ARDMS Cerebrovascular

Question 1

Where does the aortic arch originate?

Answer 1

The base of the left ventricle

Question 2

Where does the innominate originate?

Answer 2

In the superior mediastinum (right side aortic arch)

Question 3

Where does the left subclavian terminate?

Answer 3

The thoracic outlet

Question 4

What are aortic arch variants?

Answer 4

Common origin innominate/LCCA, left vertebral off aorta, common origin both CCA’s

Question 5

Where does the CCA bi-furcate into the ICA/ECA?

Answer 5

The superior aspect of the thyroid cartilage (C-4 level)

Question 6

Where do the four to sixth cervical transverse processes of the RCCA lie?

Answer 6

Posteriorly

Question 7

What does the carotid bifurcation contain?

Answer 7

Many receptor endings of the glossopharyngeal nerve which responds to blood pressure changes controlling intracranial pressure

Question 8

How does the ICA lie in relation to the ECA?

Answer 8

Posterior and lateral

Question 9

What does the ICA supply blood to?

Answer 9

Anterior portion of brain / eyes with branches to the forehead and nose

Question 10

What are the four segments of the ICA?

Answer 10

Cervical, Petrous, Cavernous, and Cerebral

Question 11

Which extra-cranial portion enters the skull at the carotid canal and has no major branches?

Answer 11

Cervical segment

Question 12

Which segment ascends in the carotid canal curving to enter the cranial cavity and has no major branches?

Answer 12

Petrous segment

Question 13

Which segment contains the “S” shaped carotid siphon?

Answer 13

Cavernous segment

Question 14

What are the branches of the cavernous segment?

Answer 14

Cavernous, Meningeal, and Hypophyseal arteries

Question 15

What is another name for the cerebral segment?

Answer 15

Supraclinioid

Question 16

Which segment is the distal portion of the ICA?

Answer 16

Cerebral (supraclinoid)

Question 17

What are the branches of the cerebral segment?

Answer 17

Ophthalmic, Middle Cerebral, Anterior Choroids, Anterior Cerebral, and Posterior Communicating Arteries

Question 18

Does the ICA typically have extra-cranial branches?

Answer 18

No

Question 19

What is the first branch of the ICA?

Answer 19

Ophthalmic Artery at the level of the carotid siphon

Question 20

Where does the OA enter the orbit?

Answer 20

Optic foramen

Question 21

What are the terminal branches of the OA?

Answer 21

Frontal, Nasal, and Supraorbital Arteries

Question 22

What condition does the OA system provide?

Answer 22

Peri-orbital circulation (collateral circulation via anastomosis with ECA branches)

Question 23

Where does the ICA terminate?

Answer 23

The Circle of Willis (into the anterior and middle cerebral arteries)

Question 24

What does the ECA supply blood to?

Answer 24

Face, scalp and neck

Question 25

What are the eight branches of the ECA?

Answer 25

Superior Thyroid, Ascending Pharyngeal, Lingual, Occipital, Facial, Posterior Auricle, Maxillary and Superficial Temporal Arteries

Question 26

Which ECA branches are most vital to collateral circulation?

Answer 26

Those that communicate with the OA or vertebral artery

Question 27

Where does the vertebral artery arise?

Answer 27

Upper and back portion of the proximal subclavian

Question 28

Where does the vertebral artery enter the skull?

Answer 28

Foramen magnum

Question 29

What are the vertebral arteries relation to the subclavian artery?

Answer 29

They are the first and largest branch

Question 30

What does the vertebral artery supply blood to?

Answer 30

Posterior portion of brain

Question 31

What is unique about the anatomy of the vertebral arteries?

Answer 31

Asymmetrical in size, left is usually larger than the right

Question 32

Which four segments does the vertebral artery divide into?

Answer 32

Pre-vertebral, Cervical, Horizontal (Atlantic), and Intracranial segments

Question 33

Where does the pre-vertebral artery enter?

Answer 33

Transverse foramen of C6

Question 34

Where does the cervical segment span?

Answer 34

C6 through transverse foramen of C6

Question 35

What does the cervical segment give rise to?

Answer 35

Multiple small branches which may anastomose ECA branches for collaterals (vertebral/carotid occlusion)

Question 36

Where does the horizontal segment course?

Answer 36

Posteriorly within the vertebral sulcus, ascends anteromedially through the dura mater and loops between atlas/axis prior to entering skull

Question 37

Where does the intracranial segment course?

Answer 37

From the dura mater through the foramen magnum and joins with the contralateral vertebral artery forming the basilar artery

Question 38

What does the intracranial segment give rise to?

Answer 38

Multiple branches that supply the inferior surface of the cerebellum

Question 39

What is another term for the vertebral and basilar arteries?

Answer 39

Vertebrobasilar circulation