Anatomical Basis of Stroke Flashcards

1
Q

what gives rise to the basilar artery?

where?

A
  • the two vertebral arteries
  • converge near inferior ponrtine sulcus to form basilar artery
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2
Q

how does the basilar artery travel?

what does it give rise to? where?

A
  • travels superiorly along the ventral midline of the pons
  • once past the superior pontine sulcus & just within interpeduncular fossa, it bifurcates caudal to the mamillary bodies to give rise to:
    1. superior cerebellar arteries (poterior / inferior)
    2. posterior cerebral arteries (anterior / superior)
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3
Q

how does the anterior inferior cerebellar arteries travel?

what vasculature do they interact with?

A
  • travel along the inferior pontine sulcus (border between pons & medulla)
  • feed into the basilar artery right as it forms
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4
Q

how do the branches of the basilar artery travel?

A

superior cerebellar, posterior cerebral

  • within the caudal-most part of the interpeduncular fossa (caudal to the mamillary bodies), both bilateral arteries extend away from the midline,
    • traveling: behind the cerebral peduncles, which are:
      • are lateral to mamillary bodies
      • the superficial / ventral - most portion of tegmentum (midbrain)
    • separated by: the oculomotor nerve
    • giving off: the ​posterior communicating artery (posterior cerebral)
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5
Q

the posterior communicating artery

  • interacts with what arteries?
  • travels how?
A
  • arises from: the posterior cerebral artery (off basilar)
  • travels: anteriorly within the interpeduncular fossa:
    • along lateral margin of fossa, immediately lateral to mammillary bodies
  • anastomoses with: the internal carotid artery
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6
Q

the internal carotid artery

  • travels how?
  • interacts with what arteries?
A
  • aries from: the carotid canal
  • travels: intracranially (superiorly) within the interpeduncular fossa,
    • just caudal to the optic chiasm
  • anastomoses with / gives off:
    • posterior communicating arteries
    • middle cerebral arteries
    • anterior cerebral arteries
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7
Q

what arteries come off of / anastamose with the internal carotid?

how do they travel?

A
  • posterior communicating (caudal connection): continues cadually along lateral interpeduncular fossa
  • middle cerebral (lateral connection): continues superiorlaterally along cortex surface
  • anterior cerebral (rostral connection): continues rostrally, connected byb anterior communicating artery
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8
Q

the anterior communicating artery

  • interacts with what arteries?
  • where?
A
  • joins the anterior cerebral arteries (off internal carotid) at the midline
  • near the caudal end of the olfactory tract
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9
Q

label

A
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10
Q

what comprises the circle of willis?

A
  • caudally: posterior cerebral arteries
  • laterally: caudal -> rostral
    • posterior communicating arteries
    • internal carotid arteries
    • anterior cerebral arteries
  • rostrally: anterior communicating arteries
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11
Q

the main supplhy to the circle of willis is from?

A
  • the internal carotid (mostly)
  • the vertebral arteries: via basilar -> posterior cerebral -> posterior communicating
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12
Q

what landmark does the oculomotor serve in with respect to the region of the circle of willis?

A

is in between the superior cerebellar arteries and posterior cereberal arteries (two bilateral branches of the basilar artery)

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13
Q

label

A
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14
Q

label

A
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15
Q

label

A
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16
Q

the anterior cerebral artery

  • interacts with what vessels?
  • travels how?
A
  • comes off: internal carotid artery
  • travels:
    • comes off rostral end of internal carotid (positioned dorsal to optic chiasm
    • passes over superior surface of optic nerve
    • travels rostrally within the longitudinal fissure
    • then, arcs caudally to continue within the midline of the frontal + parietal lobes along corpus collosum (within cingulate gyrus)
    • stops at parieto-occipital fissure
  • gives off:
    • perforating branches - enter corpus collosum
    • other branches - that extend superficially
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17
Q

the anterior cerebral artery travels in what gyrus?

A

the cingulate gyrus (i.e., along superior surface of corpus collosum)

18
Q

the anterior cerebral arteries perfuses what regions of the brain?

A
  • frontal & parietal lobes:
    • ENTIRE MEDIAL SURFACE
    • superolateral surface (i.e., superior most bits of lateral surfaces)
  • corpus collosum - except for the caudal-most end (splenium)
19
Q

the corpus collosum is perfused by

  • what portions of the anterior cerebral artery?
  • in what regions?
A
  • the perforating branches
  • every except for the splenium (caudal end)
20
Q

label

A
21
Q

what is the collosal sulcus?

what are its anatomic relations?

A
  • sulcus above the corpus collosum
  • forms the:
    • superior border of corpus collosum (except at splenium)
    • inferior border of cingulate gyrus
22
Q

what is the cingulate sulcus?

what are its anatomic relations?

A
  • sulcus above the cingulate gyrus
  • forms:
    • the superior border of the cingulate gyrus
    • marginal sulcus (at its caudal end):
      • a sulcus that extends to the superolateral surface of the brain
23
Q

the cingulate gyrus is in between what two sulci?

A
  • the cingulate gyrus (superior border)
  • the collosal gyrus (inferior border)
24
Q

what it the paracentral gyrus?

what are its anatomical relations?

