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Vignette #1: A 77-year-old woman was cooking in the kitchen when she collapsed o

by | Apr 27, 2022 | Anatomy

 

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Vignette
#1:
A
77-year-old woman was cooking in the kitchen when she collapsed onto the floor.
Her daughter called an ambulance and the woman was taken to the emergency room.
She had suffered a stroke, and slowly regained consciousness over the next two
days. However, when she woke up, she had the following signs and symptoms:
– paralysis of the right face and
arm
– loss of sensation to touch on the
skin of the right face and arm
– inability to answer questions but
ability to understand what was said to her – ability to write down her thoughts
more easily than to speak them
Questions:
1. Based upon the patient’s
symptoms, which cerebral artery was blocked? (Be Specific)
2. Why was she paralyzed in the
right face and arm?
3. What is the name of her language
disorder, and what caused it?
4. Was this woman’s dominant or
nondominant hemisphere damaged?
Vignette
#2:
A
61-year-old business executive with a long history of high blood pressure
collapsed while jogging over the lunch hour. His jogging mate quickly contacted
a police officer who helped carry the man to a hospital just down the road. At
the hospital, an MRI was performed that revealed a blockage of a major cerebral
artery and ischemic changes to the portion of the brain supplied by that
artery. With quick medical attention, the man was stabilized, and he slowly
improved over the next three weeks. The following signs and symptoms did
persist, however:
– paralysis of the right leg and
foot
– loss of sensation on the skin of
the right leg and foot
– when blindfolded, inability to
identify a tennis ball placed in the left hand, but ability to name it if
placed in the right hand
– inability to throw the tennis
ball with his left hand, but ability to throw it with his right hand
Questions:
1. Which artery was blocked in this
case? (Be Specific)
2. Explain why he is unable to
identify the tennis ball when it is placed in his left hand. In your
explanation, be sure to discuss all of the relevant pathways down which nerve
impulses must pass in order to name the object.
3. Explain why he is unable to
follow the verbal command to throw the tennis ball with his left hand but can
do so when asked to with his right hand. In your explanation, be sure to
discuss all of the relevant pathways down which nerve impulses must pass in
order follow these commands.
4. Why has he lost sensation in the
right leg and foot?
Vignette
#3:
An
81-year-old man and avid reader had a mild stroke from which he eventually
recovered. He did have some residual signs and symptoms, however, such as:
·
right-sided
homonymous hemianopia (i.e. loss of vision on the right half of the visual
field in each eye)
·
alexia
(“dyslexia”), the inability to read, which greatly frustrated this
man – loss of sensation on the skin on the right side of the body
Questions:
1. What cerebral artery was blocked
during his stroke? (Be Specific.)
2. Why was this man unable to see
the right half of his field of vision? Was there something wrong with his eyes?
3. If this man could still see the
left half of his visual field, why did he still have difficulty reading? In
your answer, be sure to mention all of the relevant pathways down which nerve
impulses must travel for him to be able to read.

 

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