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NeuroEndo Exam 2 > Blood Supply & Hemorrhage (Stephens) > Flashcards

Blood Supply & Hemorrhage (Stephens) Flashcards

1
Q

Course of Cerebral Arteries

A

ICA & VA pierce the dura and course in the subarachnoid space along with their branches. These branches penetrate into the brain parenchyma and as they do are surrounded by the tapered perivascular space (Virchow-Robbin) and the pia mater or BBB.

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2
Q

What are the primary blood supply to the brain

A

Internal Carotid (80%) - anterior circulation

Vertebrabasilar Arteries (20%) - posterior circulation

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3
Q

Branches of Internal Carotid Artery

A
  1. Opthalmic Artery
  2. Posterior Communicating Artery (PCoA)
  3. Anterior Cerebral Artery (ACA)
  4. Anterior Communicating Artery (ACoA)
  5. Middle Cerebral Artery (MCA)
  6. Anterior Choroidal Artery
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4
Q

Branches of Vertebral Arteries

A

Posterior Inferior Cerebral Artery (PICA)

Anterior Spinal Arteries

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5
Q

Branches of Basilar Artery

A

Anterior Inferior Cerebellar Artery (AICA)

Superior Cerebellar Artery

Posterior Cerebral Artery

Pontine Arteries

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6
Q

Anterior Cerebral A.

Branches of?

Supplies what?

A

Branch of ICA

Supplies anteromedial aspect of cerebral hemisphere back to parietal lobe

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7
Q

Middle Cerebral A.

Branches of?

Supplies what?

A

ICA

Supplies lateral aspect of cerebral hemisphere (except superior front/parietal & inferior temporal lobes)

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8
Q

Posterior Inferior Cerebellar Artery (PICA)

Branches of?

Supplies what?

A

Vertebral A.

Supplies bottom back of cerebellum

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9
Q

Anterior Spinal A.

Branches of?

Supplies what?

A

VA branch

supplies front of spinal cord

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10
Q

Anterior Inferior Cerebellar Artery (AICA)

Branches of?

Supplies what?

A

BA branch

supplies front and bottom of cerebellum

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11
Q

Superior Cerebral A.

Branches of?

Supplies what?

A

BA branch

Supplies top of cerebellum

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12
Q

Posterior Cerebral A.

Branches of?

Supplies what?

A

BA branch

Supplies back of cerebrum, occipital lobe (visual cortex) & inferior temporal lobe

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13
Q

Components of blood brain barrier

A

endothelium, astrocytes, basement membrane, pericytes and neurons that are in physical proximity to the endothelium.

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14
Q

What arteries contribute to the Circle of Willis

A
  • Internal Carotid A
  • Anterior Cerebral A.
  • Anterior Communicating A.
  • Posterior Communicating A.
  • Posterior Cerebral A.

Pg. 409 Q. 44 of Grey’s Anatomy Review

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15
Q

Termination of the ICA, VA and the circle of Willis are located where

A

Subarachnoid space

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16
Q

Ligation of what artery can be used as a treatment for Parkinson’s disease

A

Anterior Choroidal A.

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17
Q

What happens if there’s occlusion of the Anterior Cerebral Artery’s supply to the paracentral lobule (gyrus) region

A

Sensory and/or motor deficits in the controlateral lower limb and foot

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18
Q

MCA penetrating branches & function

A

medial and lateral striate or thalamostriate arteries.

Supply the internal capsule, corpus striatum and thalamus

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19
Q

MCA cortical distribution occlusion may result in what

A

Sensory and/or motor deficits in the contralateral upper limb and head

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20
Q

What causes Broca’s aphasia & what is it

A

MCA occlusion. Leads to speech problems. Know what you’re saying but have a frustrating problem in initiating speech motor patterns.

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21
Q

What causes Wernicke’s aphasia & what is it?

A

Obstruction of Middle cerebral artery in dominant hemisphere (back). It’s a comprehension problem. Lack meaning in their spoken and written comprehension of language.

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22
Q

What are watershed regions

A

Regions of the body that receive dual blood supply from the most distal branches of two large arteries

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23
Q

The Cerebrum Anterior watershed area is located between what arteries?

A

Anterior Cerebral Artery

Middle Cerebral Artery

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24
Q

The cerebrum posterior watershed area is located between what arteries?

A

Middle Cerebral Artery

Posterior Cerebral Artery

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25
Q

What is ischemic penumbra

A

Occurs when blood flow to the brain falls to 10-20%. Watershed region is too ischemic to function, yet critically viable.

26
Q

Methods for rescuing ischemic penumbra

A
  1. Stroke therapy targeted at improving tissue acidosis and oxygen delivery
  2. Use of Calcium channel and NMDA receptor blockers
27
Q

Luxury perfusion

A

Hyperperfusion of adjacent artieries in watershed region to make up for damged arteries, leading to autoregulation dysfunction and edema (swelling)

28
Q

Posterior Spinal Arteries (PSpA)

A

May be branches of either the vertebral or posterior infererior cerebellar artery. Two of them that supply the dorsal roots and about 75% of the posterior columns.

