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Sophie - The Nervous System - Year 2 > 16.4 Blood Supply > Flashcards

16.4 Blood Supply Flashcards

1
Q

What is the Circle of Willis?

A
  • It is the joining area of several arteries at the inferior side of the brain.
  • This is due to the anterior and posterior communicating arteries linking vessels derived from the internal carotid and vertebro-basilar systems.
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2
Q

Where is the Circle of Willis found?

A

It encloses the optic chiasm.

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3
Q

Label this.

A
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4
Q

What are the arterial pulse points you need to know.

A

*Carotid
*Facial
*Superficial temporal

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5
Q

Which sinus is the internal carotid artery related to and how?

A
  • The cavernous sinus
  • The ICA passes through the cavernous sinus
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6
Q

What event is the Circle of Willis commonly related to?

A

Subarachnoid haemorrhage:

  • Aneurysms associated with subarachnoid hemorrhages tend to occur in a circle of arteries that supply blood to the brain.
  • These are known as the circle of Willis.
  • In some people, a congenital anomaly leads to weak and thin blood vessel walls, increasing the risk of an aneurysm.
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7
Q

What event is the middle meningeal artery commonly associated with?

A

Extradural haemorrhage:

  • This tends to occur at the PTERION -> This is the point at which multiple bones join
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8
Q

Which sinus is the internal carotid artery related to and how?

A
  • The cavernous sinus
  • The ICA passes through the cavernous sinus
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9
Q

What are the consequences of ACA syndrome?

A

Anterior cerebral artery syndrome.
- Contralateral leg weakness
- Executive dysfunction/ abulia

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10
Q

What is the consequence of L MCA syndrome?

A

Left middle cerebral artery syndrome

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11
Q

What is the consequence of Top of the basilar/ Thalmic perforations?

A
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12
Q

What are the consequences of Mid-basilar stroke?

A
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13
Q

What are the consequences of cerebellar stroke?

A
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14
Q

What are the consequences of PCA syndrome?

A

Posterior cerebral artery syndrome

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15
Q

What are the consequences of R MCA syndrome?

A

Right middle cerebral artery syndrome

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16
Q

What is this vein?

A
  • Superior sagittal sinus
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17
Q

What is this vein?

A
  • Great cerebral vein
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18
Q

What is this vein?

A
  • Transverse sinus
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19
Q

What is this vein?

A
  • Sigmoid sinus
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20
Q

What is this vein?

A
  • Internal jugular vein
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21
Q

What is this vain?

A

*Cavernous sinus

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22
Q

Identify the artery marked by the arrow labelled 1:

  • Anterior cerebral
  • Basilar
  • Internal carotid
  • Middle cerebral
  • Posterior communicating
A

Middle cerebral

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23
Q

Identify the artery marked by the arrow labelled 2:

  • Anterior cerebral
  • Anterior median spinal
  • Basilar
  • Middle cerebral
  • Vertebral
A

Basilar

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24
Q

The terminal branches of the artery marked by the arrow labelled 2 supply the:

  • Auditory cortex
  • Motor cortex
  • Olfactory cortex
  • Sensory cortex
  • Visual cortex
A

Visual cortex

(Terminal branches of the basilar artery supply the posterior cerebral arteries, which in turn supply blood to the occipital lobe of the brain responsible for processing visual information)

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25
Q

Identify the artery marked by the arrow labelled 3:

  • Anterior cerebral
  • Anterior medial spinal
  • Basilar
  • Posterior cerebral
  • Posterior inferior cerebellar
A

Anterior medial spinal

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26
Q

The artery marked by the arrow labelled 3 supplies the:

  • Pons
  • Spinal cord dorsal horn
  • Spinal cord lateral horn
  • Spinal cord ventral horn
  • Trigeminal spinal nucleus
A

Spinal cord ventral horn

(Anterior medial spinal artery supplies the anterior 2/3 of the spinal cord and runs along the anterior median fissure of the spinal cord, supplying blood to structure in that region. The spinal cord is organised into three main regions: the dorsal, ventral and lateral horns. The dorsal horn receives sensory input, the ventral horn sends motor output and the lateral horn contains autonomic cell bodies.)

