Cerebral Vasculature

Question 1

What does the brachiocephalic trunk bifurcate into?

Answer 1

Right common carotid artery

Right subclavian artery

Question 2

What artery supplies the head and neck?

Answer 2

External carotid artery

Question 3

Which artery supplies the brain?

Answer 3

Internal carotid artery

Question 4

Where does the internal carotid artery pass through into the cranial cavity?

Answer 4

Carotid canal

Question 5

Which cranial bone is the carotid canal found in?

Answer 5

The temporal bone

Question 6

Which arteries do the vertebral arteries arise from?

Answer 6

Subclavian arteries

Question 7

Where do the vertebral arteries enter into the cranial cavity?

Answer 7

Foramen Magnum

Question 8

What do the paired vertebral arteries fuse into?

Answer 8

Basilar artery

Question 9

Which artery connects the posterior and middle cerebral arteries?

Answer 9

Posterior communicating artery

Question 10

What does the posterior cerebral artery supply?

Answer 10

Occipital lobe and the inferior part of the temporal lobe

Question 11

Where does the middle cerebral artery supply?

Answer 11

Supplies the temporal and parietal lobes

Question 12

Where does the anterior cerebral artery sypply?

Answer 12

Frontal lobes and superior medial parietal lobes

Question 13

Which artery connects the anterior cerebral arteries?

Answer 13

Anterior communicating artery

Question 14

How is CSF reabsorbed?

Answer 14

Via the arachnoid granules into the superior sagittal sinus

Question 15

Where does the transverse sinus drain into?

Answer 15

Sigmoid sinus

Question 16

Where does the sigmoid sinus drain into?

Answer 16

Into the internal jugular vein

Question 17

What are the meningeal layes?

Answer 17

Dura mater
Arachnoid
Pia mater

Question 18

What are the two layers of the dura mater?

Answer 18

Periosteal

Meningeal

Question 19

Which layer is adherent to the inner surface of the bone?

Answer 19

Periosteal dura layer

Question 20

What produces the cerebrospinal fluid?

Answer 20

Produced by the choroid plexus (modified ependymal cells)

Question 21

What are the four types of haemorrhages?

Answer 21

Extradural
Subdural
Subarachnoid
Intracerebral

Question 22

What is an extradural haemorrhage?

Answer 22

A collection of blood that forms between the inner surface of the skull and the outer layer of the dura (endosteal layer)

Question 23

What are the consequences of an extradural haemorrhage?

Answer 23

Causes an increase in intracranial pressure. Pressure can strip the endosteal layer, away from the cranial cavity.

A rising level of intracranial will eventually cause midline shift and tentorial herniation - compression of brainstem

Question 24

What is the weakest point of the cranial cavity?

Answer 24

Pterion -Ruptures the middle meningeal artery

Question 25

What type of pattern is shown on a CT for an extradural bleed?

Answer 25

Lemon-shaped bleed on MRI

Question 26

What is a subdural haemorrhage?

Answer 26

An accumulation of blood in the subdural space, the potential space between the dura and arachnoid mater of the meninges.

Question 27

Which type of haemorrhage is associated with delayed symptoms?

Answer 27

Subdural haemorrhage

Question 28

Which types of vessels are implicated in a subdural haemorrhage?

Answer 28

Cortical veins

Question 29

What is a subarachnoid haemorrhage?

Answer 29

Subarachnoid bleeds typically present at the base of the brain, most often due to aneurysmal ruptures  Blood accumulation with the subarachnoid space. • Berry aneurysms are arterial swellings usually at the junction of arterial bifurcation.

Question 30

What type of aneursyms are common in subarachnoid haemorrhage?

Answer 30

Berry Aneursyms

Question 31

What is an intracerebral haemorrhage?

Answer 31

Intracerebral haemorrhages usually arise from ruptures of an arteriosclerotic small artery that has been weakened predominantly by chronic arterial hypertension. • Charcot-Bouchard aneurysms more likely to be found in lenticulostriate vessels (Anterior circulation of the Circle of Willis and supplies the basal ganglia). Chronic hypertension can result in cerebral microbleeds.

Question 32

Which type of haemorrhage is linked with hypertension?

Answer 32

Intra-cerebral haemorrhage

Question 33

What are the two types of stroke?

Answer 33

Ischaemic (Thrombo-emoblic) and haemorrhagic

Question 34

What is a transient-ischaemic stroke?

Answer 34

The consequences of a temporary disruption of the circulation to part of the brain due to thrombo-embolic causes

Question 35

What is cerebral ischaemia?

Answer 35

Lack of sufficient blood supply to nervous tissue resulting in permanent damage if blood flow is not restored quickly. Compromised blood flow leads to anoxia considering there is a reduced availability of respiratory substrate and oxygen for the metabolic cerebral activity.

Question 36

What is a thrombo-embolic stroke?

Answer 36

The formation of a thrombus elsewhere within circulation can be degenerated into am embolus, being carried within circulation into cerebral arteries. Atherosclerotic debris from the internal carotid artery can further contribute to the development of a thrombo-embolic stroke.

Question 37

What are the risk factors for a stroke?

Answer 37

``` Age Hypertension Cardiac disease Smoking Diabetes mellitus ```

Question 38

What is the perfusion field for the middle cerebral artery?

Answer 38

The artery supplies a portion of the frontal lobe and the lateral surface of the temporal and parietal lobes

Question 39

What is the perfusion field for the anterior cerebral artery?

Answer 39

Supplies the para-saggital midline of the brain, perfusion of the occipital fissure

Question 40

What is the perfusion field for the posterior cerebral artery?

Answer 40

Largely supplies the occipital lobe, in addition to the inferior region of the temporal lobe

Question 41

What are the symptoms that manifest from an ACA?

Answer 41

Contralateral motor paralysis (leg>arm) Disturbance of intellect, executive function and judgement (abulia) Loss of appropriate social behaviour (disinhibition)

Question 42

Which type of stroke is referred to as a 'classic stroke'?

Answer 42

Middle cerebral artery stroke

Question 43

What are the symptoms that manifest from a middle cerebral artery stroke?

Answer 43

Contralateral hemiplegia Contralateral hemisensory deficits Hemianopia Aphasia (In a left-sided lesion)

Question 44

Which two areas are specifically affected in a left-sided lesion to the middle cerebral artery?

Answer 44

Broca's and Wernicke's

Question 45

What are the clinical manifestations for a posterior cerebral artery stroke?

Answer 45

Visual agnosia (Inability to recognise) Prosopagnosia (A cognitive disorder of face perception)

Question 46

What is visual agnosia?

Answer 46

The inability to recognise

Question 47

What is prosopagnosia?

Answer 47

A cognitive disorder of face perception

Question 48

Which topographic region is most likely implicated in a MCA stroke?

Answer 48

Arm > leg