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BB2 > Blood Supply to the Brain and the Clinical Relevance > Flashcards

Blood Supply to the Brain and the Clinical Relevance Flashcards

1
Q

how long duration of anoxia to the brain causes unconsciousness

A

20 seconds

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2
Q

how long duration of anoxia causes permanent unconsciousness and neurone death

A

5 mins

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3
Q

normotensive cerebral bloodflow

A

~50ml/100g brain per min

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4
Q

how does CO2 and O2 content in blood affect bloodflow to brain

A

incr CO2 or decr O2 increases bloodflow

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5
Q

what does autoregulation of cerebral bloodflow ensure

A

enough bloodflow to brain over wide range of BP and sO2

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6
Q

what mean arterial pressures can sufficient cerebral bloodflow be regulated over

A

60-160 mmHg

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7
Q

why is venous return from the brain more reliant on gravity than other bodyparts

A

no valves, muscles, or elasticity to help return

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8
Q

2 arteries supplying total cerebral bloodflow

A

carotid arteries
vertebral arteries

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9
Q

are the anterior and posterior communicating arteries usually open or closed

A

closed

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10
Q

does each vertebral artery supply 1 or 2 hemispheres

A

1 unless artery blockage opens communicating arteries

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11
Q

which cerebral artery has the largest territory

A

middle cerebral artery

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12
Q

3 arteries supplying the cerebral cortex

A

posterior cerebral artery
middle cerebral artery
anterior cerebral artery

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13
Q

what creates watershed regions in brain bloodsupply

A

anastomoses between arteries

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14
Q

posterior cerebral circulation main 3 branches

A

vertebral arteries
basilar artery
posterior cerebral artery

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15
Q

what does PICA branch from and supply

A

branches from vertebral artery
supplies dorsal medulla of brainstem

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16
Q

what does the basilar artery supply

A

pons
cerebellum

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17
Q

what does the posterior cerebral artery supply

A

inferior ad medial aspects of temporal and occipital cortex
thalamus
posterior internal capsule
midbrain

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18
Q

arteries supplying the midbrain

A

posterior cerebral artery
superior cerebellar artery
posterior communicating artery
interpeduncular rami of posterior cerebral artery

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19
Q

arteries supplying the pons

A

basilar artery - long circumferential, short circumferential, and paramedian branches

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20
Q

arteries supplying the medulla

A

posterior inferior cerebellar artery
anterior inferior cerebellar artery
anterior spinal artery

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21
Q

which veins cross the subarachnoid space

A

superficial cerebral veins (become bridging veins)

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22
Q

which veins pierce the dura and enter the dural venous sinuses

A

bridging veins

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23
Q

which way do arachnoid granulations allow CSF to flow between dural sinuses and the subarachnoid space

A

into sinuses
prevent blood backflow into subarachnoid space

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24
Q

which dural sinus controls 80% of venous return from the brain

A

superior sagittal sinus

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25
Q

which 3 sinuses converge and the confluence of sinuses

A

superior sagittal sinus, straight sinus, and occipital sinus

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26
Q

dural venous sinuses

A

superior sagittal sinus
inferior sagittal sinus
straight sinus
signmoid sinus
occipital sinus
transverse sinus
comfluence of sinuses

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27
Q

is right or left dominance more common in cerebral venous drainage

A

right

28
Q

what can cause spontaneous cerebral haemorrhage

A

arterio venous malformation
aneurism

29
Q

causes of haemorrhagic stroke

A

hypertension
aneurism
elderly
trauma
alcoholism
arteriovenous malformation

30
Q

how does age and alcoholism increase haemorrhagic stroke risk

A

brain atrophy and neurone loss -> bridging veins sink -> higher tension on bridging veins -> increased risk of breakage

