final- blood supply Flashcards

1
Q

spinal cord blood supply

A
  1. outer rim- posterior spinal art

2. inner circle- anterior spinal art

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2
Q

anterior spinal artery in spinal cord

A
  1. ventral horn cells.
  2. descending axial motor
  3. half of fasciculus gracilis and cuneatus
  4. anterior white commisure
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3
Q

posterior spinal artery in spinal cord.

A
  1. half of fasiculus gracilis and cuneatus
  2. anterolateral system
  3. lateral corticospinal tract
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4
Q

anterior spinal lower medulla

A
  1. pyramids
  2. decussation of pyramids
  3. spinal accesory nucleus
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5
Q

veterbral art in lower medulla

A
  1. anterolateral system
  2. part of spinal trigeminal tract
  3. dorsal spinocerebellar pathway
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6
Q

posterior spinal art in caudal medulla

A
  1. fasciculus cuneatus and gracilis
  2. external cuneate
  3. spinal trigeminal tract
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7
Q

anterior spinal artery in middle medulla

A
  1. pyramids
  2. medial lemniscus
  3. decussation of medial lemniscus
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8
Q

vertebral art in middle medulla

A
  1. spinal trigeminal tract
  2. anterolateral system
  3. nucleus ambiguus
  4. dorsal spinocerebellar pathway
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9
Q

posterior spinal art in mid medulla

A
  1. fasciculus cuneatus and gracilis

2. external cuneate nucleus

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10
Q

anterior spinal art in rostral medulla

A
  1. pyramids
  2. medial lemniscus
  3. hypoglossal nucleus- weakness on same side as damage, tongue will deviate towards damage
  4. MLF- produces central nystagmus in direction of gaze
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11
Q

vertebral art in rostral medulla

A
  1. inferior olivary nucleus- diminished motor learning
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12
Q

POSTERIOR INFERIOR CEREBELLAR art in rostral medulla aka- wallenburg syndrome

A
  1. nucleus ambiguus
  2. spinal trigeminal tract
  3. inferior cerebellar peduncle- limb ataxia and intention tremor in both UE and LE on same side as lesion
  4. anterolateral system- could have bilateral face loss
  5. solitary nucleus- loss of taste same side
  6. vestibular nuc- dizzy, vertigo, and central nystagmus- in direction of gaze.
  7. Descending axons from hypothalamus- same side pseudoptosis, miosis, inability to sweat, flushed face = Horners syndrome
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13
Q

POSTERIOR INFERIOR CEREBELLAR art in rostral most medulla

A
  1. cocholear nucleus- hearing loss in same side, sensorineural loss- will not be able to hear tuning fork in Webers test
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14
Q

paramedian and short circumferential of basilar art in the caudal pons

A
  1. corticospino corticobulbar- hypoglossal- tongue deviates towards damaged side.
  2. pontine fibers and middle cerebellar peduncle-
  3. facial nerve fibers
  4. abducens nerve fibers- paralysis of lateral rectus on the same side. eye drift medially
    Damage to all called: millard-gubler syndrome
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15
Q

anterior inferior cerebellar art in caudal pons

A
  1. facial motor nucleus
  2. abducens nucleus and paramedian pontine reticular formation- lateral locked gaze away from damage side. cannot be overcome with dolls head
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16
Q

Fovilles Syndrome

A
  1. same sided facial paralysis, locked lateral gaze away from damage, and paralysis or weakness in distal musculature on opposite side of body
    damage to anterior inferior cerebellar art in caudal pons
17
Q

Paramedian and short circumferential branches of basilar art. in rostral pons

A
  1. corticospinal, corticobulbar- hypoglossal and facial- around the mouth on opposite side.
  2. pontine fibers and middle cerebellar peduncle- intention tremor, limb ataxia, hypermetria, dysdiocokinesia
18
Q

Superior cerebellar artery in rostral pons

A
  1. reticular formation- makes you unconscious
  2. lacunar infarcts in medial lemniscus and anterolateral system- from opposite side
  3. lateral lemniscus- loss of hearing from both ears, tinnitus, or loss of sound localization
  4. trigeminal nerve/nucleus- loss of touch, proprioception pain and temp from same side face. and diminished jaw jerk and weak muscle of mastication on same side as lesion
  5. middle cerebellar peduncle- intention tremor, limb ataxia, hypermetria, dysdiocokinesia
19
Q

Posterior cerebral artery in caudal midbrain

A
  1. cerebral peduncle- paralysis/weakness of face and upper extremity opposite from lesion
  2. decussation of the superior cerebellar peduncle- tremor limb ataxia, disdiadochokinesia and hypermetria, may be ipsilateral, contra or bilateral
  3. medial longitudinal fasciculus- causes anterior internuclear opthalmoplegia- weakness in medial rectus on same side as lesion and nystagmus on lateral gaze in opposite eye
  4. trochlear nucleus- weakness in superior oblique muscle on opposite side of lesion and diplopia- patient will tilt head to damaged side
20
Q

Superior cerebellar art and SHORT circumferential branches of the posterior cerebral artery in caudal midbrain