A
  • a U-shaped gyrus made of the medial extensions of the precental & postcentral gyrus
    • rostral limb of paracentral gyrus = precentral gyrus (primary motor cortex)
    • caudal limb of paracentral gyrus = postcentral gyrus (somatosensory cortex)
  • anatomic relations:
    • just deep to central sulcus, which rests in divit bewteen superior tips of each limb\
    • just caudal to the superior frontal gyrus
    • just rostral to the marginal suclus
25
Q

what is the superior frontal gyrus?

what are its anatomic relations?

A
  • frontal lobe gyri whose caudal most portion makes up part of the accessory motor cortex
  • anatomic relations:
    • ​rostral: to primary motor cortices:
      • precentral gyrus
      • anterior limb of paracentral gyrus
    • medial to: the other frontal lobe gyri (middle, inferior)
    • superior to: cingulate cyrus
26
Q

what is the marginal sulcus?

what are its anatomical relations?

A
  • a parietl lobe sulcus that extends superolaterally off the caudal end of the cingulate gyrus
  • forms the:
    • caudal border of the paracentral gyri
    • rostral border of the precuneus
27
Q

what is the precuneus?

what are its anatomical relations?

A
  • a large medial surface of the parietal lobe
  • anatomic relations:
    • caudal to: marginal sulcus
    • rostral to: parieto-occipital sulcus
    • superior to: cingulate gyrus
28
Q

what is the calcarine sulcus?

what are its anatomical relations?

A
  • an occipital lobe sulcus: runs roughly horizontal sulcus along medial face
  • anatomic relations: divides medial surfaces of occipital lobe by fomring the
    • inferior (ventral) border of cuneus
    • superior (dorsal border) of the lingual gyrus
29
Q

what is the cuneus?

what are its anatomic relations?

A
  • a medial surface of the occipital lobe
  • anatomic relations:
    • caudal to parieto-occipital sulcus
    • superior (dorsal) to calcarine sulcus
30
Q

what is the lingual gyrus?

what are its anatomic relations?

A
  • a medial surface of the occipital lobe
  • inferior (ventral) to the calcarine sulcus
31
Q

CVAs of the anterior cerebral artery can lead to what major defects?

indicate that region affected in each defect.

A
  • paralysis / sensory disruption of foot & leg: paracentral gyrus (frontal & parietal lobe)
  • urinary incontinence: paracentral gyrus (frontal & parietal lobe)
  • gait apraxia: superior frontal gyrus (frontal lobe)
  • transcortical motor aphasia: antero-superior frontal lobe
  • cognitive impairment: frontal lobe
  • ideomotor apraxia: corpus collosum
32
Q

anterior cerebral CVAs can lead to what defects via damage to the paracentral gyrus?

explain.

A
  1. paralysis + sensory disruption of foot & leg:
    • d/t damage of medial portion of somatropic maps:
      • paralysis (motor): d/t damage of rostral limb (medial ext of precentral gyrus)
      • sensory (somatosensory): d/t damage of caudal limb (medial ext of postcentral gyrus)
  2. urinary incontenice: micturition > defecation
33
Q

anterior CVAs can lead to gait apraxia via damage to what region?

explain

A

superior frontal gyrus: (frontal lobe immediately rostral to precentral gyrus & rostral limb of paracentral gyrus)

34
Q

anterior CVAs can lead to transcortical motor aphasa via damage to what region?

explain.

A
  • transcortical motor aphase = difficultly with spontaneous vocalization
  • anterior superior portion of the frontal lobe
35
Q

anterior CVAs can lead to ideomotor apraxia via damage to what region?

explain.

A
  • ideomotor appraxia = inability to perform simple hand gestures (learned motor skills)
  • damage to body of corpus collosum
36
Q

what is the splenium?

what is it distinct anatomically?

A
  • caudal-most portion of corpus collosum
  • the only part of the corpus collosum that is not:
    • bordered inferiorly by the collosal sulcus
    • perfused by the anterior cerebral artery
37
Q

the posterior cerebral artery

  • travels how?
  • interacts with what other vasculature?
A
  • comes off: basilar artery (second bilateral split)
  • travel:
    • exits interpeduncular fossa (caudal to mamillary bodies) laterally
    • curves caudolaterally, curling behind the cerebral peduncles
    • then travels along the:
      • inferiormedial surface of the temporal lobe
      • inferiormedial surface of the occipital lobe
  • gives off:
    • thalamic branches - enters brainstem
    • other branches - extend along inf surface of temporal lobe
38
Q

the posterior cerebral artery perfuses what regions of the brain?

A
  • temporal lobe: entire inferior surface EXCEPT the rostral tip
  • occipital lobe: entire medial surface + part of occipital pole
39
Q

thalamic arteries

  • branch off of?
  • perfuse what?
A
  • posterior cerebral artery as curves it caudolaterally around cerebellar peduncle
  • peruses:
    • caudal thalamus
    • ventral midbrain:
      • crus cerebri
      • substantia nigra
40
Q

what is the olfactory sulcus?

what are its anatomic relations?

A
  • frontal lobe sulcus containing the olfactory tract
  • relations:
    • lateral to: the gyrus rectus
    • medial to: the orbital gyri
41
Q

what is the gyrus rectus?

what are its anatomic relations?

A
  • frontal lobe gyri
  • anatomic relations:
    • lateral to: longitudinal fissure
    • medial to: olfactory sulcus
42
Q

what is the orbital gyri?

what are its anatomic relations?

A