Term
| The ____ lobe is the primary motor area. It is responsible for an individual's overall _____, their _____,____,and ____values, ____ thought, ____-term memory, and _______ ____ movement. Also, this is where the _____ ______ _____ is. |
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Definition
| Frontal lobe is the primary motor area. It is responsible for an individual's personality, their moral, ethical and social values, abstract thought, long-term memory, and voluntary eye movement. This is also where Broca's speech center is. |
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Term
| The _____ lobe is responsible for understanding sensation, texture, size, shape and ____ reasoning and perception. It is important for ____, _____ ____ and processing ______ ____ experiences, as well as perception of ____ ___ and ___ _____ awareness, and ____ impulses for interpretation |
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Definition
| Parietal lobe: understanding sensation, texture, size shape and spatial reasoning. Important for playing instruments, singing, and processing nonverbal visual experiences, perception of body part and body position awareness, and taste impulses for interpretation. |
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Term
| Someone who bangs into objects after a stroke, likely has damage to the ____ lobe. |
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Definition
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Term
| The ____ lobe is the auditory center, where the brain interprets sound. It is complicated by _______ patterns. It is also where ________ area for _____ is located, so a person with a stroke in this area may have exceptional _______. |
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Definition
| Temporal lobe is the auditory center for sound interpretation. It is responsible for complicated memory patterns and is where Wernicke's area for speech is, so a person with a stroke in the Temporal lobe may have exceptional aphasia. |
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Term
| In addition to vision and visual recognition of objects, the occipital lobe is also responsible for ______ comprehension. |
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Definition
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Term
| The _____ _____ is responsible for our _____ skills, ____ behavior, moods, _____ ______ associated with _______, _______ and memory. |
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Definition
| Limbic system: survival skills, primitive behavior, moods, visceral processes associated with emotions, learning and memory |
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Term
| 80% of the brain is fed through the ________. A person with this kind of stroke will have ____ ____. |
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Definition
| MCA: Middle Cerebral Artery---> Profound deficits |
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Term
| Arteries associated with cerebral circulation |
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Definition
| Internal carotid arteries (anterior circulation) and vertebral arteries (posterior circulation) |
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Term
| Damage to the ____ arteries will inhibit supply to the _____, ______ and _____ lobes, the basal ganglia, and part of the ________ (______&________) |
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Definition
| Carotid arteries: frontal, parietal, and temporal lobes, the basal ganglia, and part of the diencephalon (thalamus & hypothalamus) |
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Term
| The _____ arteries join to for the basilar artery, supply the middle and lower part of the _____ lobes, _____ lobes, cerebellum, ______ and part of the _________. |
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Definition
| Vertebral arteries join to for the basilar artery, supply the middle and lower part of the temporal lobes, occipital lobes, cerebellum, brainstem and part of the diencephalon. |
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Term
| __ _______ __ __________ is what connects the arteries of the front and back of the brain |
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Definition
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Term
| Blood flow to the brain = ____-____ml/min, or ____% of the cardiac output |
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Definition
| 700-1000ml/min or 20% of cardiac output |
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Term
| Cerebral auto regulation maintains a range of systolic bp of ______. This auto regulation is impaired with ____ _____. |
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Definition
50-150 mm/hg
Cerebral ischemia |
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Term
| Effect of carbon dioxide on the brain |
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Definition
| Carbon dioxide is a potent vasodilator. Increased levels of Carbon dioxide increases cerebral blood flow (the vessels "open up like a pipe") |
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Term
| The right side of the brain receives messages from the ____ ____ of the body. |
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Definition
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Term
| Temporal lobe is vital of perception of _____ |
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Definition
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Term
| ___% of stroke survivors recover completely, while __% have minor impairments and can return to work |
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Definition
| 10% no impairment, 20% minor |
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Term
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Definition
HTN
Smoking
High cholesterol
Alcohol
Obesity
Sedentary lifestyle
Diabetes |
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Term
| Non modifiable risk factors for stroke |
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Definition
| Age, gender, race, family history (heredity) |
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Term
| Modifiable risk factors for stroke |
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Definition
| *HTN, heart disease, *a-fib, mi, valve disease, cardiomyopathy, DM, hyperlipidemia, smoking, obesity, physical inactivity, oral contraceptive |
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Term
| Biggest cause of an embolic stroke* |
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Definition
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Term
| Additional risk factors for stroke |
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Definition
| Carotid artery stenosis, *TIA (marker for possible stroke!!!) Transient monocular blindness (*amarosis fugax: "it felt like a shade came over my eye and alsted for 20 minutes"), migraine, prior stroke, hypercoagulability/sickle cell, alcohol and drug use |
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Term
| Cerebral blood flow must fall below _/_ of normal before brain does not receive adequate blood flow (MAP<___). After _-_ minutes, cell death and permanent changes occur. |
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Definition
| fall below 2/3 (MAP <50) then cell death and permanent changes after 3-10 minutes |
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Term
| There is a ___ hour window between having a stroke and safe, effective response to TPA |
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Definition
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Term
| Brief, reversible episodes of neurological dysfunction, usually caused by temporary, focal cerebral ischemia |
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Definition
| Transient Ischemic Attack, TIA |
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Term
| Those who have a TIA have a __% chance of having a stroke withina year |
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Definition
| 30% chance of having a stroke |
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Term
| Most important diagnostic marker for a TIA |
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Definition
| CT scan WITHOUT contrast dye |
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Term
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Definition
Ischemic: thrombotic and embolic
Partial or complete blockage of blood flow to the brain |
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Term