A
  1. Cerebral peduncle- upper motor neuron symptoms in LE

2. Ascending somatosensory systems on opposite side

21
Q

Superior cerebellar art and LONG circumferential branches of the posterior cerebral artery in caudal midbrain

A
  1. Inferior colliculus- tinnitus, loss of hearing from both ears, tinnitus, or loss of sound localization on opposite side from lesion. could produce loss of certain frequency of hearing bilaterally
22
Q

Posterior cerebral artery in Rostral midbrain

A
  1. medial cerebral peduncle- upper motor neuron in face and UE on oppo side
  2. Occulomotor nerve/nuc, edinger westphal- eye on side of damage is abducted and depressed. pupil may be unresponsive
  3. Red nucleus- tremor in UE on oppo side
23
Q

Benedikt’s syndrome

A
  1. Third nerve palsy-Occulomotor nerve/nuc, edinger westphal- eye on side of damage is abducted and depressed. pupil may be unresponsive
  2. Red nucleus-tremor in UE on oppo side
    Posterior cerebral artery in Rostral midbrain
24
Q

Weber’s syndrome

A
  1. medial cerebral peduncle- upper motor neuron in face and UE on oppo side
  2. Third nerve palsy- Occulomotor nerve/nuc, edinger westphal- eye on side of damage is abducted and depressed. pupil may be unresponsive
    Posterior cerebral artery in Rostral midbrain
25
Q

Superior cerebellar art and short circumferential branches of the posterior cerebral artery in Rostral midbrain

A
  1. Lateral cerebral peduncle- upper motor neuron symptoms in oppo LE.
  2. Medial Lemniscus
  3. Anterolateral system
26
Q

Superior cerebellar art and LONG circumferential branches of the posterior cerebral artery in Rostral midbrain

A
  1. Superior colliculus- slow saccadic eye movements- may have saccadic hypometria- eye does not move enough to engage target
27
Q

Branches of the internal carotid artery

A
  1. Opthalamic art

2. Anterior choroidal

28
Q

Opthalamic artery

A
  1. Optic nerve and retina- total or partial blindness in eye on side of injury.
29
Q

Anterior choroidal artery

A
  1. Amygdala- emotional disturbances, possibly difficulty forming new memories
  2. Hippocampal formation- difficulty forming new memories, if bilateral, symptoms will be more permanent
  3. Optic tract- homonymous hemianopia- if left is damaged: will only see left visual field from each eye
30
Q

Medial striate arteries

A
  1. Caudate nucleus- chorea, athetosis,resting tremor
31
Q

anteromedial striate arteries

A
  1. Hypothalamus- autonomic coordination- difficulties with homeostasis especially appetite, difficulty with hormone levels
  2. Optic nerve- total or partial blindness in eye on side of injury.
    Optic chiasm- bilateral heteronymous hemianopia- tunnel vision
    optic tract- homonymous hemianopia- loss of left visual field from both eyes.
32
Q

Lateral striate arteries

A
  1. Basal Ganglia- chorea, athetosis, resting tremor
  2. Internal capsule- anterior limb- descending axons from frontal eye field and produces inability to saccadically shift eyes in oppo direction of damage. over come with dolls head.
    Genu- paralysis/weakness of facial muscles around mouth and tongue muscles. loss of pain, temp, touch and proprioception from face oppo side
    Posterior limb- inability to slowly track in the same direction as damage. over come with dolls head. and loss of pain, temp, touch and proprioception from body oppo side. also paralysis in both oppo extremities
33
Q

Thalamoperforating arteries

A
  1. Anterior thalamus- interferes with memory formation loop, general detachment from surroundings: coma, disorientation, drowsiness, confabulation and cognitive impairments
  2. Subthalamic nucleus- contralateral hemiballismus
34
Q

Posteromedial arteries

A
  1. Mamillary bodies- routine memory disturbances rather than overall detachment like in anterior thalamus (thalamoperorating art)
  2. Hypothalamus- appetite disturbances and hormone irregularity.
35
Q

Thalamogeniculate arteries

A
  1. Thalamus
    Ventral posterior lateral nuc- no sensation on oppo side of body.
    Lateral geniculate nucleus- homonymous hemianopia
    Medial geniculate- tinnitus, loss of hearing bilaterally or sound localization oppo from damage.
36
Q

Anterior cerebral art

A
  1. Primary motor cortex- upper motor symptoms in oppo LE

2. Primary somatosensory cortex- loss of sensation from oppo LE

37
Q

Middle cerebral art

A
  1. Broca’s area- left cortex- motor aphasia
    right cortex- no intonation in speech
  2. Primary motor cortex- upper motor neuron symptoms in oppo UE and lower face/tongue
  3. Primary somatosensory cortex- loss of sensation from oppo UE and face
  4. Primary Auditory cortex- tinnitus loss of hearing bilaterally or sound localization oppo from damage.
  5. Wernicke’s Area- left: sensory aphasia, right: inability to interpret intonation of speech and to produce meaningful fluctuations of intonation
38
Q

Posterior Cerebellar art

A
  1. Primary visual cortex- broad damage would produce homonymous hemianopia, caudal damage would produce HH pf macular region, rostral damage will produce HH with macular sparing.
  2. Visual association cortex in temporal lobe- difficulty identifying objects and diff with visual learning