Blood supply of brain and SC Flashcards
The brain is supplied by two sets of arteries: (1) _____and (2) ______ arteries
internal carotid
vertebrobasilar
when occlusion of one of these arteries in circle of Willis’ occur ,the distal smaller arteries that it supplies can receive blood from the other arteries because it is a_____ circulation
-this protects against____ in the event of vessel disease to one of the regions
collateral
ischemia
anterior perforated substance is a bilateral irregularly____ area in front of the____ and behind the_____, from which it is separated by the_____; medially and in front, it is continuous with the ____ gyrus
quadrilateral
optic tract
olfactory trigone
fissure prima
subcallosal
Internal Carotid Arteries
- contributes __% of the total brain supply
- emerges from bifurcation of common carotid at level of____ vertebrae
- The artery then ascends up in the ____ and enters the cranial cavity through the____ and upper part of______
-T he course of the internal carotid artery is divisible into four parts: (1) cervical, (2) petrous, (3) cavernous and (4) cerebral.
80
C4
carotid sheath
carotid canal
foramen lacerum.
Cervical part of ICA
-This part of the artery is from its origin till it enters the____.
Petrous part of ICA
-This part of the artery traverses the_____ in the______ bone
carotid canal.
carotid canal
petrous temporal
1/3 of Cervical part of ICA lies within the carotid sheath along with the internal jugular vein and the vagus nerve
T/F
F
The whole length of cervical part
Cavernous part of ICA
- From the carotid canal, the artery enters the _____through the____ part of the____
- Here, the artery has a___ course and is separated from the blood in that region by the____.
- The____ nerve is related to the internal carotid artery closely in this course.
cavernous sinus
upper; foramen lacerum.
sinuous
endothelium
abducens
Cerebral part of ICA
-At the ___ end of the cavernous sinus, the artery pierces the____ mater of the___ of the cavernous sinus and enters the_____ space.
anterior
dura
roof; subarachnoid
_______ part of the internal carotid artery is also called as the “carotid siphon”
Cavernous part
Branches of the Cerebral Part
What’s your acronym!
Then list it
POMAA
Ophthalmic artery:
Anterior choroidal artery
Posterior communicating artery
Anterior cerebral artery
Middle cerebral artery
Branches of the Cerebral Part
(1) Ophthalmic artery:
- It supplies the____ and its contents
(2) Anterior choroidal artery:
- It runs ___wards close to the optic tract
- supplies the____ pathway,____ and ____
- forms the____ of the____ horn of lateral ventricle.
orbit
back
visual
internal capsule and midbrain
choroid plexus
inferior
Posterior communicating artery:
- This runs ___wards
- anastomoses with the_____ artery, a branch of the____ artery
Anterior cerebral artery:
- This supplies the____ surface of cerebrum
- ____ strip of the____ surface except____ lobe
back
posterior cerebral; basilar
medial
upper; superolateral; occipital
Middle cerebral artery:
- This supplies the____ surface of____ except___ lobe
- _____strips each of the superolateral surface.
superolateral
cerebrum
occipital
upper and lower
Vertebrobasilar Arteries
- contributes __% of the total blood supply to the brain
- Each vertebral artery is a branch of the___ part of the_____ artery in the neck.
- The course of the vertebral artery is divisible into four parts: (1) cervical, (2) vertebral, (3) suboccipital, and (4) cerebral.
20
first
subclavian
Cervical part of Vertebrobasilar Arteries
- This is the part of the artery from its origin till it enters the_____ of _____
- Here, the artery lies in the ______ triangle.
Vertebral part of Vertebrobasilar Arteries
-This is the part of the artery traversing the _____ of _____
foramen transversarium of C6 vertebra.
scalenovertebral
foramina transversaria of upper six cervical vertebrae.
