**_🧠Neurology🧠 - Cerebral Vasculature Flashcards

1
Q

What are the perfusion demands of the brain?

A

10-20% of cardiac output
20% of total body oxygen consumption
66% of liver glucos

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2
Q

What do the perfusion demands leave the brain very vulnerable to?

A

Extremely vulnerable to any impairment of blood supply

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3
Q

What major vessels supply blood to the brain?

A

Vertebral artery
Common carotid artery - splits into internal and external

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4
Q

Name these 3 vessels

A
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5
Q

Names these 3 vessels

A
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6
Q

Name these 2 vessels

A
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7
Q

Outline the venous drainage of the brain

A

Cerebral veins -> venous sinuses in the dura mater -> internal jugular veins -> brachiocephalic vein -> superior vena cava

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8
Q

Name these 3 structures

A
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9
Q

Name these 3 structures

A
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10
Q

Name these 3 structures

A
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11
Q

Name these 2 structures

A
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12
Q

What layer sits immediately deep to the skull?

A

Dura mater

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13
Q

What are the two layers of the dura mater?

A

Periosteal and meningeal

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14
Q

Which layer of the dura mater forms structures?

A

Only the meningeal dura mater folds inwards to form structures, such as the falx cerebri and tentorium cerebelli
Periosteal dura mater stays tightly adhered to the skull

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15
Q

Where do venous sinuses form?

A

Form in gaps between the two layers of the dura mater

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16
Q

What are the different types of cranial haemorrhage?

A

Extradural (aka epidural) - skull has no naturally-occurring epidural space, spine does
Subdural
Subarachnoid
Intracerebral

17
Q

Outline an extradural haemorrhage

A

Haemorrhage occurs outside the dura
Arterial blood, high pressure (pressure cant escape down the foramen magnum) that can kill quickly
Usually trauma
Immediate clinical effects

18
Q

Outline a subdural haemorrhage

A

Haemorrhage occurs within/below dura
Venous blood, lower pressure initially, but can build over time
Usually trauma
Clinical effects can be delayed, but if left can be just as fatal as epidural

19
Q

Outline a subarachnoid haemorrhage

A

Haemorrhage occurs usually in the base of the brain - circle of Willis
Ruptured aneurysm
Almost always fatal

20
Q

Outline an intracerebral haemorrhage

A

Haemorrhage occurs with cerebral hemispheres
Spontaneous, usually do to hypertensive conditions
Poor prognosis

21
Q

What is a stroke?

A

Cerebrovascular accident (CVA)
“rapidly developing focal disturbance of brain function of presumed vascular origin and of >24 hours duration”
Thrombo-embolic (85%) or haemorrhage (15%)

22
Q

What is a thrombo-embolic stroke?

A

A blood clot (thrombus) breaks free and travels through the blood stream as an embolus
Reaches the cerebrum, restricting blood flow and causing an ischaemic event

23
Q

What is a transient ischaemic attack?

A

a TIA is rapidly developing focal disturbance of brain function of presumed vascular origin that resolves completely within 24 hours

24
Q

Why should a TIA never go ignored?

A

Is a sign that someone is at significantly higher risk of developing a cerebral ischaemia, such as a stroke

25
Q

What is an infarction?

A

Degenerative changes which occur in tissue (such as cell damage and/or death) following the occlusion of an artery and therefore restriction of blood supply

26
Q

What is a cerebral ischaemia?

A

Lack of sufficient blood supply to nervous tissue resulting in permanent damage if blood flow is not restored quickly

27
Q

What is an embolism?

A

Plugging of small vessel by material carried from larger vessel e.g. thrombi from the heart or atherosclerotic debris from the internal carotid

28
Q

What statistics about strokes outline its importance as a public health issue?

A

3rd commonest cause of death
100,000 deaths in UK per annum
50% of survivors are permanently disabled
70% show an obvious neurological deficit

29
Q

What is the pneumonic for action when a stroke arises?

A

F.A.S.T
Face - face fallen on one side, unable to smile
Arms - can they raise both arms and keep them there
Speech - is their speech slurring?
Time - faster response means a better prognosis

30
Q

What are the risk factors for stroke?

A

Age
Hypertension
Cardiac disease
Smoking
Diabetes mellitus

31
Q

Label the cerebral artery perfusion fields

A
32
Q

Label the cerebral artery perfusion fields

A
33
Q

What are the symptoms of an anterior cerebral artery occlusion?

A

Paralysis of contralateral structures (leg>arm, face)
Disturbance of intellect, executive function and judgement (abulia)
Loss of appropriate social behaviour

34
Q

What are the symptoms of middle cerebral artery occlusion?

A

“Classic stroke”
Contralateral hemiplegia (arm>leg)
Contralateral hemisensory deficits
Hemianopia
Aphasia (if lesion is on L side)

35
Q

What are the symptoms of posterior cerebral artery occlusion?

A

Visual defects:
-Homonymous hemianopia
-Visual agnosia

36
Q
A