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OFS3 > arterial vascular supply to the brain > Flashcards

arterial vascular supply to the brain Flashcards

1
Q

arterial supply to the BRAIN (and cervical spinal cord) is derived from two pairs of vessels, what are they called?

A

INTERNAL CAROTID SYSTEM

VERTEBRO-BASILAR SYSTEM.

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2
Q

what is the circle of Willis?

A

Polygon shaped structure

anastomosis* between vertebral system + carotid system

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3
Q

what is the role of the circle of Willis?

A

works as a compensatory circle when occlusions of main branches of carotid or vertebral systems occur.

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4
Q

what is the trajectory of the internal carotid artery?

A

enters the brain through carotic foramen
traverses petrous temporal bone
passes through the cavernous sinus
reaches subarachnoid space at the base of the brain.

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5
Q

what are the main branches of the internal carotid artery? (5)

A 
anterior cerebral artery.
middle cerebral artery,
ophthalmic artery,
anterior choroidal artery,
posterior communicating artery,
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6
Q

where does the ophthalmic artery arise and originate from?

A

arises medially to anterior clinoid process as internal carotid artery exits cavernous sinus (C1)
originates from Antero- or superomedial surface of ICA

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7
Q

what is the course of the ophthalmic artery and what does is vascularize?

A

travels along the optic nerve to orbit cavity where it supplies the ocular bulb.

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8
Q

where does the anterior choroidal artery originate from?

A

originates from posterior wall of ICA just after the origin of posterior communicating artery (PCOM).

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9
Q

the Anterior choroidal artery can be divided into 2 segments, what are they called?

A

cisternal segment

intraventricular segment

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10
Q

what is the course of the cisternal segment of the anterior choroidal artery?

A

extends from its origin until choroidal fissure

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11
Q

what is the course of the intraventricular segment of the anterior choroidal artery?

A

after entering the choroidal fissure

runs along Optic tract

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12
Q

what does the intraventricular segment of the anterior choroidal artery vascularize?

A

provides vascularization to
• Choroid plexus of the inferior horn
• Cerebral peduncle (part)
• Internal capsule –Thalamus - hippocampus

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13
Q

what is the anterior cerebral artery?

A

smaller of the 2 terminal branches of CA

enters longitudinal fissure to supply medial + paramedian portions of frontal + parietal lobes.

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14
Q

how are the anterior cerebral arteries of the 2 sides connected?

A

a.c.a. of the 2 sides are connected through anterior communicating artery.

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15
Q

ACA is divided into 3 segments, what are they called?

A

A1 (horizontal)
A2 (vertical)
A3 (callosal)

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16
Q

What are the 2 main branching patters of the ACA?

A

A2 gives off callosomarginal artery (in cingulate sulcus) –>continues as pericallosal artery
In this configuration terminal (cortical) branches give off callosomarginal artery.

callosomarginal is absent
terminal branches arise directly from pericallosal.

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17
Q

What do the superficial branches of the ACA vascularize?

A

vascularize cerebral cortex

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18
Q

What are the 3 deep branches of the ACA?

A

A1: medial lenticulostriate artery;
A2: artery of Heubner ; orbitofrontal artery; frontopolar artery
A3: pericallosal artery; callososeptal artery

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19
Q

What is the Artery of Heubner?

A

• Artery of heubner: provides blood supply to head of caudate nucleus to anterior limb of internal capsule.

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20
Q

What is the course of the artery of Heubner?

A

Originates front a proximal portion of A2 segment of anterior cerebral artery –> turns backwards –> runs parallel to A1 segment

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21
Q

Where is the middle cerebral artery?

A

in floor of lateral fissure

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22
Q

What does the middle cerebral artery irrigate?

A

provides blood supply to most of lateral surface of cerebral hemisphere.

With its superficial branches provides arterial blood supply to lateral surface of frontal parietal lobe + superior lateral portion of temporal lobe + insular region

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23
Q

The middle cerebral artery is divided into 4 parts, what are their names?

A

M1 segment, horizontal,
M2 segment, insular,
M3 segment, opercular
M4 segment, cortical,

24
Q

What is the course of the M1 horizontal segment of the middle cerebral artery ?

A

from internal carotid artery to lateral fissure (bi/trifurcation) (sphenoidal segment)


25
Q

What is the M2 insular segment of the middle cerebral artery ?

A

designates branches located inside Sylvian fissure (to top of Sylvian fissure)

26
Q

Where are the branches of the M3 opercular segment of the iddle cerebral artery located?

A

branches located between top of Sylvian fissure + cerebral cortex


27
Q

What is the M4 cortical segment of the middle cerebral artery?

A

M4 segment, cortical, refers to arterial branches on surface of cerebral cortex.

28
Q

The middle cerebral artery has 2 types of branches. What are they called?

A

o cortical branches

o deep penetrating branches (lateral lenticulo-striate arteries)

29
Q

What do the deep penetrating branches (lateral lenticulo-striate arteries) of the middle cerebral artery suuply?

A

supply superior part of head and body of caudate nucleus, most of globus pallidus + putamen, deep structures of diencephalon + telencephalon (basal ganglia)

30
Q

What is the course of the deep penetrating branches (lateral lenticulo-striate arteries)?

