CNS Blood Supply Lecture

Question 1

Blood carries

Answer 1

O2 and glucose

Question 2

T or F: Brain cells have no energy stores of their own

Answer 2

TRUE

Question 3

Brain consumes what percentage of the total energy generated in the body

Answer 3

15 to 20%

Question 4

Brain is vulnerable to an energy crisis! Can be from what

Answer 4

Hypoxia (altitude, CO poisoning)
Hypoglycemia
Severe anemia
Drop in cerebral perfusion

Question 5

Drop in cerebral perfusion can lead to

Answer 5

Global ischemia - cardiac arrest, shock, hypoxic ischemic encephalopathy
Local ischemia

Question 6

Ischemia

Answer 6

Inadequate blood supply = reduced perfusion

Question 7

HIE - Hypoxic ischemic encephalopathy - Preterm/Premature infants

Answer 7

Organs (still developing) can’t deliver enough O2 to brain

20% of babies born before 6.5 months gestational age

Question 8

HIE - Term infants

Answer 8

Placenta abruption, umbilical cord problems, clotting of placental arteries

Question 9

HIE - Death

Answer 9

learning and/or cognitive deficits

Cooling

Question 10

Local ischemia - problem

Answer 10

lead to anoxia - lack of O2, lack of glucose
Temporary TIA
Prolonged can get neuronal death and then infarction

Question 11

Causes of local ischemia

Answer 11

Occlusive (Thrombus, Embolus)

Hemorrhage (can occur at surface of brain or inside the brain matter)

Question 12

Anterior brain blood supply - anterior circulation

Answer 12

Internal carotid artery

Question 13

Posterior brain blood supply - posterior circulation

Answer 13

Vertebral artery

Question 14

Anterior circulation -

Answer 14

Common carotid

Internal carotid/External carotid (face and neck)

Question 15

Anterior circulation - internal carotid

Answer 15

Carotid foramen, penetrates the dura
Anterior cerebral
Middle cerebral
BOTH have cortical branches and deep penetrating branches - GRAY AND WHITE matter

Question 16

Anterior circulation/Internal Carotid - ACA Gray and white matter of what

Answer 16

Inferior frontal lobe
Medial surface of frontal/parietal
Anterior corpus callosum

Question 17

Anterior circulation/Internal Carotid - MCA Gray and white matter of what

Answer 17

Hemispheric convexity
Lateral portions of frontal, parietal, temporal, some occipital
PL of internal capsule
BG

Question 18

Posterior circulation - Vertebrobasilar

Answer 18

Subclavian artery

Vertebral arter

Question 19

Posterior circulation - Vertebrobasilar - Vertebral artery give off

Answer 19

Anterior spinal artery

Posterior inferior cerebellar artery (PICA)

Question 20

Posterior circulation - Vertebrobasilar - 2 vertebral arteries join at junction of pons/medulla and form

Answer 20

BASILAR

Question 21

Posterior circulation - Vertebrobasilar - Basilar gives off

Answer 21

Anterior inferior cerebellar
Superior cerebellar
Supply brainstem, cbm, vital brainstem functions

Question 22

Basilar bifurcates into

Answer 22

2 posterior cerebral arteries

Question 23

Posterior circulation - PCA supplies

Answer 23

inferior temporal
medial occipital
posterior part of corpus callosum
Deep branches supply thalamus, cerebral peduncle

Question 24

PCA impacts

Answer 24

contralateral hemiparesis
inf temporal lobe - hippocampus (memory)
thalamus - thalamic syndrome - characterized by pain, hemisensory and motor loss

Question 25

ACA - somatosensory

Answer 25

loss of sensation of LE

Question 26

ACA - Motor

Answer 26

Apraxia Hemiplegia (usually LE) Impaired gait

Question 27

ACA - special sense, autonomic

Answer 27

No change

Question 28

ACA - emotions and bx

Answer 28

``` Flat affect Impulsiveness Perseveration Confusion Motor inactivity ```

Question 29

ACA - Cognition, language, memory

Answer 29

Difficulty with divergent thinking

Question 30

ACA - Other

Answer 30

Urinary incontinence

Question 31

MCA - Somatosensory

Answer 31

Hemianesthesia affectign face and UE

Question 32

MCA - Motor

Answer 32

Face and UE | If striate is involved, LE can be involved too

Question 33

MCA - Special sense, autonomic

Answer 33

Homonymous hemianopia

Question 34

MCA - Emotions and bx

Answer 34

If right hemisphere (left hemiplegia) - easily distracted, poor judgment, impulsive If left hemisphere - apraxia, compulsiveness, overly cautious

Question 35

MCA - Cognition, language, memory

Answer 35

Left MCA - aphasia Right MCA - difficulty understanding spatial relationships, neglect, impairment of nonverbal communication, dressing apraxia, constructional apraxia

Question 36

PCA - somatosensory

Answer 36

Hemianesthesia | Slow pain is preserved

Question 37

PCA - motor

Answer 37

Hemiparesis If lesion near origin of artery - vertical gaze palsy, oculomotor palsy, loss of medial deviation of eyes with preserved convergence , vertical skew deviation of eyes

Question 38

PCA - special sense, autonomic

Answer 38

Homonymous hemianopia, cortical blindness, hallucinations, lack of depth perception, impaired eye mvmnts, except lateral and inferomedial eye mvmnts, visual agnosia, limbs may hsow vasomotor and/or trophic abnormalities

Question 39

PCA - Emotions and bx

Answer 39

Memory loss

Question 40

PCA - cognition, language, memory

Answer 40

difficulty reading

Question 41

Basilar artery - sensory

Answer 41

Bilateral sensory loss

Question 42

Basilar artery - motor

Answer 42

Tetraplegia, abducens nerve palsy, locked in syndrome, oculomotor nerve palsy, decorticate or decerebrate rigidity, paresis or paralysis of mm of tongue, lips, palate, larynx, pharynx

Question 43

Basilar artery - special sense, autonomic

Answer 43

Vertigo, diplopia, vomit, nausea, nystagmus, hearing loss, pupil constriction

Question 44

Basilar artery - emotions and bx

Answer 44

none

Question 45

Basilar artery - cognition, language, memory

Answer 45

reduced consciousness

Question 46

Basilar artery - other

Answer 46

coma