Blood Supply to the Brain Flashcards

1
Q
  • what is ~ avergae brain blood flow? [1]
  • does this fluctuate much (e.g. with hyper /hypotension)? [1]
  • what changes in O2 [1] & CO2 [1] cause an increase in blood flow to brain?
A
  • what is ~ avergae brain blood flow? [1] ~ 50 ml per 100g of brain tissue per minute
  • does this fluctuate much (e.g. with hyper /hypotension)? [1]
  • *no: flow regulated by auto-regulation**
  • what changes in O2 [1] & CO2 [1] cause an increase in blood flow to brain?
    decrease in o2
    increase in co2 = both increase flow to brain
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2
Q

what is different about cerebral arteries compared to other arteries? [3]

what is different about cerebral veins compared to other veins? [3]

A

arteries

  • thin walled
  • easily blocked
  • easily distorted & ruptured

veins:

  • no valves
  • thin walled
  • gravity helps flow back
  • found in dural sinuses
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3
Q

which arteries provide 80% of total cerebral blood flow to anterior 2/3 cerebral cortex?

which arteries provide 20% of total cerebral blood flow to posterior 1/3 cerebral cortex?

A

which arteries provide 80% of total cerebral blood flow to anterior 2/3 cerebral cortex?
internal carotid arteries

which arteries provide 20% of total cerebral blood flow to posterior 1/3 cerebral cortex?
vertebral arteries

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4
Q
A

ICA: branch into: anterior cerebral artery (goes anterior & 2 are connected by anterior communicating artery) & middle cerebral artery

posterior blood supply:

  • vertebral arteries come in & merge to form basilar artery. at midbrain, basilar artery –> posterior cerebral artery
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5
Q

which of the following is formed from basilar artery:

anterior spinal artery
middle cerebral artery
posterior cerebral artery
posterior inferior cerebellar artery
anterior cerebral artery

A

which of the following is formed from basilar artery:

anterior spinal artery
middle cerebral artery
posterior cerebral artery
posterior inferior cerebellar artery
anterior cerebral artery

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6
Q

what is D?

middle cerebral artery
basilar artery
posterior cerebral artery
anterior cerebral artery
internal carotid artery

A

what is C?

middle cerebral artery
basilar artery
posterior cerebral artery
anterior cerebral artery
​internal carotid artery

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7
Q

what is A?

middle cerebral artery
basilar artery
posterior cerebral artery
anterior cerebral artery
internal carotid artery

A

what is A?

middle cerebral artery
basilar artery
posterior cerebral artery
anterior cerebral artery
internal carotid artery

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8
Q

what is E?

middle cerebral artery
basilar artery
posterior cerebral artery
anterior cerebral artery
internal carotid artery

A

what is E?

middle cerebral artery
basilar artery
posterior cerebral artery
anterior cerebral artery
internal carotid artery

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9
Q

what is C?

middle cerebral artery
basilar artery
posterior cerebral artery
anterior cerebral artery
internal carotid artery

A

what is C?

middle cerebral artery
basilar artery
posterior cerebral artery
anterior cerebral artery
internal carotid artery

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10
Q

what is B?

middle cerebral artery
basilar artery
posterior cerebral artery
anterior cerebral artery
internal carotid artery

A

what is B?

middle cerebral artery
basilar artery
posterior cerebral artery
anterior cerebral artery
internal carotid artery

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11
Q

draw the circle of willis xxx

A
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12
Q

Label A-C

A

A: anterior cerebral artery
B: middle cererbral artery
C: internal carotid artery

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13
Q

under normal circumstances, what are the anterior and posterior communicating arteries like?

A

closed !!

classic circle of willis is seen in ~1/3rd pop

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14
Q

label A-D [4]

A

A: vertebral artery
B: superior cerebellar artery
C: posterior cerebral artery
D: basilar artery

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15
Q

when does collateral circulation open? [1]

A

collateral circulation should only open when there is a pressure difference (increased pressure can open anterior / posterior communicating arteries)

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16
Q

what is most normal variant in cerebral arterial circle? [1]

A

what is most normal variant in cerebral arterial circle? [1]
one / both posterior communicating arteries are missing (e & f)

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17
Q

what are the main branches of the internal carotid artery? [4]

