Blood Supply of the Brain Flashcards
Internal Carotids (2)
Route: rise from the common artery
enter the brain at the level of Optic chaism
Supply: the brain
Vertebral Arteries (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
Verterbral Arteries (2)
Supply : lateral medulla areas
Anterior Spinal Artery ( 1 )
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
Anterior Spinal Artery ( 1)
Supply: anterior portion of the medulla and spinal cord
Posterior Inferior Cerebellar Arteries ( 2)
Route: rise from the vertebral arteries at the medulla level
Posterior Inferior Cerebellar Arteries ( 2)
Supply: part of the dorsolateral medulla ( including cerebellar peduncles)
- inferior surface of the cerebellum
- deep cerebellar nuclei
Anterior Inferior Cerebellar Arteries (2)
Route: vertebral arteries at the at the pons- medulla junction
Anterior Inferior Cerebellar Arteries ( 2)
Supply: inferior surface of the cerebellum and the deep cerebellar nuclei
Superior Cerebellar Arteries ( 2)
Route: rise from basilar artery at the pons- midbrain junction
Superior Cerebellar Arteries (2)
Supply: superior aspect of the cerebellum and parts of the deep cerebellar nuclei
Basilar Artery ( 1)
does not supply the cerebellum
but it does give rise to the superior cerebellar arteries
Basilar Artery ( 1)
Route: travels along anterior aspect of the pons
-gives rise to the superior cerebellar arteries
Basilar Artery ( 1)
Supply: anterior and lateral aspects of the pons
Three arteries that supply the Cerebellum
Posterior Inferior Cerebellar Arteries
Anterior Inferior Cerebellar Arteries
Superior Cerebellar Arteries
Three Main Cerebral Arteries
Posterior Cerebral Arteries
Middle Cerebral Arteries
Anterior Cerebral Arteries
Posterior Cerebral Arteries ( 2)
Route: rise from basilar artery
Posterior Cerebral Arteries ( 2)
Supply: medial and inferior surfaces of the temporal and occipital lobes
- thalamus
- hypothalamus
Middle Cerebral Arteries ( 2)
Route: rise from internal carotids and travel through lateral fissure to brain’s surface
Middle Cerebral Arteries ( 2)
Supple: lateral surfaces of the frontal, temporal, parietal lobes
-inferior surface of part of the frontal and temporal lobes
Anterior Cerebral Arteries ( 2)
Route: rise from internal carotids
Anterior Cerebral Arteries ( 2)
Supply: superior, lateral and medial aspects of the frontal and parietal lobes
- part of the basal ganglia and corpus callosum
Communicating Arteries
provide blood supply pathways to the major cerebral arteries
Multiple Encircling Arteries
provide blood supply pathway to the pons
Posterior Communicating Arteries ( 2)
Route: posterior communicating arteries connect the internal carotids and the posterior cerebral arteries
Posterior Communicating Arteries ( 2)
Supply:
diencephalon
internal capsule
optic chaism
Anterior Communicating Artery ( 1)
connects the 2 anterior cerebral arteries
Pontine Encircling Arteries ( Multuple)
Route: rise from the basilar artery and wrap around the pons
Pontine Encircling Arteries ( Multiple)
Supply: lateral and posterior portions of the pons
Circle of Willis
Circuit of interconnecting arteries that function to prevent lack of blood flow to the brain due to occlusion
Components of Circle of Willis
Posterior Cerebral arteries Posterior Communicating Arteries Internal Carotid arteries Anterior cerebral arteries Anterior communicating artery
Middle Cerebral Arterial Occlusion
middle cerebral arteries are the most common site of occlusion resulting in CVA
Middle Cerebral Arterial Occlusion in Left hemisphere
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
Middle Cerebral Arterial Occlusion in Left hemisphere
Aphasia: Broca or Wernicke area may be lesioned
other language areas may also be damaged
Middle Cerebral Arterial Occlusion in Left hemisphere
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
Middle Cerebral Arterial Occlusion in Right Hemisphere
Contralateral hemiplegia ( on left side of body): primary motor area is lesioned
Contralateral Hemiparesthesia ( Left side of body) primary somatosensory areas is lesioned
Middle Cerebral Arterial Occlusion in Right Hemisphere
Perceptual deficits: left neglect syndromes; damage to the posterior multimodal association area
Middle Cerebral Arterial Occlusion in Right Hemisphere
Apraxia: anterior multimodal association area, premotor area, and primary motor cortex may be lesioned
Middle Cerebral Arterial Occlusion in Right Hemisphere
Cognitive invlovement: impairment in cognitive function results from frontal lobe lesion
Middle Cerebral Arterial Occlusion in Right Hemisphere
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
Posterior Cerebral Arterial Occulsion
does not affect the thalamic and hypothalamic functions
Posterior Cerebral Arterial Occulsion
Lesion may affect:
-memory loss due to temporal lobe involvement
