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Neuroanatomy Test 3 > Blood Supply of the Spinal Cord and Brain > Flashcards

Blood Supply of the Spinal Cord and Brain Flashcards

1
Q

True or False: glucose and oxygen are stored in neural tissue?

A

false, there is little storage of glucose or O2 in neural tissue and there is a big demand for maintaining profuse blood supply

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2
Q

How much of cardiac output and oxygen does the brain require?

A

17% and 20% of the oxygen used by the entire body

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3
Q

what happens if blood supply to the brain areas are interrupted for even 30 seconds?

A

brain metabolism is altered

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4
Q

what happens if blood supply to the brain areas are interrupted for even 1 minute?

A

neuronal function may cease

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5
Q

what happens if blood supply to the brain areas are interrupted for even 5 minutes?

A

cerebral infarction may occur and damage may be reversible only if blood flow is restored quickly

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6
Q

What happens if a brain infarction occurs?

A

Brain tissue softens, liquefies, and cavities form in the brain and some neuroglial cells proliferate and ingrow into the region

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7
Q

What is a stroke?

A

A condition with an abrupt onset of neurological deficits caused by ischemia or hemorrhage in brain tissue as a result of vascular disease

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8
Q

What arteries supply blood to teh spinal cord/

A

Anterior and posterior spinal arteries

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9
Q

Are posterior spinal arteries paired?

A

Yes, though most of their length

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10
Q

Where do posterior spinal arteries branch from?

A

either the vertebral or posterior inferior cerebellar arteries in the cranial vault

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11
Q

where do the posterior spinal arteries descend the spinal cord?

A

near the dorsal lateral sulcus in the subarachnoid space (near dorsal rootlets of spinal nerves)

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12
Q

are anterior spinal arteries paired?

A

no, it is unpaired through most of the length of the spinal cord

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13
Q

where does the anterior spinal artery branch from?

A

as a branch from each vertebral artery

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14
Q

where do the anterior spinal arteries descend the spinal cord?

A

descend the length of the cord along the ventral median fissure in the subarachnoid space

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15
Q

how do the spinal arteries supply the pia/

A

via small branches called arterial vasa corona around the cord

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16
Q

what are sulcal branches?

A

branches from the vasa corona that enter the ventral median fissure and supply deeper cord areas

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17
Q

what are penetrating branches?

A

branches from the vasa corona that supply peripheral parts of the cord (deeper cord tissue)

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18
Q

how much of the spinal cord is supplied by the anterior spinal artery?

A

supplies about the anterior 2/3 of the chord including;

1) gray matter - ventral horn, lateral horn and intermediate zone, and base of dorsal horn
2) white matter - ventral and lateral funiculi

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19
Q

with a vascular lesion caused by the anterior spinal artery what sensory and/or motor disturbances would be affected?

A

Flaccid paralysis inferior to the lesion
Loss of temperature, pain and crude touch sensation
Loss of proprioception in the lower body

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20
Q

how much of the spinal cord is supplied by the posterior spinal artery?

A

blood from the posterior arteries supply the psoterior 1/3 of the cord, including:
Dorsal horn - gray
dorsal funiculus - white

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21
Q

True or false: blood from the anterior and posterior spinal arteries is sufficient in supplying the whole spinal cord?

A

false, the anterior and posterior spinal arteries is sufficient only for the upper cervical segments of the spinal cord.

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22
Q

Where does the additional blood required for lower spinal cord segments come from?

A

segmental arteries

anterior and posterior radicular arteries

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23
Q

what are segmental arteries?

A

vertebral
intercostal
lumbar

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24
Q

what are spinal branches of segmental arteries?

A

Branches from the segmental arteries that enter the vertebral canal through the IVF

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25
Q

where do anterior radicular arteries travel?

A

Travel along anterior rootlets of a spinal nerve

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26
Q

where do posterior radicular arteries travel?

A

Travel along posterior rootlets of spinal nerves

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27
Q

Where do the radicular arteries supply?

A

supply the nerve rootlets

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28
Q

What do some of the radicular arteries anastamose with?

A

The anterior or posterior spinal arteries

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29
Q

how many anterior radicular arteries are present?

A

about 12 (total of both sides) that join the anterior spinal artery

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30
Q

How many posterior radicular arteries are present?

A

About 14 total that join the posterior spinal arteries

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31
Q

Where are most of the large radicular arteries found?

A

In the lower cervical, lower thoracic and upper lumbar parts of the cord

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32
Q

What occurs with an impairment of radicular artery?