Suboccipital part of Vertebrobasilar Arteries
-This is the horizontal part of the artery lying in the______ triangle.
cerebral part of Vertebrobasilar Arteries
- The artery enters the cranial cavity by passing through the_____
- It then pierces the ____ mater to enter the ____ space
- This is the intracranial part of the artery lying in the____ space lateral to the____
suboccipital
foramen magnum.
dura; subarachnoid
subarachnoid; medulla oblongata.
Branches of the Cerebral Part of vertebrobailar artery
What is your acronym 😭😭
Then list it!
2P;2M;1A
Posterior spinal artery Posterior inferior Cerebellar artery Medullary branches Meningeal branches Anterior spinal artery
Anterior spinal artery:
It supplies the____ part of the____ and then _____and descends to supply the spinal cord.
-Posterior spinal artery:
It descends to supply the_____.
-
medial; medulla oblongata
fuses with the opposite anterior spinal artery
spinal cord
Posterior inferior cerebellar artery:
It supplies the____ part of the _____, ______ part of the cerebellum and the____ of the____ ventricle.
Medullary branches:
These branches supply directly____ part of the_____
Meningeal branches:
They supply the meninges of the___ cranial fossa.
dorsolateral; medulla oblongata
posteroinferior
choroid plexus; fourth
anterolateral; medulla oblongata.
posterior
The two vertebral arteries ascend up and unite at the_____ to form the_____ artery.
pontomedullary junction
basilar
The basilar artery runs in the____ sulcus of the____ and at the _____divides into two_____ arteries(each with___and____ segments)
basilar
pons
pontomesencephalic junction
posterior cerebral
p1 and p2
Branches of Basilar Artery
Acronym is PL_-_
Now list them🌚
Anterior inferior cerebellar artery:
-Labyrinthine artery:
-Pontine branches:
Superior cerebellar artery:
-Posterior cerebral arteries:
.
Anterior inferior cerebellar artery:
It supplies the_____ part of the cerebellum.
Labyrinthine artery:
It supplies the___
Pontine branches:
These paramedian branches dip into the pons and supply the___ part of the pons.
anteroinferior
inner ear
basilar
Superior cerebellar artery:
-It supplies the____ surface of the cerebellum and_____
-Posterior cerebral arteries:
They supply the____ lobes of the cerebrum,____ surface of tentorial part of cerebrum and a____ strip of superolateral surface of cerebrum.
superior
midbrain
occipital; inferior
lower
posterior choroidal branches are from the ______ artery
Posterior cerebral
posterior choroidal branches form the choroid plexus of the____ ventricle and the____ part of the lateral ventricle.
third
central
Circle of Willis
- aka_____
- is an arterial anastomotic circle present in the ______
- It is ____ in shape
- extends between the_____ and____
- It is closely related to the____ chiasma,____,____ bodies and____ perforated substance.
- The arterial circle is an anastomosis between the ______ and _____system of arteries
Circulus Arteriosus
interpeduncular cistern.
polygonal
superior border of pons and median longitudinal fissure
optic; tuber cinereum; mamillary
posterior
internal carotid and the vertebrobasilar
Formation of circulus arteriosus
-The____ artery, which connects the _____arteries and forms anterior part of the circle of Willis.
- The_____ artery forms the anterolateral part on each side.
- The lateral part is formed by the _____artery on each side.
- Posterolaterally, the _____artery is the connecting link between the____ and _____ arteries
- T he circle is completed posteriorly by the ____
anterior communicating; right and left anterior cerebral
anterior cerebral
termination of internal carotid
posterior communicating ; internal carotid and posterior cerebral
bifurcation of basilar artery into the right and left posterior cerebral arteries.
Functional Importance of circle of Willis
-This arterial circle equalizes the____ to the two sides of the brain
pressure of the blood flow
the main collateral channel of blood in the brain is the ____
Circuluus arteriosus
Anterior Cerebral Artery
- This artery arises from the____ artery____ the____ perforated substance and____ to the optic chiasma.
- It crosses the optic chiasma to reach the_____
internal carotid
below; anterior
lateral
median longitudinal fissure.
Anterior cerebral artery
At the anterior end of the longitudinal fissure, the____ artery connects the right and left anterior cerebral arteries.
