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Neuro Block 2 > Blood Supply > Flashcards

Blood Supply Flashcards

1
Q

What are the 4 arteries that supply blood to the brain?

where in the brain are they located?

A
  • Two internal carotid arteries
  • Two vertebral arteries

* located in the sub-arachnoid space

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2
Q

What is the Virchow-Robin space?

A

small perivascular extensions of the SAS that surround the blood vessels as they penetrate the brain.

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3
Q

From what artery will the the internal carotid come from?

From what artery will the external carotid come from?

Both, internal and external carotids will supply what structures?

from where do the vertebral arteries come from?

A

common carotid artery.

common carotid

head and neck

subclavian arteries

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4
Q

name the arteries

A
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5
Q

name the arteries of the circle of willis

A
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6
Q

The circle of Willis provides interconnection

between what 2 arteries?

A

the two carotid arteries and the two

vertebral arteries.

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7
Q

In the event of an occlusion of one (or more) of these arteries, what will happen to the overall flow of blood?

A

would not be interrupted; blood from the unaffected arteries would still flow through the circle.

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8
Q

What are the Branches of the Internal Carotid Artery?

A
  1. Anterior Cerebral Artery (ACA)
  2. Middle Cerebral Artery (MCA)
  3. Opthalmic artery
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9
Q

what are the 2 divisions of the anterior Cerebral artery?what is the extent of the supply of each of these?

A
  1. A1 = from internal carotid (ICA) to anterior communicating
  2. A2 = beyond the anterior communicating
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10
Q

what does the anterior cerebral artery supply?

A
  1. Medial surface of the cerebral hemispheres which would include ‘leg’ area of pre- and post-central gyri.
  2. deep grey structures
  3. head of caudate, anterior part of putamen and globus pallidus, anterior limb of internal capsule.
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11
Q

from where does the recurrent artery of Heubner come off from?

what structures does it supply?

A

the anterior cerebral artery

very big striate artery, supplies head of caudate, anterior part of putamen and globus pallidus, anterior limb of internal capsule.

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12
Q

what arteries can we find here

A
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13
Q

what are the extent of the 3 divisions of the MCA?

A

M1 = from ICA to Insula

M2 = supplies the insular area

M3 = supplies the lateral cortical region

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14
Q

from which division of the MCA does the lenticulostriate artery come from?

A

form M1

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15
Q

identify the divisions of the MCA

A
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16
Q

what structures will the lenticulostriate arteries supply?

A
  • Dorsal head, and whole body of caudate nucleus.
  • Parts of lentiform nucleus (globus pallidus and putamen).
  • Internal capsule (part of anterior limb along with ACA, the genu, and posterior limb along with anterior choroidal).
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17
Q

what will M2 and M3 supply?

A

supply lateral surface of hemispheres

(except the ‘leg’ part of pre- and post-central gyri)

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18
Q

what artery will the opthalmic artery give up?

what areas will this aretery supply?

what nerve will this artery go along with?

A

central retinal artery

  1. Frontal area of scalp
  2. Ethmoid and frontal sinuses
  3. Dorsum of the nose

The optic nerve

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19
Q

From where will the posterior communicating artery branch off?

what is it a part of?

what areas will the anterior choroidal artery supply?

A

the internal carotid

part of the circle of willis

  1. Choroid plexus of inferior horn of lateral ventricles, third ventricle, amygdala, hippocampal formation, posterior limb of internal capsule, LGN of thalamus, tail of the caudate.
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20
Q

identify the arteries that supply the following areas

A
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21
Q

from what structure do the vertebral arteries arise from?

how do the reach the basilar artery?

what branches does the vertebral arteries give off before joining the basilar artery?

A

the subclavian arteries

pass through the foramen magnum and travel over the medulla

  1. Posterior spinal artery
  2. Anterior spinal artery
  3. Posterior Inferior Cerebellar Artery (PICA)
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22
Q

what will the posterior spinal arteries supply?

what will the anterior spinal arteries supply?

what will the posterior inferior cerebellar artery supply?

A

posterior 1/3 of spinal cord

anterior 2/3 of spinal cord

  1. Inferior vermis
  2. Central nuclei of cerebellum
  3. Inferior side of cerebellar hemispheres.
  4. Medulla
  5. Choroid plexus of the 4th ventricle.
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23
Q

what arteries supply the rostral medulla?

A

Anterior spinal, PICA and vertebral arteries

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24
Q

what are the branches off the basilar artery?