A

Can result in vascular lesions of the spinal cord

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33
Q

What areas are the most common site of vascular injury for radicular arteries?

A

T1-T4 cord segments and L1 cord segment

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34
Q

What do the arterial supply of the brain branch from?

A

Paired internal carotid and vertebral arteries

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35
Q

Where do vertebral arteries branch from?

A

subclavian arteries that ascend through the transverse foramina of the upper six cervical vertebrae

36
Q

How do the vertebral arteries enter the skull and what brain structures does it pass by?

A

enters the skull at the foramen magnum and ascends along the ventrolateral surface of the medulla

37
Q

Where do the veretebral arteries join and what do they form?

A

At the inferior border of the pons, the vertebral arteries join to form the basilar artery

38
Q

what are the branches of the vertebral arteries?

A

Anterior spinal artery
Posterior spinal arteries
Posterior inferior cerebellar artery (PICA)

39
Q

Which branch is the largest branch of the vertebral artery?

A

Posterior inferior cerebellar artery

40
Q

What does the PICA supply?

A 
posterior-inferior cerebellum
medullary branches to the dorsolateral medulla including:
1) restiform body (ICP)
2) Spinal trigeminal nucleus and tract
3) vestibular nuclear complex
4) cochlear nuclei
5) nucleus ambiguus (LMN of IX and X)
6) Spinothalamic tract
41
Q

What happens when there are occlusion of the PICA?

A

lateral medullar syndrome or Wallenburgs Syndrome

42
Q

With wallenburgs Syndrome what happens to pain and temperature sensation?

A

1) Loss of pain and temperature from the body of the contralateral side (spinothalamic tract)
2) Loss of pain and temperature from the ipsilateral side of face (spinal trigminal tract)

43
Q

With wallenburgs Syndrome what happens to hearing ?

A

ipsilateral hearing loss (cochlear nuclei)

44
Q

With wallenburgs Syndrome what happens to muscles innervated by the X nerve?

A

Ipsilateral paralysis of muscles innervated by x nerve

45
Q

With wallenburgs Syndrome what happens to gait?

A

ipsilateral cerebellar disturbances therefore ipsilateral ataxia and asynergy (ICP)

46
Q

With wallenburgs Syndrome what happens to posture, eye drift and pointing??

A

unsteady posture, nystagmus, past pointing and falling occur due to vestibular nuclear complex disturbance

47
Q

What are the branches of the basilar artery?

A 
Anterior inferior cerebellar artery
Internal auditory artery (labyrinthine artery)
Pontine arteries
Superior cerebellar arteries
Posterior cerebral arteries
48
Q

What does the anterior inferior cerebellar artery supply?

A

Anterior and inferior parts of the cerebellum

49
Q

What does an occlusion of the AICA cause?

A

cerebellar disturbances

50
Q

Where does the internal auditory artery travel and supply?

A

Travels through the internal acoustic meatus to supply the inner ear therefore auditory vestibular receptors

51
Q

What occurs with an occlusion of the internal auditory artery?

A

Result in deafness on the affected side and vestibular dysfunction (nustagmus, falling ,past pointing)

52
Q

What do pontine arteries supply?

A

The basilar pons

53
Q

What does an occlusion or damage to pontine arteries cause?

A

Locked in syndrome (no motor and only sensation available, only eye and eyelids can move)

54
Q

What do the superior cerebellar arteries distribute to?

A

Superior surface of cerebellum and to superior cerebellar peduncles

55
Q

What does an occlusion or damage to superior cerebellar arteries cause?

A

Neocerebellar syndrome

56
Q

What artery is the terminal branch of the basilar artery?

A

Posterior cerebral artery

57
Q

Where do the posterior cerebral arteries travel?

A

Passes around the midbrain, superior to the tentorium cerebelli and along the medial and inferior surface of the temporal and occipital lobes

58
Q

What do the posterior cerebral arteries supply?

A

1) Ventral part of base of cerebral peduncles (cerebral crus, III nerve and substantia nigra)
2) Posterior thalamus
3) tectum of midbrain
4) posterior corpus callosum
5) inferior surface of temporal lobe including part of the hippocampus
6) medial and inferior surface of the occipital lobe
7) strip of temporal and occipital cortex along the lateral surface

59
Q

What would an occlusion of the posterior cerebral arteries cause?

A

1) Weber’s syndrome (contralateral spastic hemiplegia, contralateral lower facial muscle dysfunction, and ipsilateral III nerve dysfunction)
2) cortical blindness of contralateral half of visual field of both eyes (contralateral homonymous hemianopsia) due to primary visual cortex supply from posterior cerebral arteries

60
Q

What is the artery that connects the posterior cerebral artery with the internal carotid known as?