A
  1. opthalmic artery: orbit & retina. connects to external carotid artery
  2. posterior communicating: connext with carotid & vertebral artery system
  3. middle cerebral artery: connects to basal ganglia and lateral 2/3rds of cortex
  4. anterior cerebral artery: connects with medial side frontal & parietal lobes, anastamoses with MCA
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18
Q

which artery is a branch of the ICA that occurs in the cavernous sinus?

middle cerebral artery
anterior cerebral artery
posterior communicating artery
menigeal branch
opthalmic artery

A

which artery is a branch of the ICA that occurs in the cavernous sinus?

middle cerebral artery
anterior cerebral artery
posterior communicating artery
menigeal branch
opthalmic artery

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19
Q

which of the following supplies the basal ganglia & lateral 2/3rd of the cortex?

middle cerebral artery
anterior cerebral artery
posterior communicating artery
menigeal branch
opthalmic artery

A

which of the following supplies the basal ganglia & lateral 2/3rd of the cortex?

middle cerebral artery
anterior cerebral artery
posterior communicating artery
menigeal branch
opthalmic artery

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20
Q

which of the following supplies the medial side of frontal and parietal lobes?

middle cerebral artery
anterior cerebral artery
posterior communicating artery
menigeal branch
opthalmic artery

A

which of the following supplies the medial side of frontal and parietal lobes?

middle cerebral artery
anterior cerebral artery
posterior communicating artery
menigeal branch
opthalmic artery

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21
Q

which of the following anastamoses with the MCA?

middle cerebral artery
anterior cerebral artery
posterior communicating artery
menigeal branch
opthalmic artery

A

which of the following anastamoses with the MCA?

middle cerebral artery
anterior cerebral artery
posterior communicating artery
menigeal branch
opthalmic artery

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22
Q

which of the following connects to the external carotid artery?

middle cerebral artery
anterior cerebral artery
posterior communicating artery
menigeal branch
opthalmic artery

A

which of the following connects to the external carotid artery?

middle cerebral artery
anterior cerebral artery
posterior communicating artery
menigeal branch
opthalmic artery

23
Q

which of the following supplies the corpus callosum?

middle cerebral artery
anterior cerebral artery
posterior communicating artery
menigeal branch
opthalmic artery

A

which of the following supplies the corpus callosum?

middle cerebral artery
anterior cerebral artery
posterior communicating artery
menigeal branch
opthalmic artery

24
Q

what is A?

A

cavernous sinus

25
Q
A
26
Q

middle cerebral artery goes between which two brain lobes to get to lateral wall?

temporal & parietal
temporal and occiptal
temporal and frontal
parietal and occipital
occipital and cerebellum

A

middle cerebral artery goes between which two brain lobes to get to lateral wall?

temporal & parietal
temporal and occiptal
temporal and frontal
parietal and occipital
occipital and cerebellum

27
Q

which artery most commonly supplies Broca’s & Wernicke’s areas?

ACA
MCA
PCA
Basilar A
ICA

A

which artery most commonly supplies Broca’s & Wernicke’s areas?

ACA
MCA
PCA
Basilar A
​ICA

28
Q

which arteries supply 1-5?

A

1: anterior cerebral A
2: middle cerebral A
3: posteror cerebral A
4: anterior choroidal A
5: lenticulostriate (branch of MCA)

29
Q

describe the pathway of the posterior circualation of the brain?

A

vertebral:

  • has anterior spinal arteries and posterior spinal arteries (x2) going inferiorly
  • has PICA branching off to dorsal medulla of brainstem

turns into the basilar artery:
- has anterior inferior cerebellar artery (AICA) and superior cerebellar artery arching off

redivides at the superior cerebellar arteries and continues to **posterior cerebral arteries

  • **supplies the inferior and medial aspects of temporal and occipital cortex
  • thalamus
  • midbrain
  • anastamoses with MCA
30
Q

which artery provides blood to the pons?

PICA
AICA
superior cerebllar artery
pons
posterior cerebral artery

A

which artery provides blood to the pons?

PICA
AICA
superior cerebllar artery
pons (via pontine arteries)
​posterior cerebral artery

31
Q

which artery provides blood to the midbrain & thalamus

PICA
AICA
superior cerebllar artery
pons
​posterior cerebral artery

A

which artery provides blood to the midbrain & thalamus

PICA
AICA
superior cerebllar artery
pons
​posterior cerebral artery

32
Q

which artery provides blood to the dorsal medullar of midbrain?

PICA
AICA
superior cerebllar artery
pons
​posterior cerebral artery

A

which artery provides blood to the dorsal medullar of midbrain?