A

Originate from proximal portion of MCA
Run perpendicular to main course of M1 portion of MCA
Also arise from all arteries around base of the brain (perforating or ganglionic branches).

31
Q

What is the specificity of the deep penetrating branches (lateral lenticulo-striate arteries)?

A

vulnerable to increase of BP–>rupture–>hemorages

32
Q

What is the Posterior communicating artery?

A

The lateral side of the circle of Willis

33
Q

What does the Posterior communicating artery form?

A

Bridges between internal carotid artery + the 2 posterior cerebral (terminal branches of basilar artery: fusion of the 2 vertebral arteries along the mideline)

34
Q

What is the course of the basilar artery?

A

travels in median groove on ventral surface of pons, ends at midbrain–>divides into posterior cerebral arteries.

When travels along pons–>supplies multiple vessels that penetrate pons as paramedian, short circumferential, long circumferential arteries.

35
Q

What are the 2 types of branches given off by the basilar artery?

A

anterior inferior cerebellar arteries (AICA)

superior cerebellar arteries

36
Q

What are the anterior inferior cerebellar arteries? (AICA)

A

Symmetrical large branches arising at middle of basilar artery
(anterior portion of inferior surface of cerebellum + Caudal pons).

37
Q

What are the superior cerebellar arteries?

A

large paired vessels arising proximal to termination of basilar artery (superior portion of cerebellum, Rostral pons, midbrain)

38
Q

What is the vascular territory of the basilar artery?

A

Pontine arteries arise from basilar arteries to pons. One of them: labyrithin artery –> provides blood supply to inner ear

39
Q

Where do radicular arteries originate from and what is their course?

A

originating from segmental arteries at various levels –> divide into anterior + posterior radicular arteries as they move along ventral + dorsal roots to reach spinal cord –> reinforce spinal arteries –> anastomose with their branches

40
Q

What are the Posterior cerebral arteries: (PCA) and what do they irrigate?

A

terminal branches of basilar artery + supply occipital lobes + posteromedial temporal lobes + §(Also midbrain + posterior diencephalon)

41
Q

How many segments are the Posterior cerebral arteries: (PCA) divided into?

A

4

42
Q

What is the 1st segment of the Posterior cerebral arteries: (PCA)?

A

P1: from origin at termination of basilar artery to posterior communicating artery (PCOM), within interpeduncular cistern.

43
Q

What is the 2nd segment of the Posterior cerebral arteries: (PCA)?

A

P2: from PCOM around mid-brain, divided into P2A (anterior) + P2P (posterior) sub-segments. P2A is within crural cistern which then bridges to P2P segment in ambient cistern (thus ambient segment)

44
Q

What is the 3rd segment of the Posterior cerebral arteries: (PCA)?

A

quadrigeminal segment (segment with quadrigeminal cistern)

45
Q

What is the 4th segment of the Posterior cerebral arteries: (PCA)?

A

cortical segment (e.g. calcarine artery, within calcarine fissure)

46
Q

What are other arteries that irrigate the brain?

A

Posterior choroidal arteries, Choroid plexus of the third ventricle, Body of the lateral ventricle

47
Q

What is an aneurysm?

A

balloon-like bulge/weakening of artery wall –> enlarges –> puts pressure on surrounding structures (causing headache/vision problems) –> may eventually rupture –> releases blood into spaces around brain –>called subarachnoid haemorrhage .

48
Q

What are Symptoms of unruptured aneurysm?

A

Compression of neighbouring structures

49
Q

What are Symptoms of ruptured aneurysm/subarachnoid hemorrhage (SAH)?

A

sudden onset of severe headache (“the worst headache of my life”), nausea, vomiting, stiff neck.

50
Q

What is an Ischemic stroke?

A

interruption of blood flow to brain due to blood clot –> presence of plaque in vessels’ walls (fatty materials, calcium, scar tissue) –> narrowing of arteries that supply blood to brain –> interfering with or blocking flow of blood.

51
Q

What are the 2 types of ischemic stroke?

A

thrombotic stroke: caused by blood clot forming in artery directly leading to brain.

embolic stroke: clot develops somewhere else in body –> travels through blood stream to brain.

52
Q

What is an Intracerebral hemorrhage (ICH)?

A

High blood pressure (hypertension)
rupture of lenticulo-striate arteries (very thin)
releasing blood into brain tissue
blood collects + forms a clot (hematoma)
grows + causes pressure on surrounding brain tissue
intracranial hypertension
area that artery supplied now deprived of oxygen-rich blood
stroke.

53
Q

What does each vertebral artery give rise to before joining basilar artery?

A

Posterior spinal artery
Anterior spinal artery
Posterior inferior cerebellar artery (PICA)

54
Q

What is the course of PICA (posterior inferior cerebellar artery)?

A

Arises at inferior border of inferior olive –> runs behind rootlets of IX + X CNs –> descends along lateral side of 4th ventricle.

55
Q

What does PICA supply?

A

supplies most of inferior portion of cerebellum (inferior surface), choroid plexus of 4th ventricle, lateral medulla.

OFS3 (15 decks)

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