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A&P Exam 3 > Exam 3: 9-29 Lecture 1 > Flashcards

Exam 3: 9-29 Lecture 1 Flashcards

1
Q

Which arteries provide blood flow to the brain

A

2 internal carotids
2 vertebral arteries

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2
Q

What areas do the external carotids provide arterial circulation

A

Side of the head, the jaw, and side of the face

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3
Q

What artery provides circulation to the top of the head and the forehead

A

Internal carotid

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4
Q

Why is it useful to assess blood flow patterns on the forehead

A

This helps assess the function of internal carotids since they are responsible for perfusion of this area

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5
Q

Why do cuts to the forehead bleed profusely

A

They are perfused by a protective area of circulation, the internal carotids.

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6
Q

What is the normal range of Brain blood flow

A

750-900mL/min

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7
Q

What percent of CO is delivered to the brain

A

15%

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8
Q

How are the nutrients that reach the brain dispersed amongst the grey and white matter

A

80% grey matter (less efficient/less myelin)
20% white matter

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9
Q

What is the top energy consumer in the brain

A

Electrophysiology

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10
Q

What does electrophysiology involve

A

Running Na/K pump, allowing ions in and out, pumping ions out.

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11
Q

What does Auto regulation of blood brain flow ensure

A

It ensures the brain blood flow is maintained when we have fluctuations in arterial blood pressure.

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12
Q

Auto regulation: how do the blood vessels in the brain respond to low systemic blood pressure

A

The brain blood vessels relax to maintain constant/normal flow

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13
Q

How do we calculate spinal perfusion pressure and what is the normal level

A

Spinal perfusion pressure is:
Diastolic aortic pressure -CSF pressure
The normal diastolic pressure is 100 and CSF 10. Normal spinal perfusion pressure is 90.

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14
Q

What is the LLA (lower limit of auto regulation in regards to MAP

A

65-70mm/Hg

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15
Q

What is the ULA (Upper limit of auto regulation) in regards to MAP

A

Approximately 150mm/Hg
*(MAP of 150 often achievable with exercise)

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16
Q

Why is there a limit on auto regulation

A

At some point you run out of the ability to dilate/constrict the brain blood vessels

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17
Q

Auto regulation: how do the blood vessels in the brain respond to elevated systemic blood pressure

A

As MAP increases the blood vessels of the brain constrict or increase vascular tone.

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18
Q

In thinking about ULA why is over perfusion bad

A

A little over perfusion is okay. A lot of over perfusion can lead to subarachnoid hemorrhages and blood vessel damage.

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19
Q

Can the Upper limit auto regulation adapt and change its set point

A

Yes. The blood vessels will harden, they can also squeeze tighter due to having more muscle.

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20
Q

Auto regulation:
How does ischemic stroke/MI affect someone with chronic hypertension

A

Someone with chronic hypertension may adapt a higher ULA and therefore a higher LLA. If the blood pressure dips due to these factors, the normal MAP of 65 may actually be lower than the LLA and the pt may not have the ability to offer collateral circulation.

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21
Q

Why is cerebral vasculature unaffected by neosynephrine

A

The cerebral circulation has no adrenergic receptors. It self regulates blood flow.

22
Q

What is myogenic constriction

A

Constriction of blood vessels independent of neurotransmitters.
Seen in cerebral blood vessels (part of auto regulation)

23
Q

Myogenic response

A

Constriction/dilation without use of neurotransmitters.

24
Q

List the three very large cerebral arteries

A

Middle cerebral, anterior cerebral and posterior cerebral arteries.

25
Q

Which cerebral artery has the most coverage?

A

Middle cerebral artery.

26
Q

Middle cerebral artery coverage

A

Frontal, parietal, occipital and temporal lobes

27
Q

What are the different portions of the anterior cerebral artery

A

Post communicating part (A2)
Pre communicating (A1)

28
Q

What are the different portions of the posterior cerebral artery

A

Pre communicating (P1)
Post communicating (P2)

29
Q

Portion of posterior cerebral artery that extends from Circle of Willis

A

P2 segment (post communicating part)

30
Q

Portion of posterior cerebral artery that is part of the Circle of Willis

A

P1. (Pre communicating part).

31
Q

Two portions of anterior cerebral artery

A

A1 pre communicating
A2 post communicating

32
Q

Portion of anterior cerebral artery that extends from circle of Willis

A

A2 (post communicating)

33
Q

Portion of anterior cerebral artery that is part of circle of Willis

A

A1 (pre communicating)

34
Q

Term for segment of artery that is part of Circle of Willis

A

Pre communicating

35
Q

Term for segment of an artery that extends from Circle of Willis

A

Post communicating

36
Q

Bridge that connects left and right sides of Circle of Willis

A

Anterior communicating artery.

37
Q

Smallest part of the circle of Willis

A

Anterior communicating artery

38
Q

Arteries that connect middle cerebral arteries to posterior cerebral arteries

A

Posterior communicating arteries d

39
Q

What three large blood vessels feed into the Circle of Willis

A

Bilateral internal carotids and basilar artery on the posterior portion.

40
Q

Location of Basilar artery

A

Anterior side of pons.

41
Q

Where does basilar artery receive arterial blood from

A

The basilar artery receives blood from the vertebral arteries

42
Q

Where do the cerebellar arteries branch from

A

Two of the cerebellar arteries branch from the basilar artery the third is a split of the vertebral arteries.

43
Q

Cerebellar artery that branches from vertebral arteries

A

Posterior inferior cerebellar artery

44
Q

Cerebellar artery that branches off near the middle of the pons

A

Anterior inferior cerebellar artery

45
Q

Cerebellar artery that branches off at the top of the pons

A

Superior cerebellar artery

46
Q

What is the term for an aneurysm of the Circle of Willis

A

Berry aneurysm

47
Q

Are aneurysms if the Circle of Willis operable? Why or why not?

A

They are often times inoperable due to being a deep brain structure. Accessing this area and being able to tie off a bleed would be difficult to do.

48
Q

How is the setup of the Circle of Willis beneficial

A

There are lots of areas for collateral blood supply. The circle of Willis acts as a safeguard should one of the vessels become occluded.

49
Q

How rare is it to not have a complete Circle of Willis

A

It is very common to not have a complete Circle of Willis. This does predispose someone to more damage should something go wrong within the structure.

50
Q

How does Subdural hematoma differ from epidural

A

Subdural is a problem with the large sinuses (venous blood). Epidural is involving an arterial bleed. The subdural bleed is a much slower bleed.

51
Q

Subarachnoid hemorrhage onset

A

Very rapid

A&P Exam 3 (3 decks)

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