcohol, drugs
Severe injury can result in permanent unconsciousness (coma)
Filers out repetitive,familiar, or weak stimuli
Helps control coarse limb movements
Sends impulses to cerebral cortex to keep it conscious and alert
Insomnia
Liver failure
Alcohol disrupts sleep by increasing your need to go the bathroom
Alcohol affects short-term memory by slowing down how nerves communicate with each other in a part of the brain called the hippocampus
Alcohol-induced amnesia is known as a blockout since alcohol inhibited the brain's memory-making process
A very high concentration of alcohol in the blood can cause varying states of unconsciousness, including coma.
Chronic alcohol abuse causes destruction of liver cells
Lack of oxygen send to the brain
Hypertension
Starts walking without assistance
Able to speak again
Gets motivation to practice playing the piano so eventually will start to use right hand and arm
Get liver failure
Gets hypertension
Looses his memory
High cholesterol
Enviornment
Type of work
Working in the heat can cause a heat stroke
Acquires other health problems
Neuroplasticity
Ability to rewire the brain
Improve condition
Worsen condition
Potentiation (the increase in strength of nerve impulses)
Depression
Synaptic changes
Causing a release of more neurotransmitters
Causing to create more receptors
Leading to a greater response
Synaptic changes
Less neeurotransmitters releasing
Causing less receptors to react
Eventually having a weak or no response
Becomes dizzy or loses balance
He begins to loose gustatory sensation