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Neuro > 4: CNS Blood Supply > Flashcards

4: CNS Blood Supply Flashcards

1
Q

anterior circulation pathway

A
  • Right: L ventricle → ascending aorta → brachiocephalic a → R common carotid a → R internal carotid a
  • Left: L ventricle → ascending aorta → aortic arch → L common carotid → L internal carotid
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2
Q

posterior circulation pathway

A
  • Right: L ventricle → ascending aorta → brachiocephalic → R subclavian → R vertebral
  • Left: L ventricle → ascending aorta → aortic arch → L subclavian → L vertebral
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3
Q

what is the main difference between anterior and posterior circulation?

A

anterior covers a lot more surface area than posterior

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4
Q

where can you find the anterior cerebral artery (ACA)?

A

in longitudinal fissure above corpus callosum, along the medial aspect of the frontal and parietal lobes

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5
Q

what are the 2 major branches of the ACA?

A
  • Callosomarginal artery

- Pericallosal artery

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6
Q

how much of the cortex is supplied by the middle cerebral artery (MCA)?

A

2/3

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7
Q

what are the 3 divisions of the MCA?

A
  • stem
  • superior division
  • inferior division
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8
Q

what are the lenticulostriate arteries and what structures do they supply?

A
  • arteries branching off of the stem of the MCA

- supply basal ganglia and internal capsule

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9
Q

what is significant about the lenticulostriate arteries?

A
  • When these arteries are involved in a stroke, you’ll likely see motor symptoms
  • These arteries are also very sensitive to high BP
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10
Q

what structures are supplied by the superior division of the MCA?

A

cortex above the sylvian fissure (lateral frontal and parietal lobes)

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11
Q

what structures are supplied by the inferior division of the MCA?

A

cortex below the sylvian fissure (lateral temporal and parietal lobes)

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12
Q

name all of the structures supplied by the MCA

A
  • Lateral frontal lobe
  • Lateral parietal lobe
  • Insular cortex
  • Medial and lateral temporal lobes
  • Subcortical deep structures (basal ganglia, internal capsule, limbic structures)
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13
Q

where does the anterior choroidal artery arise?

A

arises off ICA near where MCA arises

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14
Q

what structures does the anterior choroidal artery supply?

A
  • Choroid plexus of lateral ventricles
  • Optic tract
  • Deep structures of telencephalon (posterior limb of internal capsule and portions of basal ganglia)
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15
Q

strokes involving the anterior choroidal will impact what?

A

CSF

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16
Q

the circle of willis is an anastomosis b/w ____ and ____

A

ICAs and basilar artery

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17
Q

the circle of willis provides collateral blood flow b/w what 2 circulations of the brain?

A

R and L anterior and posterior circulations

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18
Q

The complete full-caliber circle of willis is only present in what percentage of people?

A

34%

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19
Q

what are the components of the circle of willis?

A
  • ACAs
  • anterior communicating artery (connects 2 ACAs)
  • posterior communicating artery (connects MCAs to PCAs)
  • PCAs
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20
Q

where does the posterior cerebral artery (PCA) come from, and where does it go?

A

arises from basilar a. and travels posteriorly to occiput

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21
Q

what are the superficial branches of the PCA and what do they supply?

A
  • anterior and posterior inferior temporal a’s
  • calcarine a’s
  • supply medial and inferior occipital lobes + inferior temporal lobes
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22
Q

what are the deep branches of the PCA and what do they supply?

A
  • tuberothalamic, thalamogeniculate, and posterior choroidal a’s
  • supply subcortical structures (midbrain, thalamus, subthalamic structures)
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23
Q

what are the 4 branches of the vertebral artery?

A
  • posterior inferior cerebellar artery (PICA)
  • anterior spinal artery
  • posterior spinal artery (branches off PICA)
  • basilar artery
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24
Q

where does the PICA come from and what does it supply?

A
  • Arises at level of medulla

- Supplies lateral medulla and inferior cerebellum

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25
Q

where can the anterior spinal a. be found and what does it supply?

A
  • supplies medial medulla and anterior 2/3 of SC

- sits in ventral median fissure of SC

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26
Q

what does the posterior spinal a. branch off of and what does it supply?

A
  • branches off PICA

- supplies dorsal medial medulla and posterior 1/3 of SC

27
Q

what are the 7 branches of the basilar artery?

