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NE Exam 2 > Lecture 3: Blood Supply, Hemorrhage, and Herniation (Keim) > Flashcards

Lecture 3: Blood Supply, Hemorrhage, and Herniation (Keim) Flashcards

1
Q

Where does blood supply to the anterior cerebrum come from?

A

Internal Carotid Artery

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2
Q

Where does blood supply to the posterior cerebrum come from?

A

Vertebral Artery

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3
Q

What are the four parts of the Internal Carotid Artery?

A
  • Cervical Part
  • Petrous Part
  • Cavernous Part
  • Cerebral Part
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4
Q

Label the parts of the Internal Carotid Artery

A
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5
Q

What are the three parts of the Vertebral Artery?

A
  • Cervical Part: passes through cervical transverse foramina
  • Atlantic Part: passes throgh foramen magnum
  • Intracrainal Part
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6
Q

Label the sections of the Vertebral Artery

A
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7
Q

What arteries make up the Circle of Willis?

A
  • Anterior Cerebral Artery
  • Internal Carotid Artery.
  • Posterior Cerebral Artery
  • Anterior communicating Artery
  • Posterior Communicating Artery

Middle Cerebral Artery is not part of it!

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8
Q

Label the Circle of Willis

A
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9
Q

What arteries from the Circle of Willis can compress CN II?

A
  • Internal Carotid Artery
  • Anterior Cerebral Artery
  • Anterior Communicating Arteries
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10
Q

What arteries from the Circle of Willis can compress CN III?

A
  • Posterior Communicating Artery
  • Posterior Cerebral Artery
  • Superior Cerebellar Artery

First pupil will be affected then motor functions

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11
Q

What symptoms can CN III compression cause?

A

First pupil (dilated) will be affected then motor functions

Parasympathetic functions affected first!

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12
Q

What arteries from the Circle of Willis can compress CN V?

A

Superior Cerebellar Artery

Can Cause Trigeminal Neuralgia

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13
Q

What arteries from the Circle of Willis can compress CN VI?

A
  • Labyrinthine Artery
  • Anterior Inferior Cerebellar Artery
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14
Q

What arteries from the Circle of Willis can compress CN VII?

A

Abberant branches from the Anterior Inferior Cerebellar Arteries

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15
Q

What is the clinical significance of border zones?

A

Watershed areas that are susceptible to damage in times of sudden systemic hypotension or hypoperfusion

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16
Q

An anterior watershed infarct can result in what?

A

Motor and sensory defects, especially in lower limbs

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17
Q

A posterior watershed infarct can result in what?

A

Visual disturbance and language issues

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18
Q

What arteries is the Anterior watershed area located between?

A

Anterior Cerebral Artery

Middle Cerebral Artery

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19
Q

What arteries is the posterior watershed area located between?

A

Middle Cerebral Artery

Posterior Cerebral Artery

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20
Q

What does the Anterior Cerebral Artery supply?

A

Most of the medial and superior surface of frontal and parietal lobes

Deals with midline structures (e.g. legs)

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21
Q

What does the Middle Cerebral Artery supply?

A

Most of the lateral surface of frontal and parietal lobes and superior part of temporal lobe

Deals with lateral structures (e.g. arms)

22
Q

What does the Posterior Cerebral Artery supply?

A

Occipital Lobe and Inferior Temporal Lobe

23
Q

What are the segments of the Anterior Cerebral Artery?

A
  • A1: Precommunicating Segment
    • ICA to Anterior Communicating Artery
  • A2: Infracallosal Segment
    • Anterior Communicating Artery to rostram and genu of corpus callosum
  • A3: Precallosal Segment
    • Genu to caudal part of corpus callosum
  • A4: Supracallosal
    • Superior to corpus callosum
  • A5: Postcallosal
    • Caudal to Corpus Callosum
24
Q