A
  1. Labyrinthine arteries
  2. Pontine arteries
  3. Superior cerebellar artery
  4. Posterior cerebral artery
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25
Q

Labyrinthine arteries will travel with what nerves?

What other artery coudl the labyrinthine artery branch off?

Pontine arteries will supply what?

what are the pontine arteries?

what area will the superior cerebellar artery supply?

A

CN 7 and 8 towards the ear

AICA

the Pons

  1. Paramedian pontine arteries
  2. Short circumferential arteries
  3. Long circumferential arteries, including AICA
  • Superior surface of: cerebellum, pons, and pineal gland
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26
Q

Posterior cerebral artery divides into 2 parts?

what will the posterior cerebral artery supply?

A

1) cortical branches
2) central branches
3) choroidal branch
- Cortical branches supply inferolateral, and medial, surface of temporal lobe, medial and lateral branches supply
- Central branches supply internal structures, such

as thalamus, midbrain, geniculate bodies

  • choroidal branch supplies choroid plexus in lateral and third ventricles.
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27
Q

what ar the branches of the posterior cerebral artery?

A
  1. Thalamogeniculate
  2. Thalamoperforate
  3. Calcarine
  4. Quadrigeminal
  5. Medial posterior choroidal
28
Q

the Thalamogeniculate artery will supply what area?

the Thalamoperforate artery will supply what area?

the Calcarine artery will supply what area?

the Quadrigeminal artery will supply what area?

the Medial posterior choroidal artery will supply what area?

A
  • geniculate bodies of thalamus ventral lateral and ventral posterior nuclei.
  • thalamus and hypothalamus
  • supplies primary visual area
  • midbrain
  • midbrain
29
Q

What artery supplie the lower 1/3 of the spinal cord?

A

The artery of Adamkiewicz

30
Q

where are veins located in the brain?

do brain vein have valves?

the the 4 major veins of the brain?

A

in the subarachnoid space

no

  1. Superior Cerebral
  2. Superficial Middle Cerebral:
  3. Deep Middle Cerebral
  4. Great Cerebral Vein (or Great Vein of Galen)
31
Q

where is the superior cerebral vein?

where does it empty?

what area does Superficial Middle Cerebral vein drain?

where does the Superficial Middle Cerebral vein pass through?

where does the Superficial Middle Cerebral vein drain into?

A
  • Ascend upwards over lateral surface of hemispheres.
  • into superior sagittal sinus
  • Drains lateral surface of cerebral hemispheres.
  • Passes through lateral sulcus
  • empties into cavernous sinus.

*

32
Q

what is important about the deep middle cerebral vein?

where does the deep middle cerebral vein drain?

where does the Great Cerebral Vein (or Great Vein of Galen) drain?

the great cerebral vein is formed from what 2 other veins?

A
  • Along with anterior cerebral and striate veins, forms the basal vein
  • drains into the insula
  • empties into the straight sinus
  • union of thalamostriate and choroid veins
33
Q

identify the sinuses and the veins

A
34
Q

what is subclavian steal syndrome?

these patients will show difference in what?

what are these patients at risk of?

A

occlusion in one subclavian causes the other subclavian to send blood through the vertebrals in order to supply the demand when working out

in blood pressure when taken in both arms

syncope and pre-syncope symptoms

35
Q

what is the 3rd cause of death?

what is the most common cause of upper motor symptoms?

A

strokes

strokes

36
Q

what causes a stroke?

A

Results from cerebrovascular disease causing

interruption of blood flow, leading to ischemia

and infarction.

37
Q

what are the 3 types of strokes?

what are the 2 most common types of strokes

A
  1. thrombosis
  2. embolism
  3. hemmorrhage

• thombosis and embolism

38
Q

what risk factors can lead to stroke?

A
  • Hypertension
  • Hyperlipidemia
  • Smoking
  • Diabetes mellitus
  • Heart disease
39
Q

what is a silent stoke?

these occur usually in what are of the brain?

silent strokes are the leading cause of what?

A

stokes that are asymptomatic

in white matter areas

leading cause of cognitive impairment.

40
Q

what is a thrombosis?

what forms a thrombus?

When do 60% of thrombotic strokes happen?

what should we notice about symptoms of a stroke?

A
  • A blood clot in a cerebral vessel.
  • Atherosclerotic plaque damages vessel wall, leading to accumulation of fibrin and platelets. This forms the thrombus. Occludes a vessel when the Blood pressure decreases (sleep)
  • during sleep
  • neurological signs usually increase over time
41
Q

what are watershed infarcts?