A

Posterior communicating artery

61
Q

How does the internal carotid artery travel in the skull?

A

Traverse the cavernous sinuses and approach the brain just lateral to the optic chiasm

62
Q

What are the branches of the internal carotid system?

A

1) Hypophyseal branches
2) Opthalmic artery
3) Anterior choroidal artery
4) Anterior Cerebral artery
5) Middle cerebral artery

63
Q

What does an aneurysm of the internal carotid artery cause?

A

It becomes a lesion of the lateral margin of the optic chiasm and leads to nasal hemianopsia of the ipsilateral eye

64
Q

What do hypophyseal branches of the internal carotid artery supply?

A

supply the pituitary gland

65
Q

What does ophthalmic artery supply and travel with?

A

Follows the optic nerve through the optic canal to supply the eyeball and other contents of the orbit

66
Q

Where does the anterior choroidal artery travel?

A

Along the optic tract

67
Q

What does the anterior choroidal artery supply?

A

Uncus, amygdala, optic tract, hippocampus

68
Q

What occurs with an aneurysm of the anterior choroidal artery?

A

Can lead to compression of optic tract and lead to homonymous hemianopsia

69
Q

Where is the anterior cerebral artery found and what are the two anterior cerebral arteries joined by?

A

Meet at the longitudinal cerebral fissure and join by a short anterior communicating artery

70
Q

Where does the anterior cerebral artery travel?

A

Travels along the corpus callosum to the medial surface of the frontal and parietal lobes, posteriorly to the parieto-occipital fissure

71
Q

What does the anterior cerebral artery supply?

A

Much of corpus callosum, cingulate gyrus, cortex of medial surface of frontal and parietal lobes, orbital frontal gyri and olfactory bulbs and tracts

72
Q

What do the branches of the naterior cerebral artery supply?

A

Strip of cortex along the lateral (superior) surface of frontal and parietal lobes

73
Q

What functional cortex does the anterior cerebral artery supply?

A

Supplies to the lower extremity, perineum and trunk regions of the primary somatosensory and motor cortex

74
Q

What would an occlusion of the anterior cerebral artery cause?

A

1) Deficits of contralateral lower extremity and trunk
2) loss of somatosensations
3) spastic paralysis (monoplegia)
4) urinary and fecal incontinence
5) other disabilities related to prefrontal cortical areas

75
Q

What is the largest branch of the internal carotid artery?

A

middle cerebral artery

76
Q

Where does the middle cerebral artery travel?

A

Enters the lateral sulcus

77
Q

What artery branches from the middle cerebral artery as it enters the lateral sulcus?

A

Lenticulostriate arteries (striate or chartos [sp?] arteries)

78
Q

What internal carotid system artery is prone to vascular disease?

A

Anterior choroidal artery

79
Q

What do lesions of the lenticulostriate arteries cause? and are they common?

A

Yes they are prone to vascular disease and lesions of the internal capsule will cause various sensory or motor problems

80
Q

What functional areas are supplied by the branches of the middle cerebral artery?

A

1) Auditory cortex
2) primary motor including association (except for lower extremity and trunk)
3) premotor (including frontal eye field)
4) primary somatosensory except for lower extremity and trunk
5) If in the dominant hemisphere - sensory to motor and sensory language centers

81
Q

What would occlusion of the middle cerebral arteries result in?

A

1) slight decrease in hearing for both ears
2) (upper motor lesion) -> spastic paralysis of contralateral upper extremity and muscles of facial expression of lower 1/2 of face
3) loss of voluntary gaze to contralateral side
4) loss of all somatosensation for contralateral upper extremity and face
5) aphasias (if in the dominant hemisphere)

82
Q

What is the arterial circle of Willis?

A

Arterial circle at the base of the cerebrum is formed through anastomotic connection between major arteries

83
Q

What arteries contribute to the circle of willis?

A 
Anterior communicating artery
Anterior cerebral arteries
Internal Carotid arteries
Posterior communicating arteries
Posterior cerebral arteries
Basilar artery
84
Q

In normal circumstances is there any exchange of blood between the right and left halves of the circle or between the vertebrobasilar and internal carotid systems?

A

No, typically very little exchange of blood occurs due to small communicating vessels

85
Q

What happens with blood exchange from right and left halves of the circle when occlusions occur?

A

Some alteration of blood flow from one of the anastomosing vessels may occur although they are often inadequate to avoid vascular lesions

Neuroanatomy Test 3 (7 decks)

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