Label this diagram of the Anterior Cerebral Artery

25
What are the segments of the Middle Cerebral Artery?
* M1: Sphenoidal/Horizontal Segment * ICA to bifurcation at insula * M2: Insular Segment * Bifurcation at insula to circular sulcus of insula * M3: Opercular Segment * Circular sulcus or insula to external surface of lateral fissure * M4: Cortical Segment * On Cortex
26
Label this diagram.
27
What are the segments of the Posterior Cerebral Artery?
* P1: Sphenoidal/Horizontal Segment * ICA to bifurcation at insula * P2: Insular Segment * Bifurcation at insula to circular sulcus of insula * P3: Opercular Segment * Circular sulcus or insula to external surface of lateral fissure * P4: Cortical Segment * On Cortex
28
Label this diagram
29
What structures does the Anterior Spinal Artery supply?
Medulla * Hypoglossal Nucleus * Medial Lemniscus (sensory tract) * Pyramid (motor tract)
30
What does the Posterior Spinal Artery supply?
Lower Medulla * Gracile fasciculi and nuclei * Cuneate fasciculi and nuclei
31
What does the Posterior Inferior Cerebellar Artery supply?
Lateral Medulla * Nuclei * Dorsal Motor Nucleus of Vagus * Medial Vestibular Nucleus * Inferior Vestibular Nucleus * Accessory Cuneate Nucleus * Solitary Nuclues * Spinal Trigeminal Nucleus * Nucleus Ambiguous * Tracts * Solitary Tract * Spinal Trigeminal Tract * Rubrospinal Tract * Anterolateral System
32
What does the Paramedian Branches of Basilar Artery supply?
Medial Pons * Abducens Nucleus and Nerve * Medial Longitudinal Fasciculus * Medial Lemniscus * Corticospinal Fibers
33
What does the Long Circumferential Branches of Basilar Artery supply?
Lateral Pons * Mesencephalic Nucleus and Tract * Spinal Trigeminal Nucleus and Tract * Facial Motor Nucleus * Anterolateral System
34
What supplies the superior and inferior colliculi?
**Superior Colliculus:** Quadrigeminal (*from PCA*) and Posterior Medial Choroidal Arteries (*from PCA*) **Inferior Colliculus:** Quadrigeminal and Superior Cerebellar Arteries
35
What supplies the lateral and medial geniculate bodies?
Thalamogeniculate Artery ## Footnote *From Posterior Cerebral Artery*
36
What supplies the forebrain?
37
What supplies the spinal cord?
Posterior and Anterior Spinal Cord
38
What are some important structures found in the subarachnoid space?
* CSF * Circle of Willis * Veins
39
What causes an epidural hematoma? What does it look like on an x-ray?
* Ruptured _Middle Meningeal Artery_: can be caused if hit at the pterion * Lens shaped hematoma on side of brain
40
Pt presents after MVC, states he hit the left side of his head and had momentary unconsciousness before waking up. After 6 hours in the ED, pt starts feeling nauseous and sleepy. What should you be concerned for?
Epidural or subdural hematoma
41
What causes a subdural hematoma? What does it look like on an x-ray?
* Bleeding of bridging veins most commonly seen in babies and the elderly * Crescent shaped hematoma on side of brain
42
What causes a subarachnoid hemorrhage? What does it look like on an x-ray?
* Ruptured aneurysm from cerebral arteries mostly in post-menopausal women and people with hypertension * Spider like webs in middle of brain
43
What is the source of bleeding for an intracerebral/subpial hemorrhage?
Middle Cerebral Artery
44
What artery may be compressed in a Subfalcine herniation? What symptoms can manifest?
* Anterior Cerebral Artery can be compressed * Opposite lower extremity motor and sensory loss
45
What is this?
Subfalcine Herniation
46
What structures are compressed in a transtentorial herniation?
Upper brainstem CN III Maybe Basilar Posterior Cerebral Arteries
47
Patient presenting with contralateral hemiplesia and ipsilateral CN III palsy most likely has a hernia where?
Uncus (and portions of parahippocampal gyrus)
48
What structures are compressed in uncal herniations?
CN III Cerebral peduncles
49
What is Kernohan's syndrome?
Uncal herniation that shifts the midbrain Disrupts ipsilateral CN III and bilateral hemiplesia
50
What structures can be compressed in a tonsillar herniation?
Medulla Upper cervical Spinal Cord

NE Exam 2 (28 decks)

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