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Year 2 Neuro > Cerebral Vasculature > Flashcards

Cerebral Vasculature Flashcards

1
Q

What percentage of cardiac output is used by the brain?

A

10-20-%

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2
Q

What percentage of oxygen is consumed by the brain?

A

20%

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3
Q

What percentage of liver glucose is used by the brain?

A

66%

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4
Q

Why is the brain so vulnerable?

A

Very vulnerable if blood supply is impaired because it is so metabolically active

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5
Q

What three arteries supply the brain?

A

Common carotid
Internal carotid
Vertebral artery

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6
Q

What is the path of the common carotid?

A

branches from brachiocephalic
runs up the side of the neck
divides at the laryngeal prominence

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7
Q

What does the external carotid supply?

A

Supplies the structure of the face

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8
Q

What is the pathway of the internal carotid artery?

A

Passes through base of skull into cranial cavity

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9
Q

What is the first branch of the subclavian artery?

A

Vertebral artery

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10
Q

What is the path of the vertebral artery?

A

Goes up in the neck

Posteriorly through transverse foramen of the cervical vertebrae

Passes through the base of skull via foramen magnum into cranial cavity

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11
Q

What arteries comprises the circle of willis?

A 
Anterior communicating artery
Anterior cerebral artery 
Internal carotid artery
Middle cerebral artery
Posterior communicating artery
Posterior cerebral artery 
Basilar artery
Vertebral artery
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12
Q

What are the main feeding arteries to the circle of willis?

A

Internal carotid

Vertebral artery

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13
Q

Anatomically, where can you find the Basilar artery?

A

Sits on the base of the pons

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14
Q

What is the benefit of the arrangement of the circle of willis?

A

If you have a blockage in one of the internal carotids e.g. atherosclerotic build up

Chance of compensatory flow from the other side

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15
Q

How does blood exit the cranial cavity?

A

Cerebral vains

Venous sinuses in the dura mater

Internal jugular vein

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16
Q

What is the path of blood flow in the venous sinuses?

A

Superior sagittal sinus
drains down the back of the head to the occipital lobe to form the confluence of sinuses
then drains laterally down the transverse sinus through the sigmoid sinus into the internal jugular vein

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17
Q

What is the fold of the dura between the two hemisphere called?

A

Falx cerebri

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18
Q

What is the fold of the dura between the hemispheres and the cerebellum called?

A

Falx cerebelli

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19
Q

How does blood drain from the brain itself?

A

Great cerebral vein (of Galen) drains into straight sinus and then on to the confluence

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20
Q

What are the layers of the brain?

A

Dura mater
(Inner meningeal layer and Outer periosteal layer)
Arachnoid mater
Pia mater

21
Q

Is there any extradural space?

A

No space between the skull and the dura mater

22
Q

What are the 4 types of haemorrhage?

A

Extradural
Subdural
Subarachnoid
Intracerebral

23
Q

What are main features of extradural haemorrhage?

A

trauma, immediate clinical effects (arterial, high pressure)

Can strip dura away from the skull

24
Q

What does a fracture to the pterion result in?

A

Main artery supplying the dura is behind the pterion

Rupture of this artery causes a extradural haemorrhage

25
Q

What are main features of subdural haemorrhage?

A

trauma, can be delayed clinical effects (venous, lower pressure)
which is why patients are often kept overnight after a head injury

26
Q

What are main features of subarachnoid haemorrhage?

A 
Ruptured aneurysms (congenital) 
Weaknesses in the blood vessel walls that burst and cause subarachnoid bleeds
27
Q

What are main features of subarachnoid haemorrhage?

A

Spontaneous hypertensive

28
Q

What is a CVA?

A

Cerebrovascualr accident (stroke)

29
Q

What is the definition of a CVA?

A

rapidly developing focal disturbance of brain function of presumed vascular origin and of >24 hours duration

30
Q

What are the two types of stroke?

A

Thrombo-embolic (85%)

Haemorrhagic (15%)

31
Q

What is a TIA?

A

Transient ischaemic attack

32
Q

What is the definition of a TIA?

A

rapidly developing focal disturbance of brain function of presumed vascular origin that resolves completely within 24 hours

can last seconds/minutes

33
Q

What is an infarct?

A

Degenerative changes which occur in tissue following occlusion of an artery

34
Q

What is cerebral ischaemia?

A

Lack of sufficient blood supply to nervous tissue resulting in permanent damage if blood flow is not restored quickly

35
Q

What does thrombosis mean?

A

formation of a blood clot (thrombus) causing a blockage

36
Q

What does embolism mean?

A

plugging of small vessel by material carried from larger vessel e.g. thrombi from the heart or atherosclerotic debris from the internal carotid

37
Q

Why is stroke a huge public health issue?

A

3rd commonest cause of death
100,000 deaths in UK per annum
50% of survivors are permanently disabled
70% show an obvious neurological deficit

38
Q

What are the risk factors for stroke?

A 
Age
Hypertension
Cardiac disease
Smoking
Diabetes mellitus
39
Q

What are the three main cerebral arteries?

A

Anterior
Middle
Posterior

40
Q

Which cerebral artery has the biggest perfusion field?

A

Middle cerebral artery

It also supplies many of the subcortical, deep structures of the brain

41
Q

What does the anterior cerebral artery supply?

A

Midline structures

Perfuses all the way back to the parietal-occipital fissure

42
Q

What does the posterior cerebral artery supply?

A

Inferior part of the temporal lobe

Occipital lobe

43
Q

What are the anterior cerebral artery symptoms?

A

Paralysis of contralateral structures (leg > arm, face)

Disturbance of intellect, executive function and judgement (abulia)

Loss of appropriate social behaviour

44
Q

What are the middle cerebral artery symptoms?

A

Classic stroke”

Contralateral hemiplegia: arm > leg

Contralateral hemisensory deficits

Hemianopia (loss of one side of the visual field)

Aphasia (L sided lesion)

45
Q

What are the posterior cerebral artery symptoms?

A

Visual deficits

homonymous hemianopia

visual agnosia

46
Q

How would atherosclerosis look on a specimen?

A

yellow discolouration in the walls of the vessels is a build-up of atheroma, fatty deposits that cause atherosclerosis or “hardening of the arteries”

47
Q

How does fresh blood present on a CT scan?

A

White lesions

48
Q

How does blood that has become a haematoma present (after time has passed)?

A

Black lesions

Year 2 Neuro (15 decks)

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