Lecture 4: Blood Supply Flashcards
What are the two main blood supplies to the brain?
•Internal Carotid
•Vertebral Basilar
What two main blood vessels does the Internal Carotid make?
•Middle Cerebral Artery (MCA)
•Anterior Cerebral Artery (ACA)
What main blood vessel does the Vertebral Basilar system make?
Posterior Cerebral Artery (PCA)
What are the two main blood vessels of the brain responsible for supplying?
•Internal Carotid - Anterior Circulation
•Vertebrobasilar System - Posterior Circulation
What does the External Carotid Artery supply?
The face, neck and middle meningeal artery
What does the Middle Meningeal artery arise from?
The External Carotid artery
What is the Anterior Part of the brain supplied by?
The Internal Carotid Artery
What is the Posterior Part of the brain supplied by?
The Vertebrobasilar system
What parts of the brain does the Internal Carotid Arterial System supply?
Frontal, Parietal and Temporal lobes
What parts of the brain does the Vertebrobasilar System supply?
Occipital lobe, cerebellum, brainstem, and upper cord
What blood system supplies the Frontal, Parietal and Temporal lobes?
Internal Carotid Arterial System
What blood system supplies the Occipital lobe, cerebellum, brainstem and upper cord?
Vertebro-basilar System
Where do the Internal Carotid Arterial System and the Vertebrobasilar System anastomose?
At the Circle of Willis
What is the Circle of Willis?
Where the Internal Carotid Arterial System and the Vertebro-basilar system anastomose at the base of the brain
What is the Circle of Willis composed of?
•Middle Cerebral Artery
•Posterior Communicating Artery
•Posterior Cerebral Artery
•Anterior Cerebral Artery
•Anterior Communicating Artery
What are the two beginning arteries of the Vertebro-basilar system?
The two Vertebral Arteries
What system are the Vertebral Arteries apart of?
The Vertebro-Basilar System
Describe the Vertebral Arteries?
•First paired arteries of the Vertebral Basilar system
•Protected by cervical vertebrae by vertebral foramen
•Climb up along with spinal cord to ventral surface of the medulla
What do the two Vertebral Arteries become?
They become the singular Basilar artery at the pontomedullary junction
Where do the two Vertebral Arteries become a singular artery?
They become the Basilar Artery at the Pontomedullary Junction
What branches off of the Vertebral Artery?
•Post Inferior Cerebellar Artery (PICA)
•Anterior Spinal Artery
Where does the Post Inferior Cerebellar Artery (PICA) come from?
It branches off of the Vertebral Artery
What does the Posterior Inferior Cerebellar Cerebellar Artery supply?
It supplies the posterior inferior part of the cerebellum
What supplies the posterior inferior part of the cerebellum?
The Posterior Inferior Cerebellar Artery
Where does the Anterior Spinal Artery come from?
It branches off of the Vertebral Artery
What does the Anterior Spinal Artery supply?
It supplies the anterior surface of the brainstem and spinal cord
What supplies the anterior surface of the brainstem and spinal cord?
The anterior spinal artery
What branches off of Posterior Inferior Cerebellar Artery (PICA)?
The Posterior Spinal Arteries
Where do the Posterior Spinal Arteries come from?
They branch off the Posterior Inferior Cerebellar Arteries (PICA)
What do the Posterior Spinal Arteries go?
They run the length of the dorsal spinal cord
What does the Posterior Spinal Artery Supply?
The Posterior Spinal Chord
What supplies the posterior spinal cord?
The Posterior Spinal Arteries
What Branches off of the Basilar Artery?**
•Anterior Inferior Cerebellar Artery (AICA)
•Pontine Arteries
•Superior Cerebellar Artery
Where does the Anterior Inferior Cerebellar Artery (AICA) come from?
It branches off the Basilar Artery
What does the Anterior Inferior Cerebellar Artery (AICA) supply?
The Anterior Inferior Cerebellum
What vessels supply the cerebellum?
•Posterior Inferior Cerebellar Artery (PICA)
•Anterior Inferior Cerebellar Artery (AICA)
•Superior Cerebellar Arteries
Where do the Pontine Arteries come from?
The Basilar Artery
What does the Pontine Artery supply?
The Pons
What supplies the Pons?
The Pontine Artery
What does the Superior Cerebellar Artery come from?
The Basilar Artery
What do the Superior Cerebellar Arteries supply?