29
Q

Central Cord Syndrome

A

An ischemia of the central region of the spinal cord due to a disruption (thrombosis) of blood flow to the anterior spinal artery.

Characterized by central necrosis and cavitation of the spinal cord and the development of a syrinx.

30
Q

Tabes dorsalis or tertiary neurosyphilis

A

Meningovascular infection of posterior spinal arteries and their branches leading to an irritation or destruction of their associated neuroanatomical structures

31
Q

What are the watershed zones of the spinal cord

A

C2,3

T1-4

L1

32
Q

Great artery of Adamkiewicz

A

Major blood supply to the inferior two-thirds of the spinal cord. It may be compromised secondary to thoracolumbar fracture or surgical repair of Abdominal Aortic Anuerysms (AAA)

33
Q

Lateral Medullary (Wallenberg) Syndrome

A

Thrombosis of Posterior Inferior Cerebellar A.

34
Q

The vertebral arteries merge to form what

A

Basilar A

35
Q

The anterior spinal artery is usually a branch of what

A

Vertebral A.

36
Q

The posterior spinal artery is usally a branch of what

A

Posterior Inferior Cerebellar A. (PICA)

37
Q

The internal carotid artery bifurcates inot what

A

ACA & MCA

38
Q

Where is the arterial circle (Willis) located

A

Subarachnoid space

39
Q

Rupture of the anterior communicating artery results in the presence of blood where

A

subarachnoid space

40
Q

Regarding primary cortex, the posterior cerebral artery supplies what

A

Primary visual cortex

41
Q

The paracentral lobule is supplied by what

A

ACA

42
Q

Broca’s area us supplied by what

A

MCA

43
Q

Wernicke’s area is supplied by what

A

MCA

44
Q

The motor cortex associated with the hands is supplied by what

A

MCA

45
Q

An infract of the central region of the spinal cord indicates occlusion of what

A

Anterior Spinal Artery

46
Q

The most common area for infracts in the cerebrum is in the region of?

A

Basal ganglia, interal capsule

47
Q

The sigmoid sinus empties into where

A

IJV & jugular foramen

48
Q

The superior opthalmic sinus empties into where

A

Cavenrous sinus

49
Q

In two-thirds of the cases the superior sagittal sinus usual empties into where

A

Right transverse venous sinus

50
Q

In two-thirds of the case the straight sinus drains directly where

A

Left transverse sinus

51
Q

What is the deep venous drainage of the cerebrum

A

Internal cerebal vein + Basal vein of Rosenthal merge and drain into the Great vein of Galen. GVG drains into the straight sinus and finally to the confluences.

52
Q

Great vein varix

A

Dilation of the Great Vein of Galen due to bloackage. It may compress the pineal body and posterior commissure. Because it drains most of the deep cerebrum it is usually fatal.

53
Q

In relation to the dural venous sinus what can cause cortical ischemia and/or necrosis

A

Thrombosis of the posterior portion of the superior venous sinus or right transverse venous sinus

54
Q

In relation to the dural venous sinus what can cause cortical ischemia and/or necrosis of structures in the deep cerebrum

A

Thrombosis of the posterior portion of the straight venous sinus or left transverse venous sinus

55
Q

What causes an epidural hematoma?

What does it look like on an x-ray?

A
  • Ruptured Middle Meningeal Artery resulting in bleeding between the tough outer membrane covering the brain (dura mater) and the skull, expanding the epidural space. Can be caused if hit at the pterion
  • Lens shaped hematoma on side of brain
56
Q

What causes a subdural hematoma?
What does it look like on an x-ray?

A

Bleeding of bridging veins resulting in blood gathering between the inner layer of the dura mater and the arachnoid mater (subdural space). May be due to blow to head that jerks brain inside cranium (i.e. hitting windshield in car accident).

Crescent shaped hematoma on side of brain

57
Q

What causes a subarachnoid hemorrhage?
What does it look like on an x-ray?

A

Rupture of one of the blood vessels supplying the CNS. All of the major blood vessels supplying the CNS pass through or course in the subarachnoid space.

Spiderweb shape

58
Q

Subfalcine (Falx) herniation

A

The most common form of intracranial herniation and occurs when brain tissue is displaced under the falx cerebri. The cingulate gyrus is herniated under the falx, and if progression occurs, other areas of the frontal lobe are involved.

“Midline shift”

59
Q

Tentorial or Uncal herniation

A

Downward herniation of uncus through the tentorial notch. Can lead to progressive decrease in the level of consciousness.

60
Q

Tonsillar herniation

A

Tonsilar portion of cerebellum herniates through foramen magnum

Leads to Arnold-Chiari Malformation - lower part of brain expands into spinal cord

NeuroEndo Exam 2 (13 decks)

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