Cerebrovascular Gross anatomy Flashcards
What artery arises from ophthalmic artery, exits orbit medially to supply mid-forehead, joins ECA via some of its branches
frontal artery
The majority of blood flows into which portion of the carotid, internal or external?
internal
distributes blood to low-resistance vascular beds
Where does the ICA terminate?
middle cerebral artery and anterior cerebral artery
What branch of the carotid has eight major branches, the first branch is usually the superior thyroid artery?
external carotid artery
distributes blood to high-resistance vascular beds
Formed by confluence of vertebral arteries, divides into posterior cerebral arteries?
basilar artery
The internal carotid travels into the base of the skull, intracranial branches are?
Ophthalmic artery: originates near carotid siphon, a significate curve in the ICA
Posterior communicating artery
What is the largest intra-arterial connection?
circle of willis
Blood flow must change direction as the flowstream narrows entering the stenosis and enlarges as it exits. What causes energy loss through inertia?
Eddy currents, turbulence, and vortices
What arteries in the circle of willis?
Distal internal carotid, anterior cerebral arteries joined together by the anterior communicating artery, posterior cerebral arteries joined together by the posterior communicating arteries.
What are the important anastomoses?
a) ECA-ICA connections via orbital and ophthalmic arteries
b) occipital branch of ECA with atlantic branch of vertebral
c) deep cervical and ascending cervical branches of subclavian to branches of lower vertebral artery
First branch off the subclavian artery, unite after entering skull to form basilar artery?
vertebral
rt usually smaller than lt
What artery arise from ophthalmic artery, travels anteriorly and superiorly to the globe, joins ECA via some of its branches
supraorbital artery
What is an atheromatous plaque complicated lesion?
a fibrous plaque that includes fibrous tissue, more collagen, calcium, and cellular debris
What results because velocity and area are inversely proportional, acceleration causes increased energy losses?
velocity acceleration
Total fluid energy along a streamline of fluid flow is constant?
bernoulli principle
Transient ischemic attack?
A fleeting neurological dysfunction, symptoms last less than 24 hours, and usually embolic from heart or carotid artery
Transient symptoms?
transient ischemic attack
vertebral basilar insuffficiency
Permanent symptoms: cerebrovascular accident
symptoms last more than 24 hours
complete recovery does not occur
A form of arteriosclerosis; localized accumulations of lipid-containing material (atheroma), smooth muscle cells, collagen, fibrin and platelets
atheromatous
Most commonly caused by dysplasia of media along with overgrowth of collagen, bead-like appearance, and seen often in women?
fibromuscular dysplasia
Formed within or beneath the intima, causing thickening, hardening, and loss of elasticity of walls?
atherosclerosis
can result in decreased perfusion to brain
Fibrous plaque atheromatous plaque?
accumulation of lipids, collagen and elastic fibers
Large amounts of red blood cells trapped within a fibrin network, clumps of platelets may be evident?
thrombus
Where is an aneurysm rarely seen?
cervical carotid artery
Fatty streak atheromatous plaque?
thin layer of lipid material on intimal layer
Piece of thrombus breaks loose and travels distally until it lodges in a small vessel
embolism
Common sites for bruit evaluation?
carotid and subclavian
Atheromatous plaque ulcerative lesion?
deterioration of the normally smooth surface of the fibrous cap; may result in distal embolization
Highly vascular structure that develops between the ICA and ECA, usually fed by the ECA?
carotid body tumor
A noise heard as the result of turbulent flow, frequently associated with a hemodynamically significant lesion?
bruit
may not be evident with a very tight stenosis
A left hemispheric CVA results in neurological deficits where?
on the rt side of the body
Symptoms frequently seen with ICA lesion?
unilateral paresis, unilateral paresthesia, aphasia, amaurosis fugax
Intimal thickening from rapid production of smooth muscle cells, a response to vascular injury/reconstruction post carotid endarterectomy?
neointimal hyperplasia
significant stenosis may occur 6 to 24 months
Weakness or slight paralysis on one side of body?
unilateral paresis
muscular uncoordination, inability to control gait?
ataxia
It is recommended to obtain bilateral BP measurements to detect what?
prox obstruction, subclavian steal
What specific eye symptom is suggestive of ipsilateral ICA disease?
amaurosis fugax
Symptoms frequently seen with vertebrobasilar lesion?
vertigo, ataxia, bilateral visual blurring or double vision, bilateral paresthesia or anesthesia, drop attack
Prickling or tingling of the skin?
unilateral paresthesia
Aphasia?
inability to speak
amaurosis fugax?
temporary, partial or total blindness, usually of one eye
Non-localizing symptoms of posterior circulation?
dizziness, syncope, severe headache
Symptoms frequently seen with MCA lesion?
aphasia or dysphasia
more severe facial and arm hemiparesis or hemiplegia
behavioral changes
Symptoms frequently seen with ACA lesion?
more severe leg hemiparesis or hemiplegia
incontinence
loss of coordination
falling to the ground without a loss of consciousness?
drop attack
Symptoms frequently seen with PCA lesion?
dyslexia, coma, paralysis usually does not occur