-visual perceptual deficits’ from damage to occipital lobe and posterior multimodal association
Posterior Cerebral Arterial Occulsion
Visual field cuts result from occlusion to the optic chaism
Optic chaism
supplied by the posterior communicating arteries which connect to the posterior cerebral arteries
Anterior Cerebral Arterial Occlusion
Contralateral hemiplegia: often of the lower extremites; primary motor cortex is lesioned
Anterior Cerebral Arterial Occlusion
Contralateral hemiparesthesia: often the lower extremities’ primary somatosensory area is lesioned
Anterior Cerebral Arterial Occlusion
Cognitive involvement: due to frontal lobe involvment
Anterior Cerebral Arterial Occlusion
Apraxia: anterior multimodal association area, premotoe area, and/or primary motor area may be lesioned
Anterior Cerebral Arterial Occlusion
Affective Involvment: if the left hemisphere is lesioned,
emotional liability and depression may occur
Right hemisphere is lesioned euphoria or emotional dissociation may occur
Cerebellar Arterial Occlusion
3 symptoms of cerebellar disorders include:
incoordination
ataxia
intention tremors
Posterior Inferior Cerebellar Arterial Occulsion
Ipsilateral hypertonicity
hyperactive reflexes
Posterior Inferior Cerebellar Arterial Occulsion
Vertigo
nausea
nystagmus
diplopia
Posterior Inferior Cerebellar Arterial Occulsion
Ipsilateral loss of pain and temperature on the face
Posterior Inferior Cerebellar Arterial Occulsion
contralateral loss of pain and temperature on the trunk and extremities
Posterior Inferior Cerebellar Arterial Occulsion
Dysphagia and dysarthria
Posterior Inferior Cerebellar Arterial Occulsion
ipsilateral Horner syndrome ( miosis, ptosis)
Anterior Inferior Cerebellar and Superior Cerebellar Arterial Occlusion
Ipsilateral ataxia ipsilateral hypotonicity and hyoreflexia dysmetria adiadochokinesia movement decomposition asthenia rebound phenomenon Staccato voice ataxic gait interntion tremors incoordination nystagmus
Anterior Spinal Artery Occlusion
Bilateral motor function loss at and below the lesion
Bilateral loss of pain and temperature at and below the lesion level
Vertebral Arterial Occlusion
dysphagia may occur
Basilar Arterial Occlusion
Contralateral hemiplegia
contralateral sensory loss of the body
Ipsilateral sensory loss of the face
medial or internal strabismus
Basilar Arterial Occlusion
ipsilateral loss of masseter reflex and corneal reflex
Bell palsy and hyperacusis
deviation of the tongue to the affected side
Nystagmus and balance disturbances
Thrombic Strokes
thrombi are clots formed by plaque development in a vessel wall
Most common type of ischemic stroke and occur in atherosclerotic blood vessels
Thrombic Strokes
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
Thrombic strokes
Usually occur gradually or over time
Thrombic strokes
Frequently seen in older people with arteriosclerotic heart disease
Thrombic Strokes
This type of stroke is not associated with exertion or activity and can occur when the person is at rest
Thrombic Stokes
Small clots located in the deep regions of the brainstem and subcortical structures
Lacunar Infarcts
Often found in single deeply penetrating arteries that supply the internal capsule, basal ganglia, and brainstem
Lacunar Infarcts
Commonly result from occlusion of the smaller branches of the large cerebral arteries
Lacunar Infarcts
Often they are small and usually don’t cause severe impairment
Lacunar Infarcts
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
Embolic stroke
Embolic strokes often affect the smaller cerebral vessels and the most frequent site is the middle cerebral artery
Embolic Strokes
This type of stroke commonly has a sudden onset and is associated with the presence of cardiac disease
Embolic Strokes
This stroke is frequently fatal ,however if patients survive prognosis is generally good
Hemorrhagic Stroke
This type of stroke results in edema and compression of brain tissue, if not medically treated can become fatal
Hemorrhagic Stroke
This stroke involves bleeding into brain tissue after the rupture of a blood vessel wall
Hemorrhagic Stroke
This type of stroke occurs suddenly and is associated with exertion and activity
Hemorrhagic Stroke
A bulge occurring in a blood vessel wall as a result of clot formation
Aneurysm
Commonly occur in the circle of Willis or the junction of 2 vessels
Berry Aneuryseums
Tend to enlarge with time and weaken vessel walls until rupture occurs
Aneurysms
Mini strokes
Transient ischemis attacks ( TIAs)
Characterized by focal ischemic cerebral incidents that last less than 24 hours; most TIAs usually last less than 1 to 2 hours
Transient ischenis attacks ( TIAs)
May provide as a warning of an impending larger strokes
TIAs
Causes include atherosclertic disease and emboli
TIAs
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
TIAs