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Cva Stroke

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CVA (cerebrovascular accident), or stroke, is sudden brain injury from interrupted blood flow or bleeding in the brain. It is a medical emergency.
  1. Definition and types
    • Ischemic stroke: arterial blockage, most common
    • Hemorrhagic stroke: bleeding into or around the brain
    • TIA: transient neurological symptoms without established infarction
  2. Risk factors and causes
    • Hypertension, diabetes, atrial fibrillation, smoking, dyslipidemia
    • Large-artery atherosclerosis, cardioembolism, small-vessel disease, hemorrhage causes
  3. Clinical features
    • Sudden facial droop, one-sided weakness/numbness, speech difficulty, visual loss, imbalance, severe sudden headache
  4. Diagnosis
    • Immediate assessment, blood glucose, non-contrast CT head, vascular imaging, ECG, and selected laboratory tests
  5. Acute treatment
    • Airway and physiological stabilization
    • Reperfusion treatment for eligible ischemic strokes
    • Mechanical thrombectomy for selected large-vessel occlusions
    • Blood-pressure and bleeding management for hemorrhagic stroke
  6. Complications and nursing care
    • Aspiration, cerebral edema, seizures, DVT, pressure injury, depression, recurrent stroke
  7. Secondary prevention and rehabilitation
    • Antiplatelet or anticoagulant treatment when indicated, statin therapy, risk-factor control, physiotherapy, speech and swallowing rehabilitation
If someone has sudden FAST symptoms, call emergency services immediately. Do not wait to see if symptoms improve.
Which section do you want in detail: acute management, pathophysiology/types, clinical features and diagnosis, or nursing care and rehabilitation?

Facial nerve

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"facial nerve"

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facial nerve anatomy branches functions official medical reference

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Facial nerve (Cranial Nerve VII)

The facial nerve is a mixed cranial nerve responsible mainly for facial expression.

Functions

Fiber typeFunction
MotorMuscles of facial expression, stapedius, stylohyoid, posterior belly of digastric
TasteAnterior two-thirds of the tongue, via chorda tympani
ParasympatheticLacrimal gland, submandibular and sublingual salivary glands, nasal and palatal glands
SensorySmall area of external auditory canal and auricle
Gray's Anatomy for Students, p. 1038

Course

  1. Arises from nuclei in the pons.
  2. Enters the internal acoustic meatus with CN VIII.
  3. Passes through the facial canal in the temporal bone.
  4. Gives branches:
    • Greater petrosal nerve: lacrimation and nasal/palatal secretion
    • Nerve to stapedius
    • Chorda tympani: taste from anterior two-thirds of tongue and salivation
  5. Leaves the skull via the stylomastoid foramen.
  6. Enters the parotid gland, where it divides into terminal motor branches.

Five terminal branches in the face

Temporal
Zygomatic
Buccal
Marginal mandibular
Cervical
Mnemonic: “To Zanzibar By Motor Car.”
These branches supply muscles of facial expression. The nerve passes through the parotid gland but does not provide secretomotor innervation to it. Parotid salivation is supplied by CN IX. Gray's Anatomy for Students, p. 1052

Clinical correlation: facial palsy

  • Upper motor neuron lesion, for example a stroke: weakness mainly of the contralateral lower face, while forehead wrinkling is relatively spared because the upper face has bilateral cortical innervation.
  • Lower motor neuron lesion, for example Bell palsy: weakness of the entire ipsilateral half of the face, including inability to close the eye or wrinkle the forehead.
The NCBI facial-nerve anatomy review similarly describes the five parotid terminal branches and their motor role.
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