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27
Q

Name the artery marked by the arrow labelled 1

  • Basilar
  • Internal carotid
  • Middle cerebral
  • Posterior cerebral
  • Vertebral
A

Internal carotid

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28
Q

Through which bone in the skull does the artery labelled 1 pass?

  • Ethmoid
  • Frontal
  • Parietal
  • Petrous temporal
  • Sphenoid
A

Petrous temporal

(Passes through the carotid canal, an opening in the petrous temporal bone - 16.2)

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29
Q

Identify the artery marked by the arrow labelled 2

  • Anterior cerebral
  • Anterior communicating
  • Internal carotid
  • Middle cerebral
  • Posterior cerebral
A

Anterior cerebral

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30
Q

Vascular lesions of the artery labelled 2 will affect which part of the cortex?

  • Auditory cortex
  • Frontal and motor cortex
  • Insula cortex
  • Parietal cortex
  • Visual cortex
A

Frontal and motor cortex

(The ACA supplies blood to the superior and medial portions of the frontal lobe, including the prefrontal cortex, supplementary motor area and primary motor cortex. It also supplies the parietal lobe, including the primary somatosensory cortex.)

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31
Q

What symptoms would you associate with a loss of function of the area supplied by the artery with the arrow labelled 2?

  • Behavioural disturbances
  • Facial paralysis
  • Loss of sensation to the hand
  • Loss of taste
  • Vocal cord paralysis
A

Behavioural disturbances

(The symptoms that are most commonly associated with a loss of function of the area supplied by the anterior cerebral artery are: behavioural disturbances, contralateral weakness or paralysis, loss of sensation to the leg and foot, apraxia, gait apraxia, and urinary incontinence)

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32
Q

The region of the cortex marked by the yellow arrow receives its arterial supply from the:

  • Anterior cerebral artery
  • Anterior spinal artery
  • Internal carotid artery
  • Middle cerebral artery
  • Posterior cerebral artery
A

Posterior cerebral artery

(Visual cortex)

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33
Q

Which blood vessel supplies the part of the tract marked by the yellow arrow?

  • Anterior cerebral artery
  • Anterior median spinal artery
  • Middle cerebral artery
  • Posterior cerebral artery
  • Posterior inferior cerebellar artery
A

Anterior median spinal

(Pyramidal tract)

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34
Q

A

A

Posterior cerebral artery

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35
Q

B

A

Basilar artery

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36
Q

C

A

Anterior inferior cerebellar artery

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37
Q

D

A

Vertebral artery

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38
Q

Name 2 areas of the brain supplied by A

A

1 - Occipital lobe

2 - Inferior part of the temporal lobe

(Occipital lobe, inferolateral surface of the temporal lobe, midbrain, thalamus, choroid plexus, cerebral peduncles)

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39
Q

Describe the effects on motor and sensory function of a complete occlusion of the anterior spinal artery at the mid thoracic level.

A

Loss of motor and sensory function of the lower limb

(Paralysis of the lower limb and trunk, loss of sensation below the level of the lesion, bladder and bowel dysfunction, respiratory compromise)

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40
Q

Identify A

A

Anterior cerebral artery

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41
Q

Identify B

A

Internal carotid

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42
Q

State the expected consequence of a lesion resulting from occlusion of vessel A

A

Loss of motor and sensory function of the lower limb (presents contralaterally)

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43
Q

In the angiogram, identify vessel A name one major

CNS structure that it supplies

A

Posterior cerebral artery - occipital lobe and inferior temporal lobe

(Occipital lobe, inferior surface of the temporal lobe, midbrain, thalamus, choroid plexus, cerebral peduncles)

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44
Q

In the angiogram, identify vessel B name one major

CNS structure that it supplies

A

Basilar artery - circle of Willis

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45
Q

In the angiogram, identify vessel C name one major

CNS structure that it supplies

A

Vertebral artery - brainstem and cerebellum

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46
Q

On the cerebral angiogram identify A

A

Internal carotid artery

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47
Q

On the cerebral angiogram identify B

A

Middle cerebral artery

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48
Q

On the cerebral angiogram identify C

A

Anterior cerebral artery

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49
Q

Through which foramen does A pass to enter the skull?

