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COM Neuroendocrine > Blood Supply, Hemorrhage and Herniation of the Brain > Flashcards

Blood Supply, Hemorrhage and Herniation of the Brain Flashcards

1
Q

Border zones

A

Area between arteries

Susceptible to damage under conditions of sudden systemic hypotension or hypoperfusion

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2
Q

Anterior cerebral artery

A

Supplies most of the medial and superior surface of the frontal and parietal lobes

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3
Q

Middle cerebral artery

A

Supplies lateral surface of frontal and parietal lobes and the superior part of temporal lobe

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4
Q

Posterior cerebral artery

A

Supplies the occipital lobe and the inferior parietal lobe

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5
Q

Segments of anterior cerebral artery

A

A1- precommunicating segment- ICA to anterior communicating artery
A2- infracallosal segment- anterior communicating artery to where rostrum and genu of corpus callosum meet
A3- precallosal segment- arches around the genu of corpus callosum, ends when vessels turn caudal
A4- supracallosal- superior to corpus callosum
A5- postcallosal- caudal to corpus callosum

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6
Q

Segments of middle cerebral artery

A

M1- sphenoidal or horizontal- ICA to the bifurcation at insula
M2- insular- bifurcation at insula to circular sulcus of insula
M3- opercular- circular sulcus of insula to external surface of lateral fissure
M4- cortical- on the cortex

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7
Q

Segments of posterior cerebral artery

A

P1- basilar bifurcation to posterior communicating artery
P2- posterior communicating artery to around the midbrain
P3- quadrigeminal- segment within the quadrigeminal cistern
P4- cortical segment

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8
Q

Parts of the internal carotid artery

A

Cervical- bifurcation to carotid canal, anterior to transverse processes of upper 3 vertebrae
Petrous- carotid canal in petrous part of temporal, upward and medially above foramen lacerum
Cavernous- in the cavernous sinus, surround by sympathetic plexus, CN III, IV, VI and V1
Cerebral part

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9
Q

Vertebral artery parts

A

Cervical- transverse foramina of first 6 cervical vertebrae
Atlantic- perforates the dura and arachnoid, pass through foramen magnum
Intracranial- in the cranium, unite at the caudal border of pons to form basilar artery

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10
Q

Cranial nerves association to arteries CN II, III and VI

A

CN II is near ICA, anterior cerebral and anterior communicating artery
CN III is near posterior cerebral a, superior cerebellar a, and posterior communicating a
CN VI is near labyrinthine and AICA

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11
Q

Circle of willis

A 
A ring of 9 arteries supplying blood to the cerebral hemispheres
2 anterior cerebral a.
2 internal carotid a.
2 posterior cerebral a.
Anterior communicating artery
2 posterior communicating a.
Located in the subarachnoid space
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12
Q

Intracerebral (subpial) hemorrhage

A

Bleeding within brain substance (stroke)
Complication in 2-3% of all head injuries
Source is usually middle cerebral artery
Hypertension or degenerative artery disease is commonly found at autopsy

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13
Q

Causes of herniation syndromes

A 
Hemorrhage
Mass/tumor
Trauma
Abscess
Infection
Metabolic conditions
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14
Q

Divisions of herniation syndromes

A

Supratentorial compartment- above the tentorium and divided into right/left by falx cerebri
Infratentorial compartment- below tentorium cerebelli
Tentorial notch- continuation of the supra and infratentorial compartment

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15
Q

Subfalcine herniation

A

Also called a cingulate or falcine or falx herniation
Supratentorial compartment has mass/lesion- displaces brain tissue under the falx cerebri
May compress the ACA- frontal/parietal lobes affected
May evolve into a transtentorial herniation

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16
Q

Transtentorial herniation

A

Also called central herniation
Brain displaced downward toward tentorial notch
Comprises the upper brainstem, CN III and possibly even lower structures. May compress basilar artery and posterior cerebral arteries
Decorticate rigidity
Decerebrate rigidity

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17
Q

Uncal herniation

A

Uncus and frequently portions of the parahippocampal gyrus are extruded over the edge of tentorium cerebelli and through the tentorial notch

