Blood Supply To Brani Flashcards

1
Q

Importance of arterial blood supply to the brain

A

Needs a continuous supply of oxygenated blood and glucose as a primary energy source

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2
Q

Lobes of the cerebral cortex

A

Parietal, frontal, occipital, temporal

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3
Q

Subcortical structures of the brain

A

Diencephalon - thalamic masses and basal ganglia
Mesencephalon
Pons
Medulla
Cerebellum

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4
Q

5 branches of aortic blood supply

A

Aortic root (supplies blood to heart)
Ascending aorta
Arch of aorta
Descending aorta
Abdominal aorta

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5
Q

3 branches of the apex of the aortic arch

A

Braciocephalic trunk/artery
Left common carotid
Left subclavian

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6
Q

What does the brachiocephalic artery divide into?

A

Right subclavian artery
Right common carotid artery

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7
Q

Where does the brachiocephalic artery bifurcate?

A

Level of the sternoclavicular articulation

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8
Q

What do the common carotid arteries supply?

A

Right supplies the right side of neck and right anterior cerebral circulation
Left supplies the left side of neck and left side of cerebral circulation

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9
Q

What level does the arch of the aorta sit?

A

T4/T5 discs at the sternal angle of Louis

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10
Q

When does bifurcation of the common carotid occur?

A

Superior part of thyroid cartilage, roughly c3/4 vertebral levels

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11
Q

What does internal carotid supply?

A

No branches in the neck, branches constitute the anterior cerebral circulation

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12
Q

How do distinguish internal and external carotid

A

Internal has a dilation at the start (carotid sinus) and has no branches in the neck

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13
Q

What does the external carotid artery supply?

A

Neck, face, scalp, mouth and jaw tissues

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14
Q

What are the branches of the external carotid artery?

A

SALFOPMS - some anatomists like freaking out poor medical students
Superior thyroid, ascending pharyngeal, lingual, facial, occipital, posterior auricular, maxillary, superficial temporal
Last 2 are terminal branches

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15
Q

4 segments of the ICA

A

Cervical, petrous, cavernous, cerebral

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16
Q

What else does the ICA carry with it?

A

Sympathetic supply to the head region

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17
Q

What are the 3 major branches of the ICA

A

Anterior cerebral artery, middle cerebral artery, posterior communicating artery

18
Q

What are the 2 terminal minor branches of the ICA?

A

Anterior choroidal artery, ophthalmic artery

19
Q

What does the anterior cerebral artery supply?

A

Smaller major branch of ICA. Supplies frontal and parietal lobes. Runs through head like Mohawk. Joined by anterior communicating artery.

20
Q

What does the middle cerebral artery supply?

A

2/3 of the flow. Frontal parietal and occipital cortex.
Lateral striate arteries supply the basal ganglia.

21
Q

Where do most strokes occur in the brain?

A

Middle cerebral artery territory

22
Q

What does the posterior communicating artery supply?

A

Posterior circulation. Supplies midbrain, thalamus, temporal and occipital lobes of cortex.

23
Q

Describe the route of the ICA

A

Up (from below skull) into the carotid canal. Gives off caroticotympanic branch to the ear. Courses through the top of the foramen lacerum. Forwards into the cavernous sinus, and gives off inferior hypoohyseal branch. Moves medial to the anterior clinoid process, giving off the ophthalmic branch. Back on the roof of the cavernous sinus, giving off superior hypophyseal and anterior choroidal branches. Upwards to terminate as 3 major terminations.

24
Q

What is the circular arterial anastomosis of the brain?

A

Circle of Willis

25
Q

What is the purpose of the circle of Willis?

A

Allows for any disruption to blood supply along the anastomosis without loss of function due to the circular arrangement allowing perfusion on any part of the brain.

26
Q

Why are strokes still possible?

A

Because only 20-30% of people have a fully formed circle of Willis.

27
Q

Where is the circle of Willis located?

A

Within the subarachnoid space. Sits below the brain, forming the floor on which the brain rests upon.

28
Q

Anterior circulation of the circle of Willis

A

ICA, MCA, ACA, PCommA

29
Q

Posterior circulation of the circle of Willis

A

PCA, BA, VA

30
Q

Where do vertebral arteries arise from and what do they branch?

A

Arise from the subclavian arteries
Largest branch - posterior inferior cerebellar artery
Other branches - spinal artery

31
Q

What forms the basilar artery?

A

Formed by the union of the left and right vertebral arteries at the pinto-medullary junction.

32
Q

What does the basilar artery supply?

A

Most of the brainstem

33
Q

What branches does the basilar artery give off?

A

Gives for superior and anterior inferior cerebellar arteries
Bifurcates into 2 posterior cerebral arteries

34
Q

What does the venous system of the brain drain?

A

CSF and blood

35
Q

What is the most superficial vein of the brain and where does it course?

A

Superior sagittal sinus. Runs along the superior border of the falx cerebri and drains into the confluence of sinuses.

36
Q

What is the main deep vein of the brain and how does it course?

A

Great vein of Galen. Joined by the inferior sagittal sinus and drains into the straight sinus to join the confluence of sinuses.

37
Q

What does the confluence of sinuses split into?

A

Confluence of sinuses splits into 2 transverse sinuses, which drain into the sigmoid sinus before draining into the internal jugular vein.

38
Q

What does the cavernous sinus drain?

A

Drains the superior and inferior ophthalmic veins from the superior orbital fissure, as well as the superficial middle cerebral vein and sphenoparietal sinuses.

39
Q

What are the veins of the infratemporal fossa?

A

Maxillary vein
Superior ophthalmic veins, anterior intercavernous sinus, inferior ophthalmic vein, pterygoid venous plexus, middle meningeal vein

40
Q

What is stroke?

A

Clinical syndrome of abrupt loss of focal brain function lasting more than 24 hours that is due to either spontaneous haemorrhage into brain substance or inadequate blood supply to part of the brain (thrombosis, embolism)

41
Q

What is transient ischaemia attack TIA?

A

Sudden onset, focal disturbance of brain function, presumed to be of vascular origin. Resolves completely within 24 hours.

42
Q

Why might infection of the pterygoid region be of danger to the eye?

A

Pterygoid venous plexus lies deep in the temporal fossa is connected with the ophthalmic and anterior facial veins. This plexus drains into the cavernous sinus and so pus within the venous plexus may cause direct increased ophthalmic venous pressure or may even lead to a cavernous sinus thrombosis, resultant paralysis of extraocular muscles.