-Inside the longitudinal fissure, the anterior cerebral artery winds around the___of____ and then runs ___riorly on the___ aspect of the____of_____
anterior communicating
genu of the corpus callosum
poste; superior
body of corpus callosum.
Branches of anterior cerebral artery
- orbital:_____ and _____ of ____ lobe
- frontopolar:____
- Callosomarginal:____gyrus;____ lobule;___
- Pericallosal:_____ and _____
olfactory system;medial orbital surface of frontal lobe
frontal pole
medial frontal ; paracentral; precuneus
corpus callosum and cingulate gyrus
Middle Cerebral Artery
- It is one of the terminal branches of the____ artery.
- It turns____ on the____ perforated substance to enter the stem of the____ sulcus, where it divides into four to five cortical branches.
internal carotid
laterally; anterior; lateral
Posterior Cerebral Artery
-The right and left posterior cerebral arteries are the terminal branches of_____ artery. Each passes laterally around the____ of _______, where it receives the_______ artery. It continues along the lateral aspect of the midbrain and enters the____ compartment through the tentorial notch. Then, it courses on the tentorial surface of the brain giving out its branches.
basilar
crus cerebri of the midbrain
posterior communicating
supratentorial
VASA CORONA ARTERY
-small anastomoses between the____ and ____ on both sides
anterior and posterior spinal arteries
ARTERY OF ADAMKIEWICZ
- aka______ or the _______artery
- they branch directly from_____ artery and they join the ____artery from about ____vertebral level ___wards
arteria radicularis magna
great anterior segmental medullary
left posterior intercoastal
anterior spinal
T10-T12 ; down
Trauma to the internal carotid artery in cavernous sinus leads to the formation of______ causing pulsating_____.
arteriovenous fistula
exophthalmos
The internal carotid artery shows multiple bends, which produce S-shaped shadow called the carotid siphon on an angiogram. The carotid siphon helps in_______ in the cranial cavity.
damping down its pulsations
Berry aneurysm(aka_____ aneurysm ):
- is a localized dilatation on one of the arteries of the circle of Willis due to____. The most common sites of berry aneurysm are the_______ arteries and at the_____.
- Rupture of berry aneurysm may cause life-threatening_______.
- mostly occurs in those with_____ or _____ diseases
saccular
congenital muscular weakness
junction of anterior cerebral and anterior communicating
bifurcation of internal carotid arteries
subarachnoid haemorrhage
chronic hypertension or connective tissue
Recurrent artery of Heubner: Recurrent branch of the____ cerebral artery .
- is one of the anteromedial group of arteries.
- It supplies the____,____ limb and___ of the internal capsule. Thrombosis in the artery of Heubner results in contralateral paralysis of the_____and____(_______)
anterior
caudate nucleus
anterior;genu
face and upper extremity
faciobrachial monoplegia
Charcot’s artery of cerebral haemorrhage: One of the lateral striate arteries is usually larger than the others. Rupture of this artery, in______ individuals, results in loss of blood supply to____ leading to contralateral spastic hemiplegia, paralysis of lower half of face and altered sensorium (due to involvement of ____and____limb of internal capsule).
elderly hypertensive
internal capsule
genu and posterior
Effects of occlusion of anterior cerebral artery:
_Paralysis (or weakness) of muscles of the_____ of the____ side (by involvement of the upper part of the motor area).
_Loss or diminution of sensations from the ____of the opposite side (by involvement of the upper part of the____ area).
_Sense of stereognosis is impaired (by involvement of____ lobe).
_Personality changes by involvement of___ lobe usually do not occur unless there is involvement of____
leg and foot; opposite
leg and foot ; sensory
parietal
frontal
both prefrontal cortices
What is stereognosis
the mental perception of depth or three-dimensionality by the senses, usually in reference to the ability to perceive the form of solid objects by touch.
