Blood Supply of the Brain

Question 1

Internal Carotids (2)

Answer 1

Route: rise from the common artery
enter the brain at the level of Optic chaism

Supply: the brain

Question 2

Vertebral Arteries (2)

Answer 2

Vertebral Arteries (2)
Route:
-run along the lateral aspect of medulla
-connect to form basilar artery at the base of the pns-medulla junction
- give rise to the anterior spinal artery

Question 3

Verterbral Arteries (2)

Answer 3

Supply : lateral medulla areas

Question 4

Anterior Spinal Artery ( 1 )

Answer 4

Route: begin as 2 small branches that become 1 artery

• the 2 anterior spinal branches rise off of the vertebral arteries & become 1 main artery that travel along the anterior surface of the medulla and spinal cord

Question 5

Anterior Spinal Artery ( 1)

Answer 5

Supply: anterior portion of the medulla and spinal cord

Question 6

Posterior Inferior Cerebellar Arteries ( 2)

Answer 6

Route: rise from the vertebral arteries at the medulla level

Question 7

Posterior Inferior Cerebellar Arteries ( 2)

Answer 7

Supply: part of the dorsolateral medulla ( including cerebellar peduncles)

• inferior surface of the cerebellum
• deep cerebellar nuclei

Question 8

Anterior Inferior Cerebellar Arteries (2)

Answer 8

Route: vertebral arteries at the at the pons- medulla junction

Question 9

Anterior Inferior Cerebellar Arteries ( 2)

Answer 9

Supply: inferior surface of the cerebellum and the deep cerebellar nuclei

Question 10

Superior Cerebellar Arteries ( 2)

Answer 10

Route: rise from basilar artery at the pons- midbrain junction

Question 11

Superior Cerebellar Arteries (2)

Answer 11

Supply: superior aspect of the cerebellum and parts of the deep cerebellar nuclei

Question 12

Basilar Artery ( 1)

Answer 12

does not supply the cerebellum

but it does give rise to the superior cerebellar arteries

Question 13

Basilar Artery ( 1)

Answer 13

Route: travels along anterior aspect of the pons

-gives rise to the superior cerebellar arteries

Question 14

Basilar Artery ( 1)

Answer 14

Supply: anterior and lateral aspects of the pons

Question 15

Three arteries that supply the Cerebellum

Answer 15

Posterior Inferior Cerebellar Arteries

Anterior Inferior Cerebellar Arteries

Superior Cerebellar Arteries

Question 16

Three Main Cerebral Arteries

Answer 16

Posterior Cerebral Arteries
Middle Cerebral Arteries
Anterior Cerebral Arteries

Question 17

Posterior Cerebral Arteries ( 2)

Answer 17

Route: rise from basilar artery

Question 18

Posterior Cerebral Arteries ( 2)

Answer 18

Supply: medial and inferior surfaces of the temporal and occipital lobes

• thalamus
• hypothalamus

Question 19

Middle Cerebral Arteries ( 2)

Answer 19

Route: rise from internal carotids and travel through lateral fissure to brain’s surface

Question 20

Middle Cerebral Arteries ( 2)

Answer 20

Supple: lateral surfaces of the frontal, temporal, parietal lobes
-inferior surface of part of the frontal and temporal lobes

Question 21

Anterior Cerebral Arteries ( 2)

Answer 21

Route: rise from internal carotids

Question 22

Anterior Cerebral Arteries ( 2)

Answer 22

Supply: superior, lateral and medial aspects of the frontal and parietal lobes
- part of the basal ganglia and corpus callosum

Question 23

Communicating Arteries

Answer 23

provide blood supply pathways to the major cerebral arteries

Question 24

Multiple Encircling Arteries

Answer 24

provide blood supply pathway to the pons

Question 25

Posterior Communicating Arteries ( 2)

Answer 25

Route: posterior communicating arteries connect the internal carotids and the posterior cerebral arteries

Question 26

Posterior Communicating Arteries ( 2)

Answer 26

Supply: diencephalon internal capsule optic chaism

Question 27

Anterior Communicating Artery ( 1)

Answer 27

connects the 2 anterior cerebral arteries

Question 28

Pontine Encircling Arteries ( Multuple)

Answer 28

Route: rise from the basilar artery and wrap around the pons

Question 29

Pontine Encircling Arteries ( Multiple)

