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Osborn Angio > Internal Carotid Artery > Flashcards

Internal Carotid Artery Flashcards

1
Q

What are the 7 segments of the ICA? And their branches

A

C1 Cervical
C2 Petrous: Vidian artery and carotico tympanic artery, mandibular artery
C3 Lacerum
C4 Cavernous: Posterior trunk (inferior/ meningohypophyseal artery) and inferolateral trunk
C5 Clinoid: Clival artery
C6 Opthalmic: Ophtalmic artery and superior hypophyseal arteries
C7 Communicating: Anterior choroidal artery
Posterior communicating artery

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2
Q

What are the embryonic precursors of the internal carotid artery?

A

C1: Fetal 3rd aortic arch

C2-C7: Dorsal aortae

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3
Q

Give the average diamters of the ff:

  1. Common Carotid artery
  2. Carotid bulb
  3. ICA distal to bulb
A
  1. 7mm
  2. 7.5 mm
  3. 4.7 mm
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4
Q

What are the contents of the carotid sheath?

A

Common carotid artery (C1 ascending segment)
Internal jugular vein
Lymph nodes (Jugulodigastric nodes of the high deep cervical chain)
Post ganglionic sympathetic fibers
CN 9, 10, 12 (But only 10 extends throughout the length of the CS)

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5
Q

How does the course of the ICA relate to the ECA?

How about with the IJV?

A

Initially posterolateral then ascends medially as it courses superiorly

Lies in front and slightly medial to it.

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6
Q

Where is the usual level of CCA bifurcation?

A

C4 at the level of the thyroid cartilage

Range: C1 to T2

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7
Q

What is the most common persistent basilar carotid anastomosis?
The second?

A
  1. Persistent trigeminal artery

2. Persistent hypoglossal

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8
Q

What parts are connected by the following carotid basilar anastomoses:

  1. Persistent trigeminal
  2. Persistent otic
  3. Persistent hypoglossal
  4. Persistent proatlantal intersegmental artery
A
  1. Persistent trigeminal: Cavernous
  2. Persistent otic: Petrous
  3. Persistent hypoglossal: Cervical
  4. Persistent proatlantal intersegmental artery: Cervical
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9
Q

What hole?

How does the persistent hypoglossal artery connect with the basilar?

How does the persistent proatlantal intersegmental artery connect with the distal vertebral artery?

A

Through the enlarged anterior condyloid (hypoglossal) canal

Through the foramen magnum

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10
Q

What commonly gives rise to the occipital artery among the persistent basilar carotid anastomosis?

A

Persistent proatlantal intersegmental artery

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11
Q

Which part of the ICA is most intimately related to hearing structure ie tympanic cavity posteriorly, cochlea superiorloy and eustachian tube anteriorly?

A

C2

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12
Q

What does the vidian artery connect?

A

Petrous ICA to terminal ECA connection:

The proximal petrous carotid ICA (purple) to the pterygopalatine fossa (yellow) through the pterygoid canal

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13
Q

What is the usual angiographic origin of the vidian artery?

A

Usually from the IMAX but in cases such as sacrificing of the IMAX and tumors like juvenile angiofibroma the vidian artery can be seen to originate from the ICA.

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14
Q

The vidian artery is AKA?

A

Artery of the pterygoid canal

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15
Q

The vidian artery is a remnant of?

A

1st aortic arch

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16
Q

How does the caroticotympanic artery connect the ICA and the ECA?

A

C2» Caroticotympanic artery&raquo_space; Inferior tympanic artery&raquo_space; Ascending pharyngeal&raquo_space; ECA

17
Q

What C2 anomaly presents as a retrotympanic pulsatile mass?

What does it look like on angio?

A

Aberrant petrous ICA

More posterior and narrowed genu while passing through the inferior tympanic
canaliculus

18
Q

The persistent stapedial artery terminates as?

A

Middle meningeal artery

19
Q

What is the extent of C3 (Laceral segment)?

A

From the endocranial opening of C2 to the petrolingual ligament

20
Q

What nerve crosses the laceral segment?

A

Greater superficial petrosal nerve– innervates the lacrimal gland

21
Q

What is the only cranial nerve that course inside the cavernous sinus proper? Not merely attached to the dural sinus wall.

A

CN6

22
Q

What does the meningohypophyseal artery (<

A

Pituitary gland and tentorium

Note that inconstant medial C4 branches called the capsular arteries of McConnel are found in 28% of specimens and supply the pituitary gland

23
Q

How does C4 anastomose with the ECA?

A

C4» Lateral trunk» artery of the foramen rotundum&raquo_space; intermal maxillary artery&raquo_space; ECA

24
Q

Which is the more lateral genu of C4?

A

Anterior because the horizontal part of C4 courses slightly laterally

25
Q

What are the two types of the persistent trigeminal artery?

A

Saltzman Type 1: PTA supplies the entire vertebrobasilar system. Basilar proximal to the PTA is hypoplastic. Posterior communicating segments are absent

Saltzman Type 2: PTA supplies the SCA but the PCA’s come from the posterior communicating arteries

26
Q

What is the shortest ICA segment?

When does it start and end?

A

C5: Clinoid

Starts at the proximal dural ring above the anterior ICA genu and ends at the distal drual ring as the ICA enters the subarachnoid space

27
Q

Where does the C6 (Ophthalmic artery) segment end?

A

Just before the takeoff of the posterior communicating artery.

28
Q

The choroidal blush is seen at the end of which artery?

A

Opthalmic artery

Represents the vascular plexus of the ocular choroid

29
Q

Name all the branches of the ophthalmic artery (C4)
Ocular
Orbital
Extraorbital

A

Ocular: Central retinal artery and ciliary arteries
Orbital: Lacrimal artery (»recurrent meningeal artery&raquo_space; middle meningeal artery anastomoses) and muscular branches
Extraorbital: supraorbital, anterior and posterior
ethmoidal, dorsal nasal, palpebral, medial frontal, and
supratrochlear arteries, anterior falx artery

Extraorbital OA
branches have extensive anastomoses with ethmoidal and
facial branches of the external carotid artery.

30
Q

What do the superior hypophyseal arteries supply?

A

Anterior pituitary

lobe, pituitary stalk, optic nerve, and chiasm

31
Q

What is the most common reported anomaly in literature?

A

Ophthalmic artery origin from the middle meningeal artery is the most common anomaly reported in the literature.

Cavernous origin is less common

32
Q

What are the branches of C7 (Communicating) segment?

A

Anterior choroidal artery

Posterior communicating artery

33
Q

What does the PCoA give off?

Where is it positioned in relatino to the 3rd nerve?

A

Anterior thalamoperforators to supply the medial thalamus

34
Q

What are the structures supplied by the anterior chroidal artery?

A

Optic tract, posterior
limb of the internal capsule, cerebral peduncle,
choroid plexus, and medial temporal lobe.

35
Q

What is a fetal PCA?

A

PCA that takes off from the PCoA. P1 segment of PCA is often hypoplastic or absent

Osborn Angio (7 decks)

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