A

Carotid canal

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50
Q

Which area of the cortex is supplied by C?

A

Superior and medial frontal lobe & superior and medial parietal lobe

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51
Q

With reference to the angiogram in which the vertebral artery has been filled, how does the vessel A enter the skull?

A

Foramen magnum

52
Q

With reference to the angiogram in which the vertebral artery has been filled, identify vessel B

A

Basilar artery

53
Q

With reference to the angiogram in which the vertebral artery has been filled, which blood vessel is indicated by C?

A

Posterior cerebral artery

54
Q

With reference to the angiogram in which the vertebral artery has been filled, which brain area is indicated by the letter D?

A

Occipital lobe

55
Q

With reference to the angiogram in which the vertebral artery has been filled, give one major role associated with area D

A

Visual processing

56
Q

How does vessel A enter the skull?

A

Carotid canal

57
Q

Identify vessel B

A

Anterior cerebral artery

58
Q

Name one other blood vessel arising directly from vessel A

A

Middle cerebral artery

59
Q

Which brain area is supplied by vessel B?

A

Superior and medial frontal lobe & superior and medial parietal lobe

60
Q

What functional loss might occur if vessel B became occluded?

A

Contralateral loss of motor and sensory functions of the lower limb

61
Q

What is the effect of a blockage to the left anterior cerebral artery?

A

Contralateral loss of sensory and motor function to (right) leg

62
Q

What is the effect of a blockage to the right middle cerebral artery?

A

Contralateral loss of sensory and motor function to (left) arm

63
Q

What is the effect of a blockage to the left posterior cerebral artery?

A

Loss of right hemifield vision in both eyes (contralateral homonymous hemianopsia)

(Contralateral homonymous hemianopsia = visual field deficit characterised by loss of vision in the same hall of the visual field of both eyes. The left PCA supplies the left occipital lobe, which receives visual input from the right visual field of both eyes, therefore, damage to the right PCA would result in a loss of visual function in the left hemifield of both eyes.)

64
Q

What is the effect of a blockage to the anterior spinal artery branches to the medulla?

A
  • Deviation of tongue to side of infarct when protruded
  • Contralateral limb weakness
  • Vibration sense on contralateral side

(Median medullary syndrome)

65
Q

What is the effect of a blockage to the hypothalamo-hypophysial portal veins?

A

Pickardt syndrome - hypothyroidism

66
Q

The ‘Circle of Willis’ is located in the

A

Interpeduncular cistern and enclosing the optic chiasm

67
Q

The anterior cerebral artery travels along the

A

Longitudinal fissure

68
Q

The anterior cerebral arterial follows the curvature of

A

The corpus callosum

69
Q

Occlusions of the anterior cerebral artery result in

A

Loss of contralateral lower limb sensation and motor function

70
Q

The middle cerebral artery enters the

A

Lateral fissure

71
Q

The middle cerebral artery supplies the

A

Lateral aspects of the frontal, temporal and parietal lobes

72
Q

Occlusions of the middle cerebral artery result in

A

Loss of contralateral upper limb sensation and motor function

73
Q

The superior sagittal sinus runs

A

From anterior to posterior by the inner surface of the frontal and parietal lobes

74
Q

The superior saggital sinus allows blood to drain from

A

The lateral aspects of the interior cerebral hemispheres

75
Q

The superior saggital sinus drains into

A

Transverse sinus

76
Q

The superior saggital sinus receives cerebrospinal fluid from

A

Arachnoid granulations

77
Q

Rupture of the middle meningeal artery results in

A

Epidural haemotoma

78
Q

Rupture of the middle meningeal artery is often caused by

A

Fracture at the pterion

79
Q

The vertebral artery enters through the

A

Foramen magnum

80
Q

The vertebral artery forms the

A

Basilar artery

81
Q

The vertebral artery gives off branches including

A

Anterior spinal artery and posterior inferior cerebellar artery

(Anterior spinal, posterior spinal, posterior inferior cerebellar, meningeal, medullary, basilar arteries)

82
Q

The vertebral artery is derived from

A

Subclavian artery

83
Q

The vascular structure most commonly involved in extradural haemorrhage

A

Middle meningeal artery

84
Q

Which arteries unite to form the basilar artery that then supplies blood to the brain stem?