Answer 29

Supply: lateral and posterior portions of the pons

Question 30

Circle of Willis

Answer 30

Circuit of interconnecting arteries that function to prevent lack of blood flow to the brain due to occlusion

Question 31

Components of Circle of Willis

Answer 31

``` Posterior Cerebral arteries Posterior Communicating Arteries Internal Carotid arteries Anterior cerebral arteries Anterior communicating artery ```

Question 32

Middle Cerebral Arterial Occlusion

Answer 32

middle cerebral arteries are the most common site of occlusion resulting in CVA

Question 33

Middle Cerebral Arterial Occlusion in Left hemisphere

Answer 33

Contralateral hemiplegia ( on the right side of the body): primary motor area is lesioned Contralateral hemiparesthesia (right side of body): primary somatosensory area is lesioned

Question 34

Middle Cerebral Arterial Occlusion in Left hemisphere

Answer 34

Aphasia: Broca or Wernicke area may be lesioned | other language areas may also be damaged

Question 35

Middle Cerebral Arterial Occlusion in Left hemisphere

Answer 35

Cognitive involvement: impairment in cognitive function results from a frontal lobe lesion Affective invlovment: patient may display emotional lability and depression; known as CATASTROPHIC RESPONSE

Question 36

Middle Cerebral Arterial Occlusion in Right Hemisphere

Answer 36

Contralateral hemiplegia ( on left side of body): primary motor area is lesioned Contralateral Hemiparesthesia ( Left side of body) primary somatosensory areas is lesioned

Question 37

Middle Cerebral Arterial Occlusion in Right Hemisphere

Answer 37

Perceptual deficits: left neglect syndromes; damage to the posterior multimodal association area

Question 38

Middle Cerebral Arterial Occlusion in Right Hemisphere

Answer 38

Apraxia: anterior multimodal association area, premotor area, and primary motor cortex may be lesioned

Question 39

Middle Cerebral Arterial Occlusion in Right Hemisphere

Answer 39

Cognitive invlovement: impairment in cognitive function results from frontal lobe lesion

Question 40

Middle Cerebral Arterial Occlusion in Right Hemisphere

Answer 40

Affective involvement: may display euphoria or report a sense of well- being If a neglect syndrome is present the patient is often unaware of their deficits

Question 41

Posterior Cerebral Arterial Occulsion

Answer 41

does not affect the thalamic and hypothalamic functions

Question 42

Posterior Cerebral Arterial Occulsion

Answer 42

Lesion may affect: -memory loss due to temporal lobe involvement -visual perceptual deficits' from damage to occipital lobe and posterior multimodal association

Question 43

Posterior Cerebral Arterial Occulsion

Answer 43

Visual field cuts result from occlusion to the optic chaism

Question 44

Optic chaism

Answer 44

supplied by the posterior communicating arteries which connect to the posterior cerebral arteries

Question 45

Anterior Cerebral Arterial Occlusion

Answer 45

Contralateral hemiplegia: often of the lower extremites; primary motor cortex is lesioned

Question 46

Anterior Cerebral Arterial Occlusion

Answer 46

Contralateral hemiparesthesia: often the lower extremities' primary somatosensory area is lesioned

Question 47

Anterior Cerebral Arterial Occlusion

Answer 47

Cognitive involvement: due to frontal lobe involvment

Question 48

Anterior Cerebral Arterial Occlusion

Answer 48

Apraxia: anterior multimodal association area, premotoe area, and/or primary motor area may be lesioned

Question 49

Anterior Cerebral Arterial Occlusion

Answer 49

Affective Involvment: if the left hemisphere is lesioned, emotional liability and depression may occur Right hemisphere is lesioned euphoria or emotional dissociation may occur

Question 50

Cerebellar Arterial Occlusion | 3 symptoms of cerebellar disorders include:

Answer 50

incoordination ataxia intention tremors

Question 51

Posterior Inferior Cerebellar Arterial Occulsion

Answer 51

Ipsilateral hypertonicity hyperactive reflexes

Question 52

Posterior Inferior Cerebellar Arterial Occulsion

Answer 52

Vertigo nausea nystagmus diplopia

Question 53

Posterior Inferior Cerebellar Arterial Occulsion

Answer 53

Ipsilateral loss of pain and temperature on the face

Question 54

Posterior Inferior Cerebellar Arterial Occulsion

Answer 54

contralateral loss of pain and temperature on the trunk and extremities

Question 55

Posterior Inferior Cerebellar Arterial Occulsion

Answer 55

Dysphagia and dysarthria

Question 56

Posterior Inferior Cerebellar Arterial Occulsion

Answer 56

ipsilateral Horner syndrome ( miosis, ptosis)

Question 57

Anterior Inferior Cerebellar and Superior Cerebellar Arterial Occlusion

Answer 57