The Superior part of the Cerebellum
What supplies the superior part of the Cerebellum?
The Superior Cerebellar Arteries
What does the Vertebral Basilar System supply?
•Spinal cord
•Brainstem
•Cerebellum
•Occipital lobe and underside of temporal lobe
What does the Posterior Cerebral Artery (PCA) Supply?
•Occipital lobe
•Undersurface of temporal lobe
What supplies the occipital lobe and the undersurface of the temporal lobe?
The Posterior Cerebral Artery (PCA)
Summary of the branching of the Vertebral-Basilar system:
•Vertebral arteries join together at the pontomedullary junction to create the basilar artery
•Post-inferior cerebellar artery (PICA) branches off of the vertebral arteries
•Posterior Spinal Arteries branch off the Posterior Inferior Cerebellar Arteries (PICA)
•Anterior Inferior Cerebellar Artery (AICA) branches off of Basilar Artery
•Superior Cerebellar Artery branches off of the Basilar Artery
•Basilar Artery splits into Posterior Cerebral Artery (PCA)
What are the vessels of the Vertebro-Basilar System?
- Vertebral Artery
- Basilar Artery
- Post Inferior Cerebellar Artery (PICA)
- Posterior Spinal Arteries
- Anterior Spinal Artery
- Anterior Inferior Cerebellar Artery (AICA)
- Pontine Artery
- Superior Cerebellar Artery
- Posterior Cerebral Artery (PCA)
What does the Internal Carotid Artery come from?
The splitting of the the common carotid in the neck
What does the Internal Carotid Supply?**
The Cerebral Cortex
What does the Internal Carotid Artery Branch into?
The Middle Cerebral Artery
Where does the Middle Cerebral Artery (MCA) come from?
The Internal Carotid Artery
Where does the Middle Cerebral Artery (MCA) lie?
In the Sylvian fissue
What artery lies in the Sylvian fissue?
The Middle Cerebral Artery (MCA)
What does the Middle Cerebral Artery (MCA) Supply?
•Temporal lobe
•Frontal lobe
•Parietal lobe
What supplies the Temporal, Frontal and Parietal lobe?
The Middle Cerebral Artery (MCA)
What does the Anterior Cerebral Artery branch off of?
The Middle Cerebral Artery
What does the Anterior Cerebral Artery (ACA) supply?
The Midsagittal section of the cerebral hemispheres
What supplies the midsagittal section of the Cerebral Hemispheres?
The Anterior Cerebral Arteries (ACA)
What is the anastomoses between the Internal Carotid system and the Vertebro-Basilar system?
The Posterior Communicating Artery
What does the Posterior Communicating Artery do?
It is anastomoses between the Internal Carotid system and the Vertebro-Basilar system
What connects the two Anterior Cerebral Arteries (ACA)?
The Anterior Communicating Artery
What does the Anterior Communicating Artery do?
Serves as the anastomosis between the two Anterior Cerebral Arteries
What branches off of the Anterior Cerebral Artery (ACA)?
The Medial Striate
Where does the Medial Striate come from?
It branches off of the Anterior Cerebral Artery
What does the Medial Striate do?
Goes along with the MCA and supplies the deep tissue (striatum)
What vessel goes along with the Middle Cerebral Artery (MCA)?
The Media Striate
What does the Medial Striate supply?
The deep tissues around the striatum
What is the Striatum?
A part of the Basal Ganglia that is important for movement
What supplies the Striatum?
The Medial Striate
What is the good thing about Medial Striate?
If there is an occlusion in the MCA then it may be able to save some tissue
Where does the Anterior Choroidal Artery make CSF?
The Lateral ventricles and the Third Ventricle
What part of the brain does the MCA supply?
The Lateral surface
Where does the Central Artery come from?
The Middle Cerebral Artery
What does the Central Artery Supply?
The space between the pre-central and post-central gyrus
What supplies the space between the Pre-central and Post-Central gyri?
The Central Artery that branches from the MCA
What supplies Wernicke’s speech area?
The Angular Branch of the MCA
What does the Angular Branch of the MCA supply?
Wernicke’s speech area
What does the Middle Cerebral Artery (MCA) mainly supply?
The lateral surface of the brain’s frontal lobe
Parietal lobe
Temporal lobe
What supplies the lateral surface of the brain frontal lobe, parietal lobe and the temporal lobe?