A

Vertebral arteries

85
Q

Occlusion of a middle cerebral arteries is likely to cause

A

Loss of motor and sensory function in contralateral upper limb

86
Q

The circle of Willis is

A

An anastomotic ‘circle’ situated in the interpeduncular cistern and enclosing the optic chiasm

87
Q

The circle of Willis is composed of which vessels

A

Anterior cerebral and communicating, internal carotid (middle cerebral branches off), posterior cerebral and communicating (and Basilar)

88
Q

Vessel 1

A

Posterior cerebral artery

89
Q

Vessel 2

A

Basilar artery

90
Q

Vessel 3

A

Vertebral artery

91
Q

Through what opening does vessel 3 enter the skull?

A

Foramen magnum

92
Q

Which region of the brain would be affected by an occlusion of vessel 1?

A

Occipital lobe

93
Q

Through which opening does the vessel illustrated enter the skull?

A

Carotid canal

94
Q

The artery that supplies the medial frontal cortex

A

Anterior cerebral artery

95
Q

The pterion is found at the junction of which four bones?

A

Sphenoid (greater wing), frontal, parietal and temporal

96
Q

A skull fracture at the pterion is likely to cause

A

Epidural haematoma (extradural haemorrhage)

97
Q

Through which part of the skull does the main vessel illustrated enter?

A

Foramen magnum

98
Q

The main artery that supplies the visual cortex bordering the calcarine sulcus?

A

Posterior cerebral artery

99
Q

The artery from which the labyrinthine artery to the inner ear branches?

A

Anterior inferior cerebellar artery

100
Q

Rupture of a berry aneurysm on the posterior communicating artery will cause

A

Oculomotor nerve palsy

(Rupture leads to a subarachnoid haemorrhage; compression of the oculomotor nerve causes blown pupils - dilated, nonreactive pupil on the side of the affected nerve, in addition to ptosis, diplopia and difficulty moving the eye up, down or inward)

101
Q

Superficial cerebral veins from frontal cortex drain into

A

Superior saggital sinus

102
Q

The artery supplying the primary visual cortex

A

Calcarine branch of the posterior cerebellar

103
Q

1

A

Anterior cerebral artery

104
Q

2

A

Anterior communicating artery

105
Q

3

A

Posterior communicating artery

106
Q

4

A

Basilar artery

107
Q

5

A

Posterior cerebral artery

108
Q

6

A

Middle cerebral artery

109
Q

7

A

Internal carotid artery

110
Q

Superior saggital sinus receives

A

Cerebrospinal fluid and deoxygenated blood from the superior aspects of the brain

111
Q

Great cerebral vein receives

A

Deoxygenated blood from the medial cerebrum

112
Q

Transverse sinus receives

A

Deoxygenated blood from the superior saggital, occipital and straight sinuses

113
Q

Transverse sinus drains into

A

Sigmoid sinus

114
Q

Sigmoid sinus receives

A

Deoxygenated blood from the posterior brain and inner ear

115
Q

Cavernous sinus drains into

A

Petrosal sinus

116
Q

Internal jugular vein receives

A

Deoxygenated blood from the sigmoid sinus and petrosal sinus

117
Q

Cavernous sinus receives

A

Deoxygenated blood from the opthalmic veins, facial veins and sphenoparietal sinus

118
Q

Internal jugular vein exits via

A

Jugular foramen

119
Q

3

A

Carotid pulse point

120
Q

2

A

Facial pulse point

121
Q

1

A

Temporal pulse point

122
Q

80% of cerebral flow is delivered by

A

Internal carotid arteries

123
Q

20% of cerebral flow is delivered by

A

Vertebral arteries

124
Q

The cavernous sinus is the only place where

A

An artery (ICA) crosses a venous structure

125
Q

Supplementary blood supply for the anterior spinal artery

A

Great segmental medullary artery (artery of Adamkiewicz)

Sophie - The Nervous System - Year 2 (46 decks)

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