Lecture 6 - Blood Supply of the Brain Flashcards

1
Q

What fissure/sulci does the ACA run through?

A

Longitudinal fissure

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2
Q

What fissure/sulci does the MCA run through?

A

lateral sulcus

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3
Q

What fissure/sulci does the PCA run through?

A

transverse fissure

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4
Q

What percentage of our body weight is the brain?

A

2%

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5
Q

What percentage of blood supply goes to the brain?

A

20%

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6
Q

Does gray or white matter have more blood vessels? Why?

A

Gray matter more than white
- gray matter has the cell bodies, neurons, glia and therefore needs more energy and more blood supply
- White matter contains axons, which need less energy/blood supply

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7
Q

What two arteries supply the brain?

A
  • anterior division: internal carotid artery
  • posterior division: vertebral-basilar artery (ascends through transverse foramen of vertebrae into foramen magnum)
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8
Q

What supplies the anterior division of the brain?

A

the internal carotid artery

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9
Q

What supplies the posterior division of the brain?

A

the vertebral-basilar artery

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10
Q

What are some of the major branches of the internal carotid artery ?

A
  • anterior cerebral artery
  • middle cerebral artery
  • opthalamic artery
  • anterior choroidal artery
  • posterior communicating artery
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11
Q

What is important about the opthalamic artery in the anterior brain?

A

first branch of the internal carotid, follows the optic nerve through the optic canal for the eye

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12
Q

What is important about the antrior choroidal artery?

A

from IC, forms choroid plexus in ventricles for CSF

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13
Q

What is important about the posterior communicating artery?

A

forms an anatomoses with the basilar artery and connects anterior brain blood supply with posterior brain blood supply

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14
Q

What does the vertebral basilar artery split into?

A
  • vertebral artery (2 on each side)
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15
Q

Why is the vertebral artery at the C6 transverse foramina important?

A

it crosses over only at C6, which is where dislocations or disc herniations can happen, which can compress the vertebral artery leading to nausea, vomiting, etc.

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16
Q

What does the vertebral artery form?

A
  • anterior spinal artery
  • posterior inferior cerebellar artery (PICA)
    -> forms the posterior spinal artery
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17
Q

Why is PICA important?

A

important to cerebellar functions
- from the vertebral artery

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18
Q

What does the vertebral-basilar artery give off?

A

the basilar artery at the pontomedullary junction

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19
Q

What does the basilar artery give off?

A
  • anterior inferior cerebellar artery (AICA)
  • pontine arteries
  • superior cerebellar artery (SCA)
  • posterior cerebral artery (PCA)
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20
Q

What is important about the PCA?

A

1st CN oculomotor nerve runs through the SCA and PCA, if an aneurysm happens here it will compress the nerve!

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21
Q

A patient fractured the basal neurocranium around the jugular foramen. Which nerves coursing through would be compromised?

A

CN IX, X, and XI

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22
Q

A patient fractured the basal neurocranium around the foramen ovale. Which nerve coursing through would be compromised?

A

trigeminal nerve - mandibular branch

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23
Q

What is the circle of willis?

A

9 members, anastomosis of anterior/posteiror divisions

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24
Q

What are the 9 members of the circle of willis?

A
  • anterior communicating artery
  • ACA x 2
  • Internal carotid artery x2
  • Posterior communicating artery x2
  • PCA x2
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25
Q

What artery is NOT involved in the circle of willis?

A

the MCA

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26
Q

What percentage of the population has a typical circle of willis?

A

only 30%, huge veriations

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27
Q

Where is the ACA?

A

in the longitudinal fissure

28
Q

What does the ACA supply??

A

the medial/supeiror frontal and parietal lobes plus the cingulate gyrus

29
Q

What happens with a R ACA stroke?

A

the Left lower limb compromised

30
Q

Where does the MCA run?

A

in the lateral sulcus

31
Q

What does the MCA supply?

A

the lateral and inferior frontal/perietal lobes, & superior temporal lobe

32
Q

What can an MCA stroke cause?

A

aphasia

33
Q

Where does the PCA run?

A

in the transverse fissure

34
Q

What does the PCA supply?

A

the inferior temporal lobe and occipital lobe

35
Q

What basal nuclei does the ACA branch supply?

A

the nucleus accumbens and caudate

36
Q

What basal nuclei does the MCA branch supply?

A

the putamen and caudate

37
Q

What basal nuclei does the PCA branch supply?

A

the thalamus

38
Q

What basal nuclei does the IC branch supply?

A

the globus pallidus and internal capsule

39
Q

What branches of blood supply go to the midbrain?

A

the PCA,SCA

40
Q

What branches of blood supply go to the pons?

A

the pontine artery, AICA, SCA

41
Q

What branches of blood supply go to the medulla?

A

the anterior spinal artery and posterior spinal artery

42
Q

What branches of blood supply go to the cerebellum?

A

the superior cerebellar arteries, anterior inferior cerebellar arteries, and posterior inferior cerebellar artery

43
Q

What are the two types of hemorrhagic stroke?

A

intraparenchymal and subarachnoid

44
Q

How can we differentiate intraparenchymal and subarachnoid strokes on a CT scan?

A

intraparenchymal will push brain structures to other spaces, subarachnoid will spread to all structures so it will be light all around

45
Q

What percentage of strokes are hemorrhagic?

A

13%

46
Q

What percentage of death cases come from hemorrhagic stroke?

A

40%

47
Q

What will happen if an individual under 55 yo has a hemorrhagic stroke?

A

drug abuse screening

48
Q

What are the type of ischemic stroke?

A

intraparenchymal only

49
Q

What percentage of strokes are ischemic?

A

87%

50
Q

What percentage of ischemic strokes are death cases?

A

60%

51
Q

What happens with an ischemic stroke?

A

hypoxic damage due to blood flow being blocked

52
Q

What is a hemorrhagic stroke?

A

when a blood vessel bursts within the brain

53
Q

What is a ischemic stroke?

A

when a blood clot blocks the blood flow in an artery within the brain

54
Q

What happens with stroke lesions?

A

localized damage

55
Q

What is diaschisis?

A

distant and systemic injury

56
Q

Which kind of stroke is worse?

A

hemorrhagic stroke is worse than ischemic

57
Q

What will trauma or aneurysm present like on a CT scan?

A

Star like presentation

58
Q

What is lateralization with a cerebral cortex stroke?

A

somatotopy/homunculus affected

59
Q

What happens with a sensory somatotopy with cerebral cortex stroke?

A

paresthesia/numbness

60
Q

What happens with a motor somatotopy cerebral cortex stroke?

A

paresis/paralysis

61
Q

What is a lacunar stroke?

A

small blood vessel, silent stroke

62
Q

What happens with a lacunar stroke?

A

compromised contralateral body hemisphere
- NO sensory and motor decussations in the forebrain

63
Q

Does a lacunar stroke or a cortical stroke result in more functional loss?

A

lacunar more functional loss compared to the cortical stroke

64
Q

What happens with a brainstem stroke?

A

more functional loss
- alert, arousal, and consciousness
- vital centers

Alternating hemiplegia
- ipsilateral face/head
- contralateral body

65
Q

Which arteries supply blood to the forebrain basal nuclei and diencephalon?

A

IC branches: internal capsule, globus pallidus
ACA branches: nucleus accumbens, caudate
MCA branches: caudate and putamen
PCA branches: thalamus

66
Q

Suppose an ischemic stroke happens around the left rostral medulla. Which body parts and functions will be compromised?

A

Paresis/paresthesia of the L face and R hemiparesis