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PATHOPHYSIOLOGY

Predisposing Factors Etiology Precipitating Factors


Prior ischemic attack none diet – fatty foods
Age – 70y/o socio-economic factors
Gender – male stress
Hx of heart disease HPN

Formation of fatty streaks on Stimulates hypothalamus


arterial wall
Sympathoadrenal medullary response Anterior pituitary gland
Scar tissue formation
Sympathetic nervous system glucocorticoids mineralocorticoids
Formation of plague
Adrenal medulla Cortical secretion Aldosterone secretion
Restriction of expansion and
contraction of arteries
Secretes epinephrine, norepinephrine Na and H2O retention
CHON Fat cells Glucoge-
Blood stasis metabolism nesis
bronchodilation Pupil dilation Tachycardia
Fatty acids
Blood coagulability glucose Blood volume oliguria
Hyperventilation - RR Wide eyed Cardiac output

ThrombosisDislodging of blood Joins general Altered immune system Cardiac output


clot circulation Visual
preceptors
Embolism

Blood pressure

Continuous peripheral Stimulation of nociceptive neural

A B resistance receptors

Nape pain

C
A B C
Minute vessels dilate
pressure & weakness of vessels

Rupture of hypertensive vessels

Intracerebral Hemmorhage

Cerebral blood flow


Hypoxia Blood spills on brain tissue Venous return

Ischemia Syncope Formation of blood clot Cardiac output


Infarction
Space occupying lesion Hypotension
Necrosis
Inflammatory response triggered
Capillary pressure

Cerebral Edema

Compression of brain tissue Brain complies to in pressure without ICP

Displacement of CSF into spinal canal

D Continuous brain tissue compression ICP

Compensation by blood volume in the brain Compensation by displacement of brain tissue as


manifested by: BP, BT, RR, PR, widened
Further tissue hypoxia
pulse pressure, agitation, nausea, vomiting,
seizures, dizziness, and drowsiness
Necrosis
Death Stupor Lethargy Continues tissue displacement
D

Anterior cerebral artery Middle cerebral artery Posterior cerebral artery Posteroinferior artery

Frontal lobe Parietal lobe Frontal lobe Parietal, occipital, Medulla Brainstm cerebellum (CN V,
temporal lobes oblongata VII, IX, X, XII)
Wernicke’s area Brocha’s area
Premotor area Motor cortex left Agnosia
side Dysphonia Dysphagia Dysarthria
Receptive Aphasia Expressive
Nerve fibers cross Aphasia
Aphraxia
over pyramidal tract
RAS

Right sided
hemiplegia LOC

Strong flexor muscles /


overbalances extensor

Serious deformities