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Blood supply Flashcards

1
Q

What is affected when the Paramedian Artery of the Basilar Artery is lesioned

A

Abducens nucleus - abducts the eye

Medial lemiscus

Corticospinal/corticobulbar fibers

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2
Q

What is affected when the Short Cercumferential of the Basilar Artery is lesioned

A

Spinothalalmic

Facial Nucleus

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3
Q

What is affected when the Short Cercumferential of the Basilar Artery is lesioned

A

Spinothalalmic

Facial Nucleus

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4
Q

What is affected when the Long Cercumferential of the Basilar Artery is lesioned

A

spinal V tract and nu.

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5
Q

-hoarseness, dysphagia, and left soft palate weakness

A

Patient with lateral medullary damage.

Uvula deviates to contralateral to damaged slide.

Deviates to the Right.

Damage to the CN XII

Coud be an issue with the PICA (artery)

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6
Q

Spinal Cord Ischemia

A

Anterior Spinal Artery - small & tenuous; occlusion produces bilateral damage (below lesion effects) to:

  • Corticospinal tracts – paraplegia below lesion
  • Spinothalamic tracts – thermoanesthesia & analgesia
  • Descending autonomic tracts – loss of bladder & bowel control
  • Damage to anterior gray horns near enlargements – weakness of limb muscles
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7
Q

Middle Cerebral Artery does what

A
  • All language areas (left MCA in most people)
  • Most of primary motor & premotor cortex, frontal eye field, & primary somatosensory cortex (exceptions – lower limb & perineum)
  • Auditory cortex
    *
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8
Q

Lenticulostriate arteries are a branch of what?

Do what?

A

Middle Cerebral Artery

basal ganglia & internal capsule (all divisions)

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9
Q

Anterior Cerebral Artery does what?

A
  • Motor & Somatosensory cortex (lower limb & perineum only)
  • Corpus callosum (except for splenium)
  • Olfactory bulb & tract
  • head of caudate (ventral portion) & adjacent putamen
    • Recurrent Artery of Heubner – caudate (anteromedial portion) & internal capsule (anterior limb & genu)
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10
Q

Recurrent Artery of Heubner –

A

caudate (anteromedial portion) & internal capsule (anterior limb & genu)

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11
Q

Posterior Cerebral Artery

*

A
  • Hippocampus
  • Parahippocampal gyrus
  • Calcarine branch – all primary & some association cortex for vision
  • choroid plexus (lateral & 3rd ventricle), thalamus (posterior part), fornix, tectum
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12
Q
  1. Anterior Choroidal Artery
A
  • Hippocampus, uncus & amygdala
  • Choroid plexus (temporal horn of lateral ventricle)
  • Globus pallidus, putamen, part of thalamus
  • Internal capsule (posterior limb)
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13
Q

Subarachnoid hemorrhage - non-tramatic

A
  1. meningeal irritation from blood in the CSF; due to rupture of an aneurysm in the subarachnoid space
  2. “worst headache of my life”
  3. Saccular aneurysms:
  • Balloon-like outpouchings; neck connects parent vessel to fragile dome that can rupture
  • arise from arterial branch points
  • 85% in anterior circulation
    1. risk factors of aneurismal rupture: hypertension, cigarette smoking, alcohol consumption, sudden elevation in blood pressure
    2. affects adjacent structures e.g., pcomm arising from ICA – can cause painful 3rd nerve palsy
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14
Q
  • Traumatic Subarachnoid Hemorrhage:
A
  1. more common than spontaneous ones
  2. bleeding into CSF from vessels due to contusions [coup (i.e., side of impact) and contrecoup] and other traumatic injuries
  3. also associated with severe headache
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15
Q

Intracerebral Hemorrhage

A
  • Within the brain parenchyma or spinal cord
  • Traumatic – example: contusions of the cerebral hemispheres “ where cortical gyri abut ridges of bony skull “ thus, most common at temporal & frontal poles
  • Non-traumatic – some causes include hypertension, brain tumors, secondary hemorrhage after ischemic infarction
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16
Q

Epidural Hematoma:

A
  • between dura & the skull
  • rupture of middle meningeal artery due to fracture of the temporal bone by head trauma
17
Q

Subdural Hematoma:

A
  • Between dura & arachnoid
  • rupture of bridging veins: vulnerable to shear injury as they cross from arachnoid into dura
18
Q

Ischemic Stroke -* *Embolic infarct

A

​

  • a piece of material formed in one place (such as a blood clot) and travels through bloodstream
  • lodges suddenly into a blood vessel supplying the brain and occludes it
  • large-vessel infarcts are most often caused by emboli
  • Examples, aside from thrombotic material, include air emboli (deep sea divers) and fat or cholesterol emboli.
  • prevention of future strokes – important to determine the source of the embolus, such as the heart “
19
Q

Cardioembolic infarcts:

A

atrial fibrillation

myocardial infarction

valvular disease

20
Q

Thrombotic infarct

A
  • Blood clot formed locally, usually at the site of an underlying atherosclerotic plaque.
  • Causes occlusion of the vessel
21
Q

Acute stroke treatment

A

Once a CT rules out hemorrhage, many patients get treated with thrombolytic agents, such as tissue plasminogen activator (t-PA). If given within _3 hours_ of stroke onset, chances improve for a good functional recovery.

22
Q

Lacunar Infarcts:

A
  • Refers to small vessel infarcts
  • Often caused by chronic hypertension
  • Lacunar syndromes include thalamic lacunes (can cause contralateral somatosensory deficits) and basal ganglia lacunes (can cause movement disorders such as hemibalismus – unilateral flinging movements of the extremities contralateral to the lesion)
23
Q

Lacunar syndromes

A
  • thalamic lacunes (can cause contralateral somatosensory deficits)
  • basal ganglia lacunes (can cause movement disorders such as hemibalismus – unilateral flinging movements of the extremities contralateral to the lesion)
24
Q

Transient Ischemic Attack (TIA):

*

A
  • neurologic deficit
  • caused by temporary brain ischemia
  • lasts < 24 hrs (typically about 10 min)
  • important warning sign for a larger ischemic injury
  • possible mechanism – embolus temporarily occludes vessel but then dissolves
25
Q

Watershed Infarcts:

A
  • regions between adjacent cerebral arteries – watershed zones
  • these zones are most susceptible to ischemia & infarction when blood supply to two adjacent cerebral arteries is compromised
  • ACA-MCA watershed infarcts can occur due to a sudden occlusion of the internal carotid
26
Q
  • Uncal herniation – clinical triad
A
  • “blown pupil”: compression of CNIII
  • hemiplegia: compression of cerebral peduncles
  • coma: distortion of midbrain reticular formation
27
Q

What is the artery supply of the Midbrain

A

SCA and Proximal PCA

Paramedian Branches at the Top of the Basilar Artery

28
Q

What is the Arterial supply of the Rostral Pons

A

Superior Cerebellar Artery

Basilar Artery

-Paramedian Branches

Circomfrential branches

29
Q

Blood supply of the Caudal Pons

A

AICA

Basilar Artery

-Lateral Pontine arteries

30
Q

Blood supply of the rostral Medulla

A

Vertebral Artery

-Paramedian Branches

PICA

Nuro (9 decks)

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