Inside Your Patient s Brain Michelle Peterson, APRN, CNP Centracare Stroke and Vascular Neurology

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1 Inside Your Patient s Brain Michelle Peterson, APRN, CNP Centracare Stroke and Vascular Neurology Activity Everyone stand up, raise your right hand, tell your neighbors your name 1

2 What part of the brain did you use for this activity? (Standing, Raising Right Arm, Saying your Name, Understanding What Was Being Said) Brain is responsible for controlling many functions in the body, including memory, motor movements, sensory, speech and the function of some organs The brain is an organized structure, divided into many components that serve specific and important functions. - AANS Anatomy of The Brain 2

3 Frontal Lobe Parietal Lobe Anatomy of The Brain Occipital Lobe Temporal Lobe Thalamus Cerebellum Brain Stem Largest of the Four Lobes Controls voluntary movements (precentral gyrus/motor cortex) Frontal Lobe Behaviors (personality, memory, temper, concentration, intelligence) Executive Functions (planning for future, judgement, decision making and attention span) 3

4 Damage to the Frontal Lobe Displays excessive effects of emotion Behavior/Personality changes (Depression, losing motivation, not acting themselves) Decrease in executive functions, Decrease in thinking Weakness affecting the opposite side of the body Speech/Language Difficulty PMC1 recognition vision orientation memory emotion touch hearing Parietal Lobe Interprets signals received from other parts of the brain processes sensory information within seconds sensory motor 4

5 Slide 8 PMC1 Peterson, Michelle CNP, 4/8/2018

6 DAMAGE TO THE RIGHT PARIETAL LOBE Spatial relation Neglect of left side and left side of body Parietal Lobe DAMAGE TO THE LEFT PARIETAL LOBE Reading Difficulty Writing Difficulty Mathematics Occipital Lobe Receives and processes visual information Helps us perceive color and shape Right Occipital Lobe interprets vision from left space Left Occipital Lobe interprets vision from right space 5

7 Damage to Occipital Lobe Occipital Lobe Loss of peripheral vision on opposite site of affected lobe Hallucinations Inability to identify colors Temporal Lobe 6

8 TEMPORAL LOBE Visual Memory-Remember faces and objects Verbal Memory-Remember and Understand Language Sound and Language Processing Temporal Lobe Wernicke s Area Speech Comprehension DAMAGE TO TEMPORAL LOBE Receptive Aphasia Dyslexia Impaired verbal memory Unable to identify familiar objects Impaired recognition of faces Thalamus Relay Station or Sprint Network Almost all information that comes and goes to the cerebral cortex goes through here Regulates consciousness, sleep and alertness Basal Ganglia, surrounds the Thalamus 7

9 Trouble Concentrating Sleep Disturbance, Insomnia Thalamic Pain Syndrome (sensation affected) Coma Damage to Thalamus Sensory Signals lost to Cortex resulting to numbness Motor signals lost to Cortex resulting in weakness Regulates Senses of sight, sound, taste and touch by deciding what information from the eyes, ears, mouth and skin to relay to its area of the cerebral cortex Cerebellum Fine tunes activity including movements Helps maintain balance (equilibrium) and posture Coordination/Repetitive Actions Affects the same side of the body as where damage is (Ex: right cerebellar damage can cause right sided weakness/ataxia) 8

10 Damage to Cerebellum Clumsy movements Off Balance Dizziness Nausea/Vomiting Shaking of Extremities Weakness of same side Eye Movement Disorders (Nystagmus) Midbrain, Pons and Medulla Oblongata Another Sprint Network for passing messages back and forth to the cerebral cortex Brain Stem Like the thalamus can control levels of wakefulness Ocular movements Pons controls facial senses and movement, hearing and some balance Medulla is responsible for vegetative functions including breathing, blood pressure, swallowing and heart rates (Brain Death typically occurs here) 10 of 12 Cranial Nerves Originate here (smell and vision not here) 9

11 Blood Vessel Distribution sudden onset weakness or numbness in the face, arms, or legs (usually on one side of the body) Carotid Artery Syndrome trouble speaking (garbled speech) or understanding sudden vision problems in one or both eyes dizziness drooping on one side of your face 10

12 Carotid Arteries Starts at the Common Carotid Arteries and break off into External/Internal Carotids Anterior Circulation (front of brain) Each Individually supply their own hemisphere MCA Middle Cerebral Artery Branches off the Internal Carotid Artery Supplies the lateral sides of frontal, temporal and parietal lobes Paired with the Anterior Cerebral Artery (ACA) to supply the Anterior Circulation (Front of the Brain) 11

13 MCA Occlusion on Angiogram with Recanalization Post Thrombectomy Anterior Cerebral Artery (ACA) Supplies the midline portion of frontal lobes Superior-Medial Parietal Lobe Also branch off the Internal Carotid Artery Are Connected by the Anterior Communicating Artery (ACOMM) 12

14 Vertebral Artery Basilar Artery Posterior Circulation (Back of Brain) The Right and Left Vertebral Arteries come together to form the Basilar Artery Supply the Cerebellum, Brain Stem, Occipital Lobe and some Mid Brain and Cervical Spine Small Vessel Distribution Vascular Risk Factors (Blood Pressure, Cholesterol LDL, Diabetes, Smoking, Sleep Apnea) Tiny Hair Thin Blood Vessels Often see Chronic White Matter Disease in imaging report Midbrain (Thalamus/Basal Ganglia) and Brain Stem (Pons, Medulla) 13

15 Questions? 14

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