lecture 5: blood supply Flashcards

1
Q

what are the two primary sources of blood to the brain bilaterally

A

1) internal carotid arteries (anterior system, 80%)
2) vertebral arteries (posterior system, 20%)

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2
Q

in what foramen do the vertebral arteries pass

A

transverse foramina

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3
Q

the common carotid bracnhes off what

A

either the aorta or the brachiocephalic trunk

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4
Q

the common carotid splits into what

A

internal and external carotid aa

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5
Q

true or false: the external carotid arteries provide primary blood supply to the. brain

A

false, interior

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6
Q

the subclavian a branches off what

A

the aorta

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7
Q

what early branch of the subclavian a is considered a primary source of blood supply to the brain

A

vertebral a

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8
Q

what major artery make up the anterior brain blood supply

A

internal carotid

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9
Q

which main arteries make up the posterior brain blood supply

A

vertebral arterieis

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10
Q

what is the site of anastamoses in the brain called

A

cerebral arterial circle

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11
Q

what branches off the vertebral arteries are important in the posterior system

A
  • Anterior (ventral) spinal arteries
  • Posterior inferior cerebellar arteries (PICA)
  • Posterior (dorsal) spinal arteries
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12
Q

vertebral arteries join to form what a at the midline

A

basilar artery (located on basilar part of the pons)

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13
Q

what are the important branches off the basilar arterior for circulation

A

anterior inferior cerebellar arteries
internal auditory arteries
poutine arteries
supereical cerebrellar arteries

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14
Q

what are the important arteries for blood supply to the cerebellum off of the vertebral and basilar artery

A

anterior inferior cerebellar a
posterior inferior cerebellar
superior cerebellar a

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15
Q

Basilar artery branches terminally into what two arterries

A

posterior cerebral arteries

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16
Q

what is the most rostral branch off the basillar artery that supplies the cerebellum

A

superior cerebellar a

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17
Q

what are the two main arteries that supply the spinal corf

A

posterior spinal arteries (2)
anterior spinal a (1)

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18
Q

true or false, the anterior spinal a branch off the basillar a

A

false, branch off the vertebral arteries

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19
Q

true or false: the posterior spinal a branch off the bascillar a

A

false, it branches off the vertebral artery (or PICA)

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20
Q

what are the two general ways the spinal cord gets blood supply

A

1) off radicular arteriore
2) off segmental medullary arteries

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21
Q

where do radicular a arrise from

A

segmental spinal arteries (usually comin off a major verssel like the post intercostal)

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22
Q

what do radicular a in the spinal cord supplu

A

supply spinal roots and rootlets

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23
Q

true or false: radicular a of the spinal cord are only at some spinal levels,

A

false they are al every spinal level

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24
Q

what are the vessels called that arise from segmental spinal aa and supply spinal roots and rootlets

A

radicular arteries

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25
Q

what is the function of the segmental medullary a

A

reinforce anteior and posterior spinal arteries

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26
Q

are segmental medullary aa at all or only some spinal levels

A

only at some spinal levbels

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27
Q

what is the largest segmental medullary artery and where is it located

A

great segmental medullary artery
=lower thoracic and upper lumbar region

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28
Q

why is there the largest segmental medullary a located in the lower thoracic and upper lumbar region

A

because that provides blood supply to lumbosacral plexus (enlargement) which then innervates the nervous system for the whole lower limb

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29
Q

most of the supply to the spinal cord is done by what vessel

A

anterior spinal a

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30
Q

explain the perfusion area of the anterior spinal a

A

supplies most of the spinal cord
(anterior and lateral horns as well as their columns)

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31
Q

would there be sensory only, motor only or both deficits if there was a blockage of the anterior spinal a and why

A

both sensory and motor since it is supplying most of the spinal cord (anterior and lateral horns)

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32
Q

would there be sensory only, motor only or both deficits if there was a blockage of the posterioe spinal a and why

A

sensory only (since posterior only supplies the dorsal horns and columns)

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33
Q

true or false: there is 1 main longitunial vein that drains blood from the spinal cord

A

false thre is two

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34
Q

what is are the 2 main drainage systems for blood in the spinal cord

A

anterior spinal vein
posterior spinal vein

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35
Q

where do the longitudinal veins of the spinal cord drain

A

into the internal vertebral plexus

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36
Q

where is the internal vertebral plexus located

A

in the adipose filled space (in epidural space) surrounding meningeal layers of the spinal cord

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37
Q

where does the internal vertebral plexus drai

A

into major systemic veins (ex: inf vena cavam azygous veins) via small segmentally aranged vesseks

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38
Q

internal carotid arteries continue as what (after giving some branches)

A

middle cerebral artery

39
Q

explain the passage of the internal carotid a

A

through transverse foramina, up through carotid canal and makes an S shape through cavervous sinus

40
Q

what are some branches off the internal carotid a (before it becomes middle cerebral)

A

opthalamic
anterior choroidal
anterior cerebral aa
lenticulostriate aa

41
Q

after what 3 branches does the internal carotid a continue as middle cerebral

A

ophthalmic arteries
anterior choroidal aa
anterior cerebral aa

42
Q

what is a deep branch off the internal cartoid

A

lenticulostriate artieies

43
Q

true or false: the ophthalmic aa branch off the middle cerebral a

A

false, off the internal carotid

44
Q

the anterior cerebral aa branch off what vessel

A

internal carotid aa

45
Q

where do the anterior cerebral artieries go after branching off internal carotid

A

enter the median longitudinal fissure

46
Q

what deep branches off the anterior cerebral arteries go to subcortical structures