A
  • anterior inferior cerebellar a. (AICA)
  • labyrinthine a. (branches off AICA)
  • pontine a’s
  • superior cerebellar a. (SCA)
  • PCA
  • paramedian a.
  • circumferential a.
28
Q

where does the AICA arise and what does it supply?

A
  • arises right after basilar a. forms at level of caudal pons
  • supplies the lateral caudal pons and cerebellum (small region)
29
Q

where does the labyrinthine a. arise and what does it supply?

A
  • branches from AICA (in some cases, it arises directly off the basilar)
  • enters the internal acoustic meatus to cochlea and vestibular apparatus
30
Q

what do the pontine arteries supply?

A

rostral lateral pons

31
Q

what is the most rostral branch of the basilar artery?

A

SCA

32
Q

what does the SCA supply?

A
  • primarily supplies cerebellum

- also supplies some of the rostral dorsolateral pons

33
Q

what do the paramedian and circumferential arteries supply?

A
  • deeper brainstem structures
  • paramedian stay close to midline
  • circumferential go more lateral
34
Q

where do the segmental radicular a’s come from and how do they enter the SC?

A
  • Branch off the ascending thoracic aorta

- Enter SC via nerve roots

35
Q

what is a notable segmenral radicular a. and what does it supply?

A
  • Great Radicular Artery of Adamkiewicz

- Major supply to lumbar and sacral SC

36
Q

The venous drainage system functions to remove what 3 things from the brain?

A
  • deoxy. blood
  • harmful materials
  • circulated CSF
37
Q

where are the dural sinuses located?

A

b/w periosteal and meningeal dural layers

38
Q

what is the main difference b/w veins and sinuses?

A

sinuses don’t have valves

39
Q

straight pathway for sinus drainage

A

Straight, superior, and inferior sinuses (falx cerebri) → confluence of sinuses (occipital lobe) → transverse sinus → sigmoid sinus → internal jugular vein

40
Q

what drains into the straight sinus?

A

great cerebral vein and inferior sagittal sinus

41
Q

cavernous pathway for sinus drainage

A

Cavernous sinus → superior and inferior petrosal sinuses → internal jugular vein

42
Q

what drains into the cavernous sinus?

A

ophthalmic veins

43
Q

the cavernous pathway is ____ than the straight pathway and it drains the ____ area of the cortex

A
  • shorter

- frontal

44
Q

name the superficial veins

A
  • superior cerebral
  • superficial middle cerebral
  • inferior cerebral
  • superior anastomotic
  • inferior anastomotic
45
Q

what do the superior cerebral v’s drain?

A

superior surface of each hemisphere

46
Q

what do the superior cerebral v’s feed into?

A

superior sagittal sinus

47
Q

what do the superficial middle cerebral v’s drain?

A

lateral surface of each hemisphere

48
Q

what do the superficial middle cerebral v’s feed into?

A

cavernous sinus

49
Q

what do the inferior cerebral v’s drain?

A

inferior aspect of each hemisphere

50
Q

what do the inferior cerebral v’s feed into?

A

cavernous and transverse sinuses

51
Q

what 2 structures does the superior anastomotic vein connect?

A

superficial middle cerebral v. to superior sagittal sinus

52
Q

what 2 structures does the inferior anastomotic vein connect?

A

superficial middle cerebral v. to transverse sinus

53
Q

name the deep veins

A
  • anterior cerebral
  • deep middle cerebral
  • subependymal
  • medullary
54
Q

what does the anterior cerebral vein drain?

A

deep middle regions of each hemisphere

55
Q

what does the anterior cerebral vein feed into?

A

transverse sinus

56
Q

what does the deep middle cerebral vein drain?

A

insular cortex and some deep lateral regions of each hemisphere

57
Q

what does the deep middle cerebral vein feed into?

A

transverse sinus

58
Q

name the subependymal veins

A
  • basal veins of Rosenthal
  • internal cerebral
  • great vein of Galen
59
Q

what do the basal veins of Rosenthal drain?

A

medial temporal lobes (parahippocampal gyrus, uncus)

60
Q

what do the basal veins of Rosenthal feed into?

A

great vein of Galen

61
Q

what do the internal cerebral veins feed into?

A

great vein of Galen

62
Q

what does the great vein of Galen drain?

A

thalamus and periventricular regions

63
Q

what does the great vein of Galen feed into?

A

sagittal and straight sinuses

Neuro (7 decks)

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