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Semester 4 - Clinical Neuroscience > 6. The blood supply to the brain > Flashcards

6. The blood supply to the brain Flashcards

1
Q

what are the two sets of circulation to the brain?

A

anterior circulation and posterior circulation

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2
Q

Which areas do the anterior and posterior circulation supply?

A

o The anterior circulation supplies most of the cerebral hemispheres
o The posterior circulation supplies the brainstem, cerebellum, some of the temporal lobe and the occipital lobe

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3
Q

which two sources does the brain receive arterial blood from?

A

o The anterior circulation is fed by the internal carotid arteries
o The posterior circulation is fed by the vertebral arteries

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4
Q

which two arteries are part of the anterior circulation?

A

o anterior cerebral artery

o posterior cerebral artery

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5
Q

What are the branches of the internal carotid artery?

A

Ophthalmic artery, anterior cerebral artery, middle cerebral artery, posterior communicating artery, (anterior choroidal artery)

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6
Q

What is the main contributor to the anterior circulation?

A

Middle cerebral artery

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7
Q

what is the MCA a direct continuation of ?

A

internal carotid artery

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8
Q

what do the cortical branches of the MCA supply?

A

Cortical branches emerge from the lateral fissure to supply the lateral aspect of the cerebral hemisphere (cortex and underlying white matter), including lateral parts of the frontal and parietal lobes as well as the superior temporal lobe

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9
Q

what do the deep branches of the MCA supply?

A

Deep branches (the lenticulostriate arteries) supply deep grey matter structures including the lentiform nucleus and caudate as well as the internal capsule

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10
Q

describe the areas that the ACA supply

A

 The left and right anterior cerebral arteries anastomose in the midline via the anterior communicating artery
 The vessels loop over the corpus callosum and send branches to the adjacent cortex
 Cortical branches supply the medial aspect of the frontal and parietal lobes (not the occipital lobe)
 There are also branches to the corpus callosum itself

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11
Q

in stroked involving the ACA, which part of the body is more affected and why?

A

Lower half of body as represented more medially on the hemisphere

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12
Q

What connects the anterior cerebral arteries?

A

anterior communicating artery

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13
Q

What connects the anterior and posterior circulations (MCA and PCA)?

A

Posterior communicating artery

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14
Q

What communication do the anterior and posterior circulations form?

A

Circle of willis

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15
Q

What sits at the centre of the circle of willis?

A

Pituitary gland, optic chiasm

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16
Q

which two arteries are a main part of the posterior circulation?

A

o Basilar artery

o The vertebral arteries

17
Q

what forms the basilar artery?

A

Midline vessel formed from the confluence of the vertebral arteries

18
Q

what are 4 main branches of the basilar artery?

A
  • Terminal bifurcation gives rise to the posterior cerebral artery
  • Superior cerebellar artery\
  • Pontine arteries
  • Anterior inferior cerebellar artery
19
Q

what do the posterior cerebral arteries supply?

A

o Supplies occipital lobe, inferior temporal lobe and
thalamus (via thalamoperforator and thalamogeniculate branches)
o Also supplies midbrain en passant

20
Q

what branches form the PCA to connect it to the anterior circulation?

A

Posterior communicating arteries

21
Q

what do the Superior cerebellar artery supply?

A

the superior aspect of the cerebellum and midbrain en passant

22
Q

what do the pontine arteries supply?

A

The pons (including descending corticospinal fibres)

23
Q

what do the Anterior inferior cerebellar artery supply>

A

the antero- inferior aspect of the cerebellum and lateral pons en passant

24
Q

What can damage to the pontine arteries lead to?

A

Locked-in syndrome - patients are conscious and only able to move their eyes

25
Q

what are the two main branches of the vertebral arteries?

A

o Anterior spinal arteries

o Posterior inferior cerebellar arteries

26
Q

what do the anterior spinal arteries supply?

A

converge in the midline to supply the anterior 2/3 of the spinal cord

27
Q

what do the posterior inferior cerebellar arteries supply?

A

the postero-inferior aspect of the cerebellum en passant

28
Q

What is the supply to the cerebellum and where do these vessels originate?

A

From basilar artery:

  • Superior cerebellar arteries
  • Anterior inferior cerebellar arteries

From vertebral arteries:
- Posterior inferior cerebellar arteries

29
Q

Which vessel in the circle of willis is most commonly affected by aneurysms?

A

Anterior communicating artery - possible effects by compression on optic chiasm

30
Q

Where does the anterior spinal artery form

A

Unpaired artery formed from branches of the vertebral artery at the region of the medulla -

31
Q

What region of the brain does the anterior, middle and posterior cerebral artery supply?

A
  • Anterior: anteromedial portion of the cerebrum
  • Middle: situated laterally, supplying the majority of the lateral part of the brain
  • Posterior: supply both the medial and lateral parts of the posterior cerebrum (including the lateral inferior temporal lobe)
32
Q

What are the main branches of the middle cerebral artery?

A
  • lenticulostriate arteries
  • MCA superior division
  • MCA inferior division
33
Q

What do the lenticulostriate arteries supply?

A

basal ganglia and internal capsule

34
Q

what is the difference in symptoms If internal capsule or thalamus affected in stroke?

A

internal capsule - motor affected due to affect on descending corticospinal tracts
thalamus - sensory

35
Q

What might occlusion of the PCA lead to?

A

Contralateral
- visual impairment (pattern of supply of the PCA)
- somatosensory impairment (due to reduced blood flow to thalamus from branches supplying it from the PCA)
etc.

36
Q

What might occlusion of the ACA lead to?

A

Contralateral
- Paralysis or weakness of the foot and leg on the opposite side, due to involvement of leg part of the motor cortex
- Cortical sensory loss in the opposite foot and leg
etc.

37
Q

What might occlusion of the MCA lead to?

A

Contralateral

  • Paralysis (-plegia) or weakness (-paresis) of the contralateral face and arm (faciobrachial)
  • Sensory loss of the contralateral face and arm.
  • Damage to the dominant hemisphere (usually the left hemisphere) results in aphasia i.e. Broca’s area or Wernicke’s
38
Q

which arteries supply the spinal cord and which areas/.

A

posterior spinal artery - supply dorsal horn and dorsal column

anterior spinal artery - supply ventral horn of grey matter and cortiscospinal tract and spinothalamic tract

39
Q

What are the symptoms if ASA blockage?

A

bilateral loss of spinothalamic modalities below blockage and upper motor neurone signs due to interruption of CST

Semester 4 - Clinical Neuroscience (19 decks)

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