PICA
AICA
superior cerebllar artery
pons
​posterior cerebral artery

33
Q
A
34
Q

which of the following is the vertebral artery?

A
B
C
D
E

A

which of the following is the vertebral artery?

A
B
C
D
E

35
Q

which of the following is the PICA?

A
B
C
D
E

A

which of the following is the PICA?

A
B
C
D
E

36
Q

which of the following is the anterior spinal artery?

A
B
C
D
E

A

which of the following is the anterior spinal artery?

A
B
C
D
E

37
Q

which of the following is the basilar artery?

A
B
C
D
E

A

which of the following is the basilar artery?

A
B
C
D
E

38
Q

which of the following is the AICA?

A
B
C
D
E

A

which of the following is the AICA?

A
B
C
D
E

39
Q

what do arachnoid granulations allow to occur? [1]

A

arachnoid granulations: allow CSF to flow into venous blood of sinuses but prevent backflow of blood into sub-arachnoid space

40
Q

which sinus do most cerebral veins drain into?

straight sinus
transverse sinus
superior saggital sinus
inferior saggital sinus
sigmoid sinus

A

which sinus do most cerebral veins drain into?

straight sinus
transverse sinus
superior saggital sinus
inferior saggital sinus
sigmoid sinus

41
Q

which of the following is the straight sinus?

A
B
C
D
E

A

which of the following is the straight sinus?

A
B
C
D
​E

42
Q

which of the following is the sigmoid sinus?

A
B
C
D
​E

A

which of the following is the sigmoid sinus?

A
B
C
D
​E

43
Q

which of the following is the superior sagittal sinus?

A
B
C
D
​E

A

which of the following is the superior sagittal sinus?

A
B
C
D
​E

44
Q

which of the following is the transverse sinus?

A
B
C
D
​E

A

which of the following is the transverse sinus?

A
B
C
D
​E

45
Q

which of the following is the inferior sagittal sinus?

A
B
C
D
​E

A

which of the following is the inferior sagittal sinus?

A
B
C
D
​E

46
Q

which CN do you find in the cavernous sinus? [4]

A

CN III
CN IV
CN V1
CN V2
CN VI (more medial)

47
Q

posterior spinal arteries come off which arteries? [1]

anterior spinal artery comes off which artery? [1]

A

posterior spinal arteries come off which arteries? [1]
PICA

anterior spinal artery comes off which artery? [1]
verterbral artery

48
Q

which artery reinforces the circulation of 2/3rs of spinal cord?

​where does it come from?

A

which artery reinforces the circulation of 2/3rs of spinal cord?
greater segmental medullary artery (artery of Adamkiewicz)

where does it come from?
branch of intercostal artery

49
Q

what might happen to patients undergoing surgery for an arotic aneursym? [1]

A

what might happen to patients undergoing surgery for an arotic aneursym? [1]

may lose all sensation and vol. movement inferior to level of occlusion

50
Q

where is most common place for cerebral aneursym? [1]

when are they dangerous? [1]

A

anterior communicating artery

when are they dangerous? [1]
when they rupture

51
Q

what are the two different types of stroke? [2]

* what happens if you have stroke to MCA in dominant hemisphere? [2] *

* what happens if you have stroke to MCA in non-dominant hemisphere? [1] *

A

ischaemic: blood clot to artery supplying brain

hamorrhagic stroke: small bleed out into blood tissue

* what happens if you have stroke to MCA in dominant hemisphere? [2] *

  • *global aphasia (**bc Broca & Wernickes area’s get damaged)
  • *sensorimotor loss on controlateral face, upper limb & trunk**

* what happens if you have stroke to MCA in non-dominant hemisphere? [1] *
neglect syndrome (only will draw half of image)

52
Q

what would u see if had stroke to ACA? [4]

A

what would u see if had stroke to ACA? [4]

  • contralateral sensorimotor loss below waist
  • urinary incontinence
  • personaility defects
  • split brain syndrome (corpus callosum gets damaged)
53
Q

what would u see if had stroke to PCA? [3]

A

what would u see if had stroke to PCA? [3]

  • contralateral homonymous hemianopsia (image)
  • reading & writing deficits
  • impaired memory
54
Q

what would happen if PICA is blocked / burst?

A

lateral medullary syndrome: wallenburg syndrome

suddenly:
- vertigo, horners syndomr, nauseau, loss of pain and temp on contralateral, loss of pain and temp in face (trigeminal)