``` Ipsilateral ataxia ipsilateral hypotonicity and hyoreflexia dysmetria adiadochokinesia movement decomposition asthenia rebound phenomenon Staccato voice ataxic gait interntion tremors incoordination nystagmus ```

Question 58

Anterior Spinal Artery Occlusion

Answer 58

Bilateral motor function loss at and below the lesion Bilateral loss of pain and temperature at and below the lesion level

Question 59

Vertebral Arterial Occlusion

Answer 59

dysphagia may occur

Question 60

Basilar Arterial Occlusion

Answer 60

Contralateral hemiplegia contralateral sensory loss of the body Ipsilateral sensory loss of the face medial or internal strabismus

Question 61

Basilar Arterial Occlusion

Answer 61

ipsilateral loss of masseter reflex and corneal reflex Bell palsy and hyperacusis deviation of the tongue to the affected side Nystagmus and balance disturbances

Question 62

Thrombic Strokes

Answer 62

thrombi are clots formed by plaque development in a vessel wall

Question 63

Most common type of ischemic stroke and occur in atherosclerotic blood vessels

Answer 63

Thrombic Strokes

Question 64

Common sites of plaque formation include larger vessels of the brain , including the origin of the internal carotid arteries, vertebral arteries, and the junction of the basilar vertebral arteries

Answer 64

Thrombic strokes

Question 65

Usually occur gradually or over time

Answer 65

Thrombic strokes

Question 66

Frequently seen in older people with arteriosclerotic heart disease

Answer 66

Thrombic Strokes

Question 67

This type of stroke is not associated with exertion or activity and can occur when the person is at rest

Answer 67

Thrombic Stokes

Question 68

Small clots located in the deep regions of the brainstem and subcortical structures

Answer 68

Lacunar Infarcts

Question 69

Often found in single deeply penetrating arteries that supply the internal capsule, basal ganglia, and brainstem

Answer 69

Lacunar Infarcts

Question 70

Commonly result from occlusion of the smaller branches of the large cerebral arteries

Answer 70

Lacunar Infarcts

Question 71

Often they are small and usually don't cause severe impairment

Answer 71

Lacunar Infarcts

Question 72

Emboli are clots that dislodge from their site of origin and travel to a cerebral blood vessel, where they become trapped and interrupt blood flow

Answer 72

Embolic stroke

Question 73

Embolic strokes often affect the smaller cerebral vessels and the most frequent site is the middle cerebral artery

Answer 73

Embolic Strokes

Question 74

This type of stroke commonly has a sudden onset and is associated with the presence of cardiac disease

Answer 74

Embolic Strokes

Question 75

This stroke is frequently fatal ,however if patients survive prognosis is generally good

Answer 75

Hemorrhagic Stroke

Question 76

This type of stroke results in edema and compression of brain tissue, if not medically treated can become fatal

Answer 76

Hemorrhagic Stroke

Question 77

This stroke involves bleeding into brain tissue after the rupture of a blood vessel wall

Answer 77

Hemorrhagic Stroke

Question 78

This type of stroke occurs suddenly and is associated with exertion and activity

Answer 78

Hemorrhagic Stroke

Question 79

A bulge occurring in a blood vessel wall as a result of clot formation

Answer 79

Aneurysm

Question 80

Commonly occur in the circle of Willis or the junction of 2 vessels

Answer 80

Berry Aneuryseums

Question 81

Tend to enlarge with time and weaken vessel walls until rupture occurs

Answer 81

Aneurysms

Question 82

Mini strokes

Answer 82

Transient ischemis attacks ( TIAs)

Question 83

Characterized by focal ischemic cerebral incidents that last less than 24 hours; most TIAs usually last less than 1 to 2 hours

Answer 83

Transient ischenis attacks ( TIAs)

Question 84

May provide as a warning of an impending larger strokes

Answer 84

TIAs

Question 85

Causes include atherosclertic disease and emboli

Answer 85

TIAs

Question 86

Signs include: numbness and mild weakness on one side of the body tansient visual disturbances (blurred vision, fading vision) dizziness falls confusion and possible blackout

Answer 86

TIAs