intro neuro pt c

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shmvii
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176149
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intro neuro pt c
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2012-10-07 22:15:40
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intro neuro pt
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intro neuro pt c
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  1. 5 responsibilities of L side of brain
    • language & speach
    • motor dominance (probably flips to R side in lefties)
    • writing
    • verbal memory
    • R-L distinctions
  2. 5 responsibilies of R side o brain
    • non-verbal visual comprehension
    • music
    • attenion span/focus
    • emotion - behavior & intellectual defecits
    • figure ground deficits (understanding depth perception)
  3. in addition to the normal motor and sensory problems of stroke, a stroke in the L hemisphere can also lead to _, _, _, and _.
    • apraxia (motor sequencing problems)
    • alexia (difficulty reading)
    • R-L discrim problems
    • slow in organization and performance
  4. in addition to the normal motor and sensory problems of stroke, a stroke in the R hemisphere can also lead to _, _, _, _, _, _, and _.
    • visual-spatial defects
    • distorted body image (may not know one limb is theirs)
    • unilateral neglect
    • time orientation (shows up late or early)
    • spatial concepts
    • impulsive
    • dressing apraxia 
  5. ischemic CVAs make up what percent of all CVAs? what kinds of ischemic do we have?
    • 75-80%
    • thrombus
    • TIA
    • Embolic
  6. predisposing factors for a thrombus CVA
    • hypertension
    • diabete
    • high cholesterol
    • smoking
    • alcoholabus
    • atril fibrilation
  7. the onset, the trouble,and the tx for thrombotic CVAs
    • onset: abrupt - minutes to a few hours
    • deficit: at location of thrombus and in collateral circ
    • tx: IV heparin, oral coumadin
  8. TIAs - clear how fast? precede _% of all strokes, w/i 5 years _% chance of having a CVA?
    • clears within 24 h
    • precedes 10% of all strokes
    • within 5 years, 33% chance of a CVA
  9. symptoms of a TIA
    • heiparesis
    • hemisensory disturbances
    • transient aphasia
    • facial weakness &/or numbness
  10. treatment of TIA
    • dtermine etiology & intervene
    • endarectomy (clean out an artery)
    • aspirin therapy (as a precaution, but not if it's hemorrhagic)
  11. embolic stroke - onset, and most common site of lodging
    • onset is rapid in < a minute
    • middle cerebral artery
  12. etiology of embolic stroke
    • cardiac (atrial fib) - bc blood's not flowing right pt can form a clot
    • myocardial infarction throwing a clot
    • valve defects
    • endocarditis
  13. a big worry about embolic strokes
    33% become hemoragic over the next 3-4 days due to necrosis of the vessel secondary to the infarct
  14. tx for embolic stroke
    • best to just do prevention
    • no anticoagulants after due to possibility of hemorrhage
  15. hemorrhagic stroke - % of all strokes, locations
    • highest mortality rate -- it's uncontrolled bleeding into cranium
    • 15-20% of all strokes
    • 70% in internoal capusle
    • 20% in brainstem or cerebellum
    • the rest are elsewhere
  16. most common cuse of intracerebral hemorrhae?
    HTN - 66% die from initial bleed
  17. 4 types of hemorrhagic CVAs
    • intracerebral hemorrhage
    • ruptured aneurysm (small, berry-shaped dilation of an artery)
    • artreriovenous malformation (AVM)
    • trauma/TBI - not exactly a stroke but same ballpark
  18. arterioveous malformation
    AVM = congenital abnormality of a mass of thin wall dilated small vessles fed by large arteries - typically asymptomatic til there's rupture or progressive neurological deficit due to gradual enlargement

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