A

damage occurs at the at the junctions of major arterial territorier (area shared by 2 arteries)

42
Q

what is a transient ischemic attack?

these can precede what?

A
  • Temporary neurological deficits, usually clearing within minutes to hours.
  • a thrombotic stroke
43
Q

what is an embolism?

when does it happen?

what is the most often source of an embolism?

A
  • Occlusion of an arterial vessel by a foreign substance.
  • air bubble
  • blood clot that broke off from a thrombus.
  • occur during periods of activity, and are rarely preceded by TIA.
  • Source of embolism most often the heart
44
Q

what is a hemmorrhage?

what may lead to hemmorrhage?

what symptoms indicate hemmorrhage?

A
  • Intracerebral bleeding
  • Hypertension, aneurysms, arterovenous

malformations

  • Sudden onset of neurological symptoms, almost

always associated with headache. and may cause coma

45
Q

what is a Hematoma?

A
  • localized, contained mass of extravasted blood, resulting from a hemmorhage.
46
Q

what is an aneurysm?

where do they occur most often?

when do you know you have an aneyrism?

at what rate do Aneurysms rupture?

A

loss of elasticity in the arterial wall

most common in the circle of willis

when they burst, otherwise asymptomatic

2% per year from time of discovery

47
Q

what is this?

A

bursted aneurysm

48
Q

what does angioplasty do for aneurysm?

A

increases cross-sectional diameter of arteries narrowed by atherosclerotic plaques or emboli.

49
Q

what is stenting?

A

Plaque remains pressed against vessel by using a net resulting in blood flow being maintained long after deflated balloon catheter removed

50
Q

what is arteriovenous malformation?

A

Occur when arteries and veins do not connect properly…no capillaries in between the 2

51
Q

what is this?

A

arteriovenous malformation

52
Q

what do you call small lesions that result from chronic hypertension?

The most common locations for hypertensive hemorrhage is where?

A
  • charcot-bouchard or miliary aneurysm
  • deep gray matter, specifically the putamen, thalamus, cerebellum and pons
53
Q

What actually occurs in hypertensive hemorrhage?

what type of edema do you see in hypertensive hemorrhage?

A

arteries become brittle and break when blood pressure elevates, leading to brief period of bleeding

cytotoxic edema

54
Q

what type of hemmorrhage happened here?

A

hypertensive hemmorrhage

55
Q

what is cytotoxic edema?

what is the time frame for this type of edema?

A
  • swelling of all the cellular elements of the brain due to hypoxic event caused by: Na+/K+ ATPase shuts down
  • minutes to hours
56
Q

what is vasogenic edema?

what structures does it affect?

what is the time frame of this event?

is the damage irreversible?

A
  • Results from increased extracellular fluid volume due to increased permeability of brain capillary endothelial cells to serum proteins
  • affects white matter more than gray
  • hours to days
  • yes, it is irreversible
57
Q

what is happening here?

A

edema (widened gyri)

58
Q

what is the most common cause of intracranial bleeding?

A

amyloid angiopathy

59
Q

what causes amyloid angiopathy?

what structures are mostly affected by amoyloid angiopathy?

what lobes of the brain are mostly affected?

what patient is most prevalent for amyloid angiopathy?

A
  • caused by deposition of amyloid in medium and small cortical and leptomeningeal vessels, making vessels structurally brittle and weak
  • cerebral cortex and subcortical white matter
  • frontal and parietal
  • alzheimer’s patients
60
Q

what is happening here?

A

amyloid angiopathy hemmorrhage

61
Q

what artery has to be occluded if there is damage in the upper arrow?

what artery has to be occluded if there is damage in the inferior arrow?

A

posterior spinal artery

anterior spinal artery

62
Q

what symptoms do you see if there is damage to the upper arrow?

what symptoms do you see if there is damage to the inferior arrow?

A

Loss of proprioceptive, pressure and vibration sense (because of affected dorsal columns)

Bilateral loss of pain and temperature. *Bilateral paralysis (may not always occur as CST’s may be spared).

63
Q

identify the arteries of the midbrain

A
64
Q

identify the blood supply to the pons

A
65
Q

identify which artery represents the color part of the cerebral cortex

A

Blue: anterior cerebral

Red: middle cerebral

Brown: posterior cerebral

Neuro Block 2 (7 decks)

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