Blood Supply to the Brain Flashcards

1
Q

Brains blood supply components

A

Two Internal Carotid Arteries
Two Vertebral Arteries

Form the three major branches:
- Anterior Cerebral Artery
- Middle Cerebral Artery
- Posterior Cerebral Artery

All components of the circle of Willis.

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2
Q

What portion of the brain does the ACA Supply?

A

Anterior Frontal Lobe

Medial Surface of the Frontal Lobes and the Parietal Lobes

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3
Q

What are possible deficits caused by ACA involvement?

A
  • Contralateral LE motor and sensory involvement
  • Apraxia & Aphasia (Broca’s) (“BEN has Aphasia”)
  • Loss of behavioral control; impulsivity
  • Mental/personality/emotional changes
  • Neglect, preservation
  • Loss of bowel and bladder control
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4
Q

What portions of the brain does the MCA Supply?

A

Outer Cerebrum
- Basal Ganglia; Putamen, Globus Pallidus
- Posterior and Anterior Internal Capsule
- Lentiform Nucleus

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5
Q

What are possible deficits caused by MCA involvement? Differences found in Left and Right Hemisphere Damage

A

Left Hemisphere Damage:
- Contralateral weakness and sensory loss to the face and UE
- (Wernicke’s; Fluent; Receptive Aphasia)
- Homonymous Hemianopsia; is a visual field defect involving either the two right or the two left halves of the visual fields of both eyes.
- Limb-Kinetic Apraxia

Right hemisphere damage:
- Flat Affect
- impaired spatial regulation, body schema
- Anosognosia in the [non-dominant hemisphere]; Anosognosia, also called “lack of insight,” is a symptom of severe mental illness experienced by some that impairs a person’s ability to understand and perceive his or her illness.; Neglect

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6
Q

What portions of the brain does the PCA Supply?

A

Portions of the midbrain (mesencephalon)

Subthalamic Nucleus, Basal Nucleus

Thalamus

Inferior Temporal Lobe

Occipital and occipitoparietal cortices

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7
Q

What are possible deficits caused by PCA involvement?

Movement Deficits:
Visual Deficits:
Additional Deficits:
Contralateral Deficits:

A

Movement Deficits:
- Ataxia, athetosis or choreiform movements
- Movement quality impairments

Visual Deficits:
- Visual agnosia, Prosopagnosia; Facial Blindness
- Homonymous Hemianopsia
- Cortical Blindness from bilateral involvement
- Alexia and Dyslexia
- Topographical Disorientation

Additional Deficits:
- Memory Impairment; (inferior temporal lobe)
- Thalamic Pain Syndrome

Contralateral Deficits:
- Contralateral pain and temperature loss
- Contralateral hemiplegia

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8
Q

What portions of the brain does the Vertebral-Basilar Artery supply?

A

Lateral aspects of the pons and the midbrain

Superior Surface of the cerebellum.

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9
Q

What branches supply the Cerebellum

A

Branches from the basilar artery:

  • Posterior inferior cerebellar artery (PICA)
  • Anterior inferior cerebellar artery (AICA)
  • Superior Cerebellar Artery
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10
Q

What branches supply the Medulla

A

Posterior Inferior Cerebellar Arteries (PICA)

and

small branches from the vertebral arteries

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11
Q

What branches supply the Pons

A

Branches of the basilar artery

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12
Q

What branches supply the Midbrain and Thalamus

A

Posterior Cerebral Arteries

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13
Q

What branches supply the Occipital Cortex

A

Posterior Cerebral Arteries

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14
Q

What are deficits caused by involvement to the Vertebral-Basilar Artery?

A
  • Loss of Consciousness: LOC
  • Comatose or Vegetative States
  • Locked in Syndrome
  • Hemiplegia or tetraplegia
  • Vertigo, Nystagmus, Ataxia
  • Dysphagia & Dysarthria; inability to speak
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15
Q

Bilateral occlusion of the ACA Deficits

A
  • Paraplegia; paralysis of the legs and lower body
  • incontinence
  • Abulic Aphasia; [Definition: also known as apathy, psychic akinesia, and athymia, refers to a lack of will, drive, or initiative for action, speech and thought]
  • Frontal lobe symptoms: personality changes, potential Akinetic Mutism

[Definition: Akinetic mutism (AM) is a rare neurological disorder characterized by the presence of an intact level of consciousness and sensorimotor capacity, but with a simultaneous decrease in goal-directed behavior and emotions. Patients are in a wakeful state of profound apathy, seemingly indifferent to pain, thirst, or hunger.]

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16
Q

Bilateral occlusion of the MCA Deficits

A

Contralateral hemiplegia and sensory impairments

  • Dominant hemisphere involvement: Global, Wernicke’s and Broca’s aphasia
17
Q

What are the two most significant impairments caused by the PCA

A
  • Thalamic Pain Syndrome
  • Cortical Blindness
18
Q

What is thalamic pain syndrome?

A

Abdormal sensations of pain, temperature, touch, proprioception

  • Can become debilitating
19
Q

What is Cortical Blindness?

A

loss of vision due to damage of the visual portion of the occipital cortex

  • pupil can still dilate and constrict in response to light. (Intact pupillary light reflex)
20
Q

Severe impairments caused by the Vertebral-Basilar Artery

A
  • Locked in Syndrome
  • Coma and Vegetative States
  • Wallenberg Syndrome
21
Q

What is Wallenberg Syndrome: Secondary to Lateral Medullary Infarct

A

Ispilateral
- Facial Pain and Temperature Impairment
- Cerebellar Ataxia, Vertigo, Nystagmus
- Dysphagia (CN 9 and 10)
- Horner’s Syndrome (Descending Sympathetic Tracts)

Contralateral
- Pain and Temperature Impairment of the Body

22
Q

What is Horner’s Syndrome?

A

Ptosis; Dropping Upper Eyelid
Miosis; Decreased Pupillary Size
Anhidrosis; Decreased Sweating on Ipsilateral Face and Neck

23
Q

What is Locked- In Syndrome

A

As a result of a Complete Basilar Stroke

  • Tetraplegia and often Bilateral Cranial Nerve Palsy (with **sparing of upward gaze, blinking **)
  • COMA if (RAS: Reticular Activating System Disrupted)
  • Cognition is Spared
24
Q

Medial Medullary Syndrome

A

Ipsilateral
- Paralysis of 1/2 of tongue (CN 12)
(Deviation towards the paralyzed (weak) side on protrusion)

Contralateral
- Hemiparesis (UE and LE: due to Corticospinal Tract Disruption)
- Impaired Tactile and Proprioceptive Sense (Medial Lemniscus)