I have always found aphasia incredibly interesting and terrifying all at the same time. Imagine not being able to communicate with language as smoothly as you do everyday. It is something that many of us take for granted.

the loss or defect of language (speaking fluency, reading, writing, understanding of written or spoke words)

What are the 4 types of aphasia?
1. Wernicke's 
2. Broca's
3. conduction
4. global

Potential causes:

  • stroke
  • brain trauma
  • brain tumor
  • alzheimer's disease
-receptive, fluent aphasia
-pt has hard time comprehending written or spoken language
-fluid speech, but difficult to understand

-expressive, nonfluent aphasia
-speech is slow and requires effort
-few words used
-good comprehension of language

-disturbance in repetition
-pathology involves the connections between Wernicke's and Broca's

-often associated with RIGHT hemiparesis
-defect in all areas of language

How to treat
-many recover spontaneously in 4-6 weeks
-speech therapy

Photo source: emedia.leeward.hawaii.edu
Source: Step Up to Medicine by Agabegi and Agabegi


ACA Stroke Basics

Anterior Cerebral Artery (ACA) Stroke

The Anatomy

What deficits might you expect to see in a patient?

  • contralateral leg weakness (both motor and sensory), frontal lobe behavioral issues, +/- aphasia if prefrontal cortex involved, grasp reflex
Where does the ACA receive its blood supply from?
  • Carotid arteries

Source: http://www.neuroanatomy.ca/stroke_model/aca_info.html
Photo sources: http://missinglink.ucsf.edu/lm/ids_104_cns_injury/response%20_to_injury/watershed.htm



As always... back to the basics:

What is oliguria?
Low urine output (UOP)

What is "normal" adult UOP?
About 30cc/hr

How might you write a post op floor order for this?
"call house officer if 2 hour UOP is < 60cc"

What are the possible causes?
Think pre renal/renal/post renal causes

What is the most common cause?
Pre renal!


Causes of Renal Failure

Causes of Renal Failure broken down by pre-renal, renal, and post-renal.

Source: Clinical Survival Guide for PA Students by G.Broughton, MD, PhD