  • Impinge on midbrain
  • Can damage cerebral peduncle & oculomotor nerve and cause motor deficits on opposite side of body
18
Q

Tonsillar herniation

A

Cerebellar tonsil through foramen magnum

Compression of the medulla and upper cervical spinal cord

19
Q

Vertebrobasilar insufficiency

A

Reduced blood flow to brain from vertebral arteries

Can be caused by extreme hyperextension of the head or extreme head rotation

20
Q

Subclavian steel syndrome

A

Occlusion of subclavian artery proximal to the vertebral artery. Blood is stolen from vertebral circulation to supply upper limbs

21
Q

Trigeminal nerve is by which arteries

A

Superior cerebellar artery

22
Q

Facial nerve is by which arteries

A

Anterior inferior cerebellar artery

23
Q

Damage to border zone b/w anterior cerebral and middle cerebral arteries will cause what

A

Motor, sensory deficits
Language issues
Behavioral problems

24
Q

Damage to posterior border zone b/w posterior cerebral and middle cerebral artery will cause what

A

Visual and language problems

25
Q

What artery since right up against corpus callosum

A

Pericallosal artery

26
Q

What artery is around cingulate gyrus

A

Callosomarginal artery

27
Q

Anterior spinal artery supplies what

A

Medial aspect of medulla

28
Q

Posterior inferior cerebellar artery PICA supplies what

A 
Lateral aspect of medulla
Medial/inferior vestibular nucleus
Accessory cuneate nucleus
Solitary tract/nucleus
Dorsal motor nucleus of vagus (autonomics)
Spinal trigeminal tract/nucleus
Rubrospinal tract
ALS
Nucleus ambiguous (motor tract)
29
Q

Anterior inferior cerebellar artery supplies what

A

Cochlear nuclei (CNVIII)

30
Q

Posterior spinal artery supplies what

A

Dorsal aspect of medulla

31
Q

What arteries branch off anterior spinal artery to supply medulla and what do they supply

A

Sulcal arteries
Pyramid (motor) tract
Medial lemniscus (sensory tract)
Hypoglossal nucleus

32
Q

Blood supply to pons is via

A

Branches off basilar artery and superior cerebellar artery in more rostral regions

33
Q

Blood supply to midbrain is via

A

Posterior cerebral artery branches

34
Q

P1 anteromedial segment of PCA supplies

A 
Medial portion of midbrain
Oculomotor nucleus
Medial longitudinal nucleus
Substantia niagra
Red nucleus
Parts of oculomotor nerve
35
Q

Thalamogeniculate branches of P2 supply what

A

Lateral and medial geniculate nuclei in forebrain

36
Q

Lenticulostriate arteries supply what and is a branch off what artery

A

Internal capsule

Branch of middle cerebral artery

37
Q

Epidural hematoma information

A

Bleeds into potential space of skull and dura
Common site: pterion or squamous temporal bone
Source: middle meningeal artery
Clinical- momentary unconsciousness followed by lucidness for a few hours to 1-2 days then unconsciousness

38
Q

Subdural hematoma information

A

B/w dura and arachnoid
Seen when head strikes a fixed object
Venous source of bleeding- usually cortical veins opening into superior sagittal sinus
Clinical- slower accumulation of blood due to pressure and often self limiting
Lumbar puncture can cause subdural hematoma

39
Q

Kernohan phenomenon

A

Variation of uncle herniation that shifts the midbrain
Still hits oculomotor nerve on same side but compresses cerebral peduncle on OPPOSITE side, giving motor deficits on the same side

40
Q

Long circumferential branches of basilar artery supply

A 
Lateral, superolateral pons
Facial nerve, facial motor nucleus
Spinal trigeminal tract/nucleus
Mesencephalic nucleus/tract
ALS
41
Q

Paramedian branches of basilar artery supply

A 
Medial pons
Corticospinal fibers
Medial lemniscus
Abducens nerve/nucleus
Medial longitudinal fasciculus

COM Neuroendocrine (46 decks)

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