Chapter 3: Brain Circulation

For the Instructor Guide and Worksheet Key please contact user services at userservices@mheducation.com

OUTLINE

Objectives:

The student will:

1. Correctly identify the major arteries of the brain on a diagram or on a human brain.

2. Analyze the case histories and examination findings of four paper clients with thrombotic stroke to determine the most likely lesion location and arteries involved.

3. Identify common central nervous system syndromes.

Activity 1. Case 1: Presentation

Lab instructor goes over Case #1 on student worksheet with entire class together.

Activity 2. Identification of Blood Supply to Brain on Diagram and Whole Human Brains

Students identify arteries supplying the brain using the diagram on the lab worksheet and on whole human brains.

Activity 3. Small Groups Work on Cases 2, 3, 4

Students work together in groups of 3–4 students to answer questions on student worksheet regarding remaining three cases.

Activity 4. Wrap-Up Discussion of Cases and "Take Home"

Lab instructor discusses cases with students as a group to emphasize important concepts, answer questions, and ensure understanding of material.

WORKSHEET

Introduction

Review Discussion

Review how to locate lesions in the nervous system based on functional losses.

If higher functions are affected then likely areas are:

• Supratentorial: ________________

  • Functions: ____________________

• Infratentorial: _______________________

  • Functions: ______________________________

What is the pattern of sensory loss?

• Dissociated sensory loss:

  • ___________________________________

• ___________________________________

• Global sensory loss:

  • ___________________________________

  • ___________________________________

What is the pattern of visual deficits?

• Blindness _________________________________

• Temporal hemianopia_______________________________

• Homonymous hemianopia___________________________

Activity 1. Case 1: Presentation

Case Study 1

A 57-year-old man with headaches, diplopia, dizziness, and ataxia

A 57-year-old man was admitted to the hospital with a chief complaint of headaches located in the back of his head for the past 3 weeks. Two weeks prior to admission, the client noticed a sudden onset of diplopia (ie, double vision) when looking forward and a feeling of dizziness. He also noted ptosis (ie, drooping) of the right eyelid.

• Past Medical History. The client had been treated for hypertension for the past 3 years with blood pressure in the range of 180/110 mmHg.

• Systems Review. The client was alert, oriented, and cooperative. His blood pressure was elevated (190/95 mmHg). All other findings were normal.

• Physical Therapy Examination

  • Mental Status. The client's memory was appropriate for his age. His speech was articulate and he conversed normally.

  • Cranial Nerves. Eye movements were full. The right pupil measured 3 mm, the left ...