A

medial striate arteries

47
Q

the lenticulate arteries branch off what vessel

A

middle cerebral arties

48
Q

anterior choroidal artery supplies mostly which ventricle

A

lateral

49
Q

true or false, the anterior and posterior blood systems never meet in the brain

A

false, they do, cerebral arterior circle (circle of willis(

50
Q

what is the reason that the anteior and posterior blood systems anastamose

A

compensate for slow, chronic, changes in blood flow

balance blood pressure between left and right halvs

51
Q

what are the two communicating arteries of the cerebral arterial circle

A

anterior communicating
posterior communicating

52
Q

how many anterior communicating aa do we have

A

1

53
Q

how many posterior communicating aa do we have

A

2

54
Q

the anterior communicating a connects what

A

the left and right anterior cerebral arteries

55
Q

the posterior communicating a connects what

A

internal carotid a with posterior cerebral a

56
Q

which of these vessels is not part of the cerebral arterial circle:
internal carotid
postreior communicating
meiddle cerebral
anterior cerebral

A

middle cerebral

57
Q

true or false: the middle cerebral artery is part of the circle of willis

A

false it is not

58
Q

what vssels make up the circle of willis

A

left and right internal carotod
left and right anterior cerebral
left and right posterior cerebral
left and right posterior communicating
anterior communicating

59
Q

which structures sit in the middle of the circle of willis

A

optic chiasm (and optic nevbres)
pituitary gland
mamalary bodies

60
Q

what are the 3 main arteries that provide cortical perfusion

A

anterior cereal
posterior cerebral
middle cerebral

61
Q

explain cortical perfusion area of the anterior cerebral artery

A

medial aspect of frontal and parietal lobes
1-2 cm on lateral aspects of frontal lobe and parietal lobes

deep branches also supply the caudate nucleus

62
Q

explain perfusion area of the middle cerebral a

A

vast majority of the lateral cortex
(frontal aspects of superior and middle frontal gyri)

frontal pole of temporal lobe

insula
lentiform nucleus (globus pallidus and putamen)

63
Q

true of false: the middle cerebral artery also supplies the insula and why

A

true because it passes thru lateral fissure

64
Q

explain perfusion of the posterior cerebral a

A

entire occipital lobe
medial and inferior aspects of the temporal lobe (coveres the inferior, parahippocampal and occipitotemporal gyri)

thalamus (deep branches)

65
Q

true or false: the entire occipital lobe is supplied by posterior cerebral a

A

true

66
Q

true or false: the entire temporal lobe is supplied by the posterior cerebral artery

A

false, only the medial and ingerior aspects (inf, parahippocampal and occipitotemporal)

67
Q

what are watershed regions

A

border zones between perfusion areas that are prone to ischemic stroke during hypoperfusion

68
Q

true or false: the borders between vessels are prone to ischemic stroke

A

true, they are watershed regions

69
Q

loss of blood supply to the cerebellum is associated with what

A

impaired motor coordination, stabilitiy and or balance

70
Q

what are the 3 vessels that provide cerebellar perfusions

A

superior cerebellar artery
anterior inferior cerebellar a
posterior inferior cerebllar a

71
Q

be able to locate the cerebellar perfusion area

A
72
Q

review tyhe brainstem perfusion patterns

A
73
Q

what are aneurysms

A

bulging/outpouching due to weakness or abnormality in arterior wall

74
Q

where do saccular brain aneurysms commonly occur

A

where brain vessels meet

75
Q

what is the issue with having aneurysms near brainstem

A

can pressure against cranial nerves

76
Q

what are some treatment options for aneurisms

A

clipping
microcolis
stents

77
Q

what is a storke

A

temporary or permanent loss of blood supply to a region of the brain

78
Q

what are the 2 types of stroke and quickly define

A

ischemic (blocked vessel ex: embolus)
hermmoragic (ruptured or compromised vessel)

79
Q

true or false: ischemic strokes are due to ruptured or compromised vessels

A

false, hemmorgaic strokes are

80
Q

which of the following is part of the cerebral arterial circle

middle cerebral artey
superior spinal a
anterior communicating a
pontine as

A

anterior communicating a

81
Q

a patient is experiencing motor and somatosensory deficits in their left lower limb due to an ischemic stroke. which vessel supplying the right cerebral cortex is most likely affected

A

anterior cerebral atery

82
Q

whichh vessel supply the superior aspect of the cerebellum

A

superior cerebellar a

83
Q

which vessel supplies the lateral tips of the cerebellum from a posterior view

A

anterior inferior cerebellar a

84
Q

which vessel supples the posterir inn aspect of the cerebellum

A

posterior inferior cerebellar a

85
Q

which vessel supples the peduncles of the cerebellum

A

anterior inferior cerebellar a

86
Q

where does the superior cerebellar a branch from

A

basilar

87
Q

where does the posterior inferior cerebellar a branch from

A

vertebral

88
Q

where does the anterior inferior cerebellar a branch from

A

basilar

89
Q

what are the 2 vessels that supply the midbrain

A

posterior cerebral (majority)
superior cerebellar (dorsal)

90
Q

what are the 3 vessels that supply the pons

A

bascillar (majority)
anterior inferior cerebellar a (lateral)
superior cerebellar (dorsal)

91
Q

what are the 3 vessels that supply the rostral medulla

A

anterior spinal (medial)
vertebral (middle)
posterior inferior cerebellar a (lateral and inferior)

92
Q

what are the 3 vessels that supply the. caudal medulla

A

anterior spinal (medial)
vertebral a (middle)
posterior spinal a

93
Q

what is the only difference in blood supply to rostral medulla vs caudal medulla

A

rostral = PICA
caudal = posterior spinal

94
Q
A