CVA - 2a Stroke Syndromes Flashcards
what are the 4 things that the severity of sx depend on
- location of ischemic process
- size of ischemic area
- nature and functions of structures involved
- availability of collateral blood flow
what are the functions of the occipital lobe
vision
understanding the image
what are the functions of the temporal lobe
short term memory
hearing
equilibrium
emotion
association areas in temporal lobe
what are the functions of the primary motor cortex
motor function area
initiation of voluntary movement
location and function of Broca’s area
frontal lobe
muscles of speech
- word retreival -> Broca’s aphasia have word finding difficulties when talking
which hemisphere of the brain is the dominant one
L brain
what are 4 specific qualities/functions of the L hemisphere
- speech, language, comprehension
- wernicke’s and broca’s areas located on L - analysis and calculations
- time and sequencing
- recognition of words, letters, and numbers
what are 4 specific qualities/functions of the R hemisphere
- creativity
- spatial ability
- context/perception
- recognition of faces, places, objects
what is located in both R and L frontal lobes
- motor
- motor deficits, issues w initiation and motor planning (ie motor apraxia) - initiation
- judgment
- safety awareness
- seen more frequently in R strokes
common R sided stroke characteristics
trouble w spatial abilities, perception of surroundings, insight, judgment
what is the blood supply of the frontal lobe
MCA - lateral aspect
ACA - medial aspect
what qualities are found in just the L frontal lobe and just the R frontal lobe
L side
- expressive language
R side
- emotions
- creativity
what function is located in both R and L parietal lobes
sensation
- primary sensory cortex
what is the blood supply of the parietal lobes
MCA - lateral aspect
ACA - medial
what qualities are found in just the L parietal lobe and just the R parietal lobe
L side:
issues w communication
- reading
- writing
- numbers
R side:
- visual perception
- spatial orientation - spatial planning and awareness
- ex: unilateral neglect (perceptual dysfunction)
what is the blood supply of the temporal lobe
MCA
what function is located in both R and L temporal lobes
hearing
what qualities are found in just the L temporal lobe and just the R temporal lobe
L side:
- word memory
- language comprehension
- ex: wernicke’s aphasia
R side:
- music
- nonverbal memory (ie gestures)
what is the blood supply for the occipital lobes
PCA
what functions are located in both R and L occipital lobes
vision
no separate functions between lobes
describe the presentation of someone w a L CVA
R hemiplegia
slow, cautious, uncertain
- d/t effects on initiation
insecure, frustration, anger
better insight
memory problems
aphasia
motor apraxia
R hemianopsia
communication issues
PT strategies specific to a L CVA
give frequent assurance and immediate positive feedback
- break tasks down into steps and practice often
slow things down and be explicit w instructions
- get frustrated easily
describe the presentation of a R CVA
L hemiplegia
quick ** impulsive**
poor insight/judgment
- overestimate abilities
denying problems
emotional lability
unilateral neglect
L hemianopsia
dec spatial orientation
apraxia
PT strategies specific to R CVAs
concerned ab safety and fall risk
- cog skills lack judgment and poor attention span
impulsive and move quickly
why do sx vary so much from human to human and what does this impact
wide variability in human vasculature and collateral flow
- can change extent and nature of effects from one person to another
what impact can an infarcted area have on the brain as a whole
loss of input from infarcted area can impact other brain functions
what are the stroke syndromes which occur in the cerebral hemispheres
supplied by carotid or ant circulation
- ACA syndrome
- MCA syndrome
- ICA syndrome
what are the stroke syndromes which occur in the brainstem and posterior hemisphere
supplied by vertebral basilar or posterior circulation
- PCA syndrome
- brainstem and cerebellar stroke syndrome
—–> vertebrobasilar artery syndromes
what are lacuna arteries
terminal branches of all cerebral circulation
- small arteries
what are the 2 arterial sources from the aorta in the brain
internal carotid a.
vertebral a.
what is the circle of willis
connects the 2 arterial sources from aorta (ICA and vertebral a.)
what is the path for anterior circulation in the brain
ICA splits into ACA and MCA
- supply cerebral hemispheres
what is the path for posterior circulation in the brain
union of the 2 vertebral arteries forms the basilar a.
- this splits into 2 PCAs
perfuses post and inf parts of cerebrum, cerebellum, and brainstem
what part of the brain has a rich blood supply and yet is not typically involved in strokes
corpus callosum
what is the blood supply of the corpus callosum
branches of ACA and PCA
what does the MCA supply
lateral frontal, parietal, and temporal lobes
what does the ACA supply
medial frontal and parietal lobes
what does the PCA supply
post hemispheres of occipital lobe and brainstem
which is larger: ACA or MCA
MCA > ACA
MCA perfuses entire lateral aspect of cerebral hemispheres except for occipital and subcortical structures
describe the difference in a prox vs distal occlusion
prox - more significant extensive neuro damage
distal - less damage and better outcomes
MCA vs ACA and the homunculus
ACA more medial - sensory and motor to LE
MCA more lateral - sensory and motor to UE and face
