Cerebrovascular Anatomy, Pathology, Patient History & Physical, Symptoms Flashcards
what are the aortic arch branches
innominate artery, left CCA, and Left subclavian artery
what are the branches of the innominate artery
right CCA, right subclavian
what is the first brach off the subclavian arteries
vertebral arteries
ICA is the primary blood supply to
the brain, low resistance
approx. 80% of volume moves through the CCA to the ICA
ICA rarely has branches
how many PRIMARY branches does the ECA have, what are they called
describe ECA flow pattern and supply
8 primary branches
SUPERIOR THYROID, ascending pharyngeal, lingual, occipital, FACIAL, posterior auricular, maxillary, SUPERFICIAL TEMPORAL ARTERY
ECA supplies face and scalp, high resistance
collateral pathway for ECA-ICA
via ophthalmic and orbital artery
collateral pathway for occipital branch of the ECA
Atlantic branch of the vertebral
collateral pathway for cervical subclavian branches
vertebral artery branches
what is the largest collateral pathway in the brain, and explain what it does and why
circle of willis
provides pathway from left to right hemispheres as well as the anterior and posterior circulation
right and left ICA and right and left vertebral arteries join into an anastomotic “ring” of arteries located at the base of the brain (circle of willis)
describe posterior circulation of circle of willis
first branch of the subclavian unites to form the basilar artery
basilar artery divides into the posterior cerebral arteries
atherosclerosis obliterans (ASO)
most common pathology affecting the extracranial carotid vessels
deposition of plaque components within the arterial wall (between the intimal and media)
type of atherosclerotic plaque: fatty streak
thin layer of lipid material in the intimal layer
type of atherosclerotic plaque: fibrous plaque
accumulation of lipids
type of atherosclerotic plaque: complicated lesion
a fibrous plaque that includes fibrous tissue and collagen
type of atherosclerotic plaque: ulcerative lesion
fibrous cap deteriorates - increased incidence of embolus
type of atherosclerotic plaque: intraplaque hemorrhage
rupture of the vase vasorum with bleed inside the plaque
most common location for fibromuscular dysplasia
distal ICA
neointimal hyperplasia
intimal thickening from rapid, smooth muscle cell growth
identified following trauma/endarterectomy (causes damage to endothelium and subsequent regeneration
occurs 6-24 months post injury
carotid body tumor
a small sensory organ just above the bifurcation
also known as paraganglioma, highly vascular structure, usually fed by branches of the external carotid artery
asymptomatic until large
treatment is usually ligation of feeding vessels and/or surgical excision
fibromuscular dysplasia (FMD)
rare condition resulting in abnormal cellular growth in the walls of medium and large arteries
primarily affects the carotid and renal arteries
most common in women 40-60 years old
increased risk of aneurysm or dissection
“string of pearls appearance on ultrasound”
carotid dissection
tear in the intimal lining
creates false lumen
different flow patterns in true and false lumens - typically high resistance in false lumen