Effects of occlusion of middle cerebral artery:
____ and ____on the opposite half of the body. The____and ___ are most affected. Foot and leg may show mild weakness.
_Aphasia (by involvement of ____ and ____areas), especially if the thrombosis is in the___ hemisphere in a___-handed person.
_Homonymous quadrantanopia on the opposite side (by involvement of Meyer’s loop passing superficially in the temporal lobe)
_
Hemiplegia and loss of sensations
face and arms
Broca’s and Wernicke’s
left; right
Hearing is l totally affected in occlusion of middle cerebral artery
T/F
F
Hearing is never totally affected in occlusion of middle cerebral artery due to compensation by the opposite hemisphere.
Effects of occlusion of posterior cerebral artery:
- The loss of cortical supply results in________ with macular sparing.
- Damage to association cortex of visual area causes_____ (distortion of____).
contralateral homonymous hemianopia
visual hallucinations
colour vision
occlusion of basilar artery
- aka_______
- leads to bilateral loss of____ tracts=_____
- the person can still do _____and are___ and ___
locked-in syndrome
corticospinal
quadriplegia
vertical eye movements
alert and conscious
Occlusion of anterior inferior Cerebellar artery:
- ____syndrome
- ___lateral damages are
- damage to CN_
- damage to___ nerve and___ artery leading to vertigo,tinnitus,nystagmus,deafness
- damage to____ cerebellar peduncle leading to ataxia, poor muscle coordination,poor muscle tone and balance
- ___lateral loss of pain and temp sensations due to damage to_____ tract
lateral pontine
Ipsi; 7
vestibular; labyrinthine
middle
contra; spinothalamic
occlusion of anterior spinal artery
- _____syndrome
- __lateral CN__ palsy
- damage to corticospinal tract causing contralateral_____
- damage to______ causing loss of contralateral touch,presssure,vibration, and proprioception sensations
medial medullary
Ipsi; 12
hemiplageia
medial lemniscus
occlusion of posterior inferior Cerebellar artery
- ataxia, poor muscle coordination,poor muscle tone and balance
- CN_ palsy leading to_____,____,and_____
- can cause ____ syndrome (sympa nerve is affected)
- ___ of upper eyelid
- pupil____
- _____(no sweating)
- contralateral loss of___and ___ sensations due to damage to spinothalamic tract
- affect____ nucleus of trigemibal nerve leading to___lateral loss of _____ of the ____
10
dysphagia and negative gag reflex and deviated uvula
Horner’s
ptosis
constriction
Anhidrosis
pain and temp
spinal; Ipsilateral loss of pain and temperature of the face
VENOUS DRAINAGE OF BRAIN
-veins draining the brain are
Valve or valveless
thin or thick walled
Have or lack muscle in their wall
Valveless
Thin
Lack
.veins of the brain
-they drain into nearby venous sinuses that almost all drain into____
IJV
Veins of the Cerebral Hemisphere
- The veins of the cerebral hemisphere consist of two sets: (1) superficial and (2) deep.
- The superficial veins on the ___ surface of the cerebral hemisphere are classified into____,_____,and____
superolateral
superior, superficial middle and inferior.
-The superficial veins on the base of the cerebral hemisphere are the____ veins.
basal
Basal veins are formed by the union of _____vein and ______vein
deep middle cerebral
anterior cerebral
Basal veins drain into_____ vein
great cerebral
The deep veins comprise of the____ veins, the____ vein and____ vein on each side. All these veins drain into the corresponding_____ vein.
septal
choroidal
thalamostriate
internal cerebral
Two internal cerebral veins join to form the ____ vein of ____, which drains into ____ sinus
great cerebral
Galen
straight
Direct branches of the ICA that contributes to circle of Willis
Anterior cerebral
Middle cerebral
Posterior communicating branch
Middle cerebral artery supplies the corpus callosum
T/F
F
Middle cerebral artery runs in the lateral sulcus
T/F
T
Middle cerebral artery is the largest contributor to circle of Willis
T/F
F
Circle of Willis is circular in shape
T/F
F