The MCA
What are the Branches of the Middle Cerebral Artery (MCA)?
•Frontal Branches
•Central Artery
•Posterior Parietal Branch
•Angular Branch
•Temporal Branches
What supplies Broca’s speech area?
The Middle Cerebral Arterty
What supplies the primary motor cortex?
The Central Artery from the MCA
What are the limitations to the Central Artery of the MCA?
It only supplies the upper limb and face of the motor and sensory cortex
What supplies the Homunculus?
The Central branch of the MCA but only the face and lower limbs and the Anterior Cerebral Artery supplies the rest
What deep parts does the MCA supply?
The thalamus and the basal ganglia
What supplies the thalamus and basal ganglia?
The Middle Cerebral Artery
What do the Basal Ganglia do?
Initiate movements and stop movements
Big picture what does the Middle Cerebral Artery Supply?
•Lateral part of cerebral hemisphere
•Sensory Motor strip of upper body
•Supplies thalamus and basal ganglia
What supplies the lateral part of the cerebral hemisphere?
The Middle Cerebral Artery (MCA)
What supplies the motor strip of the upper body?
The Middle Cerebral Artery
What supplies the thalamus and basal ganglia?
Middle Cerebral Artery
What is the most common area for infarcts and aneurysms?
The middle cerebral artery
In general what does the Anterior Cerebral Artery (ACA) supply?
The medial aspect of the brain
What lobes are supplied by the Anterior Cerebral Artery?
Frontal and Parietal Lobes
What supplies the frontal and parietal lobes?
The anterior cerebral artery
Where does the Callosomarginal Artery come from?
The ACA
What does the Callosomarginal Artery supply?
It supplies the the paracentral lobule which is where the sensory and motor cortex for the the below the trunk is housed
What supplies the paracentral lobule (the homunculus area for the lower limbs)
The Callosomarginal Artery a branch of the ACA
What are the main points of the ACA?
•Major blood vessel for the medial part of the cerebral hemisphere
•Supplies sensory and motorstrip for the lower body
•Also common area for infarcts and aneurysms
What does the posterior cerebral artery supply?
The medial aspects of the temporal lobe and occipital lobe
What supplies the medial aspects of the temporal lobe and occipital lobe?
The Posterior Cerebral Artery
What supplies the primary visual cortex?
The Posterior Cerebral Artery through the calcarine sulcus
What is Watershed?
The distal most branches of the main arteries overlap but if an individual is losing a lot of blood they do not get perfusion so those parts of the brain do not get a lot of perfusion
What is Cerebrovascular disease?
The narrowing, rupture and blockage of blood vessels
What is Atherosclerotic disease?
Accumulation of plaque build-up that narrow the blood vessels and contributes the blockages
What is the end result of Cerebrovascular disease?
The brain is deprived of oxygen which leads to necrosis
What is the result when brain tissue dies?
Necrotic brain tissue releases its content which affects healthy brain tissue and evokes an inflammatory response and brain swells
What are the two types of infarcts?
Ischemic Infarct and Hemorrhagic infarct
What is Ischemic Infarct due to?
A blockage
What is a hemorrhagic infarct due to?
A rupture (aneurysm or trauma)
What type of infarcts are the majority of infarcts?
Ischemic infarcts
What are the two main types of Hemorrhagic strokes?
•Intracerebral Hemorrhage
•Subcranial Hemorrhage
What is an Intracerebral Stroke?
When a blood vessel ruptures inside the brain
What is a Subarachnoid Hemmorage?
An aneurysm in the subarachnoid space where blood vessels lie. Bordered by the Pia and the subarachnoid mater
What is an Epidural Hemmorage?
When a blood vessel at the middle meningeal artery or vein ruptures and blood accumulates about or between the dura
What is a Subdural Hemmorage?
When bridging veins rupture and blood accumulates above the arachnoid mater and below the pia mater
What is a Subarachnoid Hemmorage?
When an aneurysm occurs usually at the base of the brain and blood accumulates under the arachnoid mater
What is an Intracerebral hemorrhage?
When a rupture occurs and blood accumulates within the brain
What are the four types of hemorrhages?
•Epidural
•Subdural
•Subarachnoid
•Intracerebral
What is the pathway from the Cavernous sinuses?
It flows into the transverse sinus and into the sigmoid sinus
