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A piano teacher in his 60's with a history of alcohol abuse suffers a…
A piano teacher in his 60's with a history of alcohol abuse suffers a stroke. He cannot speak, use his right arm or walk alone.
Upstream: The direct cause of a stroke is an abrupt blockage of arteries or a blood vessel popping .
The patient must have had a stroke that affected his cerebral cortex on order to have those symptoms
Alcohol can greatly increase the chances of having a stroke because it raises your blood pressure
Downstream: the immediate effect of the stroke was to shut down most voluntary movements. Because the patient cannot use his right arm, we can assume the left cerebral hemisphere has been damaged.
When he recovers, he will still have the ability to play the piano, but nit at the same level. He will slowly re-teach himself.
The major factor that will determine if his condition will get better is his alcohol abuse. If he continues to drink, his condition will only worsen and the risk of having another stroke is high.
ANATOMY
BRAIN REGIONS
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Ventricles: filled w cerebrospinal fluid , continuous from the brain to the spinal cord
Lateral Ventricles: paired, deep within cerebral hemisphere, C-shaped, separated by septum pellucidum
Third Ventricle: communicates w lateral ventricles via interventricular foramen, continuous w the fourth ventricle via cerebral aqueduct lies in thalamus
Fourth Ventricle: lies in the hindbrain dorsal to the pons, has three openings: paired lateral apertures and median aperture
White Matter: Consists of myelinated axons, dense coat of myelin gives it its color
Diencephalon
Hypothalamus: Below the thalamus, caps brain stem and creates the back walls of the third ventricle, connects to the pituitary gland
Epithalamus: dorsal portion, forms roof of the third ventricle,
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Cerebral Hemispheres: have elevated ridges called gyri and shallow grooves called sulci
Major gyri and sulci work as anatomical landmarks to the lobes
are contralateral, meaning they control the opposite sides.
Cerebral White Matter: responsible for communication between cerebral areas
consists of myelinated fibers bundled into tracts: association fibers, commissural fibers, projection fibers
Basal Nuclei: primarily involved on the control of movement, connects hemispheres to the thalamus
Cerebral Cortex: composed of gray matter, motor and sensory functions are located here.
Primary Motor Cortex: located in the front lobe, pyramidal cells allow for conscious control of voluntary movements of skeletal muscles
Brain Stem
Pons: wedged b/w midbrain and medulla , fourth ventricle separates it from cerebellum
Medulla Oblongata: blends into the spinal cord, form ventral wall of fourth ventricle
Midbrain: located b/w diencephalon and pons, has two cerebral peduncles on ventral side, superior and inferior colliculi for visual and auditory reflex
PHYSIOLOGY
Strokes
A stroke is a sudden interruption in the blood supply of the brain.
there are a variety of symptoms ranging from blurred vision to headaches.
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