31
Q

effect of MCA stroke in left hemisphere

A

global aphasia
sensorimotor loss on contralateral face, upper limb, and trunk

32
Q

effect of MCA stroke in right hemisphere

A

neglect syndrome

33
Q

neglect syndrome

A

contralateral hemispatial neglect - ignore 1/2 of everything

34
Q

why does neglect syndrome generally improve over time

A

other parts of brain take over from damaged part

35
Q

effects of ACA stoke

A

contralateral sensorimotor loss below waist
urinary incontinence
personality defects - unemotional then impulsive
split brain syndrome

36
Q

why does ACA stroke cause split brain syndrome

A

ACA supplies corpus callosum

37
Q

TIA

A

transient episode of neurological dysfunction caused by focal brain, spinal cord, or retina ischaemia without acute infarction

38
Q

what is a TIA a warning sign of

A

heart attack
stroke

39
Q

anterior circulation TIA symptoms

A

motor weakness
hemi sensory loss
dysarthria
transient monocular blindness - blocked opthalmic artery

40
Q

posterior circulation TIA symtoms

A

vertigo
diplopia
ataxia
amnesia

41
Q

do TIA symptoms always return to normal within 24 hours

A

no - multiple TIAs could cumulate in permanent damage

42
Q

where does blood collect in an epidural, subdural, and subarachnoid haematoma

A

epidural - between skull and dura mater
subdural - between dura mater and arachnoid mater
subarachnoid - between arachnoid mater and pia mater

43
Q

where is extra axial bleeding

A

outside brain tissue - epidural, subdural, and subarachnoid

44
Q

which type of extra axial bleed is most common

A

subarachnoid

45
Q

rupture of which veins causes subdural haematoma

A

bridging veins

46
Q

causes of extra axial bleeds

A

trauma
aging
ruptured aneurysm
ruptured arteriovenous malformation

47
Q

how may a traumatic epi/extradural haematoma present

A

lucid period immediately after trauma then unconsciousness

48
Q

which blood vessels commonly cause epi/extradural haematoma

A

middle meningeal artery
anterior ethmoidal artery
large venous sinuses

49
Q

do epi/extradural haematomas cross suture lines

A

no - dura more tightly attached at sutures

50
Q

epi/extradural haematoma symptoms

A

contralateral weakness of extremities
contralateral visual field loss
CN3 compression

51
Q

how do epi/extradural haematomas cause symptoms

A

blood collection compresses intracranial structures

52
Q

3 types of subdural haematoma

A

acute
subacute
chronic

53
Q

what source of subdural haematoma has the slowest onset

A

venous bleeds - can take days to weeks

54
Q

subdural haematoma symptoms

A

irritability
seizures
headache
numbness
disorientation

55
Q

do subdural haematomas cross suture lines

A

yes

56
Q

subarachnoid haemorrhage symtoms

A

thunderclap headache
vomiting
confusion
lowered/fluctuating consciousness

57
Q

extra/epidural, subdural, and subarachnoid haematoma appearance on CT

A

extra/epidural - biconvex hyperdense
subdural - crescent hyperdense
subarachnoid - white diffuse signal over sulci

58
Q

which type of extraaxial bleed can cause blood or bilirubin to be present in lumbar puncture

A

subarachnoid

59
Q

xanthochromia

A

presence of bilirubin in the cerebrospinal fluid

60
Q

2 types of cerebral aneurysm

A

saccular
fusiform

61
Q

what type of extra axial bleed is caused by aneurysm rupture

A

subarachnoid

62
Q

where do brain aneurysms tend to form

A

junction points

63
Q

is a berry aneurysm a type of saccular or fusiform anaurysm

A

saccular

64
Q

how can a saccular aneurysm be prevented from rupturing

A

stent vessel
clip aneurysm
fill with coil

65
Q

risks from brain arteriovenous malformations

A

damage to surrounding tissue
leakage
weak spots in vascular system

66
Q

how can arteriovenous malformations be treated

A

radiotherapy
surgical resection
embolisation

BB2 (26 decks)

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