*****Salvagable tissue, ______, is saved by keeping
O2: ____
BP: _____
Glucose: ____ |
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Definition
Penumbra
O2: > or = 92%
BP: < or = 185/105
Glucose: 140mg/dl |
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Term
| Thrombotic stroke is the formation of a ____ or ____ that results in the _____ or occlusion of a ____ ___ with eventual ____. |
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Definition
| Blood clot or coagulation that results in the narrowing of hte lumen of a blood vessel with eventual occlusion |
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Term
| The most common cause of cerebral infarction* |
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Definition
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Term
| *2 major disorders associated with a thrombotic stroke |
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Definition
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Term
| ______ strokes tend to develop in sleep, or within one hour of waking (they go to bed fine, and wake up looking terrible) |
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Definition
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Term
| 2nd most common cause of a stroke |
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Definition
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Term
| the patient with A-fib should be on ____ or ____ to prevent embolic stroke |
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Definition
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Term
| _____ stroke onset is withing a matter of seconds to minutes. The person usually remains ____ and has a _____. It is not associated with _____and usually has no _____ _____. |
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Definition
Embolic stroke
Remains conscious
Headache
Not associated with activity
Often NO warning
May have rapid improvement
Usually normotensive |
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Term
| Hemorrhagic stroke is usually caused by ______ |
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Definition
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Term
| Save the penumbra by keeping O2 |
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Definition
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Term
| Save the penumbra by keeping BP ____ |
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Definition
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Term
| Save the penumbra by keeping glucose ____ |
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Definition
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Term
| 85% of all strokes are ____. These may be either _____ or ____. |
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Definition
| Ischemic: thrombotic, embolic |
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Term
| *****Thrombotic strokes tend to develop ________ |
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Definition
| During sleep or within one hour of waking** |
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Term
| When a person has an embolic stroke, the clot is usually formed in the _____ |
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Definition
| Heart. Most common cause is a-fib! |
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Term
| Onset of an embolic stroke |
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Definition
| Rapid, matter of seconds-minutes |
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Term
| Hemorrhagic stroke is usually caused by _____ |
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Definition
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Term
| ICH, ________ ______, usually occurs during ____, during ____ ___ ____. Symptoms are ____ ____ with _____, HTN and decreased ____. The onset is ____ to complete ______. |
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Definition
| Typically during waking hours, during periods of activity. Severe, pounding* headache with n/v. Rapid onset to complete hemiplegia. Prognosis is poor. |
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Term
| Putamen(_______), internal capsule, central white matter hemorrhage symptoms |
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Definition
(In the forebrain and involved in movement) Weakness on one side, including face, arm and leg, slurred speech deviation of the eyes.
Rapid progression of symptoms r/t severe hemorrhage include hemiplegia, fixed and dilated pupils, abnormal body posturing and coma |
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Term
| Thalamic hemorrhage symptoms is characterized by more ____ than _____ loss |
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Definition
| Hemiplegia with more sensory than motor loss |
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Term
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Definition
| Severe H/A, vomiting, inability to walk, dysphagia, dysarthria, eye movement disturbances |
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Term
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Definition
Most serious! Life functions (respiration) affected.
Hemiplegia leads to complete paralysis, coma, abnormal body positioning, fixed pupils, hyperthermia and death |
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Term
| Subarachnoid hemorrhage occurs when there is _____ ______ into the _______ ____-_____ space between the arachnoid and pia mater membranes |
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Definition
| Occurs when there is bleeding into the cerebrospinal fluid-filled spaces between the arachnoid and pia mater membranes on the surface of the brain |
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Term
| Cocaine-users are high risk for ____ ____ ___ |
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Definition
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Term
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Definition
| H/A, alert to comatose LOC, N/V, stiff neck*, focal neurologic deficits |
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Term
| If someone has an aneurism, it is likely they will ___ ____ |
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Definition
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Term
SAH Treatment:
Surgical ____ of _____
Endovascular techniques: ______
Med for vasospasm _______ ____ ___ (_______) |
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Definition
Surgical clipping of the aneurysm
Endovascular techniques: coiling
Vasospasm: administer calcium channel blocker. Nimodipine (Nimotop) |
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Term
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Definition
Sudden: weakness on one side of the body, changes in speech, vision, or hearing
Abnormal sensations one side of the body
H/A |
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Term
Manifestations of left brain stroke
Paralysis on _____ side
Impaired ____/ ______ ______
Impaired ____/_____ discrimination
Slow performance
_______
Aware of _______: depression and anxiety
Impaired comprehension |
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Definition
Paralysis on the right side
impaired speech/ language aphasias
impaired right/left discrimination
slow performance, cautious
Aware of deficits: depression, anxiety
impaired comprehension r/t language and math |
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Term
| 4 key symptoms of a left brain stroke |
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Definition
L: gaze preference
R: visual field cut
R: hemiparesis
RL hemisensory loss |
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Term
| Manifestations of a R brain stroke |
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Definition
| Paralysis on the left side, left-sided neglect, spatial-perceptual deficits, tends to deny or minimize problems, rapid performance, short attention span, impaired judgement, impaired concept of time |
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Term
| Interventions for client with a R hemisphere stroke |
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Definition
Don't overestimate abilities
Use verbal cues if having difficulty with demonstration
Break tasks into small steps
Minimize clutter
Avoid rapid movement around the client |
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Term
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Definition
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