Circulation of CNS

Question 1

there is a dense network of vessels in the brain meant to maintain consistent perfusion, even throughout fluctuations in mean arterial blood pressure. Which part of the brain has the highest metabolic demand? Why?

Answer 1

Cortex

Where all the cell bodies are located.

Question 2

the circle of willis is formed by the anastamoses of the […] arterial system and the [..] arterial system

Answer 2

vertebro-basilar

internal carotid

Question 3

the internal carotid artery is a branch of the [….], it ascends through the skull base via the [….]. It runs an s-shaped route and emerges lateral to the [….] to join the circle of willis anastamoses.

Answer 3

common carotid artery
carotid canal
optic chiasm

Question 4

the vertebral artery is a branch of the [….] artery. It travels up the vertebrae through the […..] and enters the cranial cavity via the […..]. It forms the [….] artery and supplies the […] aspect of the circle of willis.

Answer 4

subclavian artery.
transverse foramina.
foramen magnum.
basilar
posterior

Question 5

The internal carotid artery branches into the [….]. The bilateral anterior cerebral arteries are bridged by the […..], completing the anterior aspect of the circle of willis.

Answer 5

anterior cerebral artery and the middle cerebral artery.

anterior communicating artery.

Question 6

the posterior communicating artery bridges the […] with the [….].

Answer 6

internal carotid arteries

posterior cerebral arteries

Question 7

the […] unite to form the basilar artery, the basilar then terminates to form two [….].

Answer 7

vertebral arteries

posterior cerebral arteries

Question 8

the anterior cerebral artery supplies the […..] portion of the [……] and [….] lobes.

Territories include motor and sensory cortices for the [….].

The ACA runs along the [….] fissure.

Answer 8

medial
frontal and parietal lobes

lower limb

longitudinal fissure.

Question 9

the middle cerebral artery supplies the […] aspect of the brain, including parts of the […..].

Territories include motor and sensory for most of the body, except for […..]. Also [……] association areas, and […..] areas on the dominant side.

the middle cerebral artery runs along the [….] sulcus.

Answer 9

lateral
frontal, parietal, temporal, occipital lobes and the insula

the lower limb.
parieto-occipital
language.

lateral

Question 10

the posterior cerebral arteries supply the […..] aspects of the [….] lobes.

Territories include the [….] cortex.

Answer 10

medial and inferior.
temporal and occipital.

visual

Question 11

pontine branches off the [….] artery service the [….] aspect of the pons.

Answer 11

basilar artery.

ventral.

Question 12

[…] branch off the middle cerebral artery to service the basal ganglia and [….].

Answer 12

lenticulostriate arteries. (remember “lenticulo”=lentiform nucleus (globus pallidus and putamen of basal ganglia).

internal capsule

Question 13

before the internal carotid artery branches in the middle and anterior cerebral artery, it sends off the […..], which supplies the ocular orbit, as well as the […..] and scalp.

Answer 13

ophthalmic artery.

top of the nasal cavity.

Question 14

another branch of the ICA, the [….] artery, supplies structures deep in the lateral hemisphere including the […..] .
Often involves in damage to the visual system via it’s supply to the optic tract.

Answer 14

anterior choroidal artery.

optic tract, lateral ventricles, and hippocampus.

***Often involved in damage to the visual system via it’s supply to the optic tract.

Question 15

the vertebro-basilar artery system gives off many branches before becoming the posterior cerebral arteries.
1st, vertebral artery gives off a branch, the […..].

After uniting with other vertebral arteries to form the basilar artery, it gives off a branch, the [….].

As it moves rostrally and gives off small pontine branches, just before it terminates as the posterior cerebral artery, it branches into the [….]

Answer 15

posterior inferior cerebellar artery.

anterior inferior cerebellar artery.

superior cerebellar artery.

Question 16

which parts of the vertebro-basilar arterial system are in the midbrain?

Answer 16

basilar artery comes up and branches into the posterior cerebral arteries, these project to the occipital lobe branching towards the back end of the midbrain.

Question 17

which parts of the vertebro-basilar arterial system are in the pons?

Answer 17

the pons has the basilar artery with pontine branches (paramedian, short circumferential, long circumferential)

Question 18

which parts of the vertebro-basilar arterial system are in the medulla?

Answer 18

anterior spinal artery runs in the midline.

vertebral artery running posterolateral.

posterior inferior cerebellar artery running around backend of medulla en route to the cerebellum (gives off branches for posterolateral aspect of medulla).

Question 19

the anterior spinal artery is the blood vessel that supplies the […..]. It arises from branches of the […] arteries and courses along the [….] aspect of the spinal cord.

Answer 19

anterior portion of the spinal cord

vertebral

anterior

*essentially supplies all of ventral horn and ventral tract

Question 20

[…..] is a cerebral vascular accident associated with the anterior spinal artery.

It’s impact includes:
1) the [….] nucleus, with damage causing ipsilateral paralysis and and atrophy of the tongue. (LMN)

2) the [….], with damage causing a contralateral somatosensory deficit.
3) the [….] tract running through the medullary pyramids, with damage causing contralateral hemiparesis (UPM).

Answer 20

medial medullary syndrome

1) hypoglossal
2) medial lemniscus
3) corticospinal tract

Question 21

[…..] is a cerebral vascular accident associated with the posterior inferior cerebellar artery.

It’s impact includes:
1) […], causing ipsilateral deficits in pain and temperature over the face

2) [….], causing ipsilateral ataxia and in-coordination
3) […], causing dysarthria, dysphagia, and decreased gag

Answer 21

Lateral medullary syndrome

1) spinal trigeminal nucleus
2) inferior cerebellar peduncles
3) nucleus ambiguus

Question 22

the posterior spinal arteries run along the […] aspect of the spinal cord, and are each formed directly from a single branch of the [….] running posteriorly.. These supply most of the [….].

Answer 22

posterior

vertebral arteries

dorsal horn and dorsal funiculus (located between dorsal horn and midline)

Question 23

[….] are communications between the anterior and posterior spinal arteries that service the [….].

Answer 23

circumfrential branches

lateral tracts

Question 24

cerebral veins run in the [….] space and drain into a series of [….]

Answer 24

subarachnoid space

sinuses (superior saggital sinus, sigmoid sinus, inferior saggital sinus, straight sinus).

Question 25

blood brain barrier permits some gasses and lipid soluble substance to pass through via […..] process. Whereas glucose and important amino acids must pass via […] process.

Answer 25

diffusion

active transport.