M1: Arterial Circulatory Sys Flashcards by M B

describe the tunica intima

inner most layer of a vessel

made of endothelial cells and c-tissue

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describe the tunica media

middle layer

made of smooth muscles arranged circularly around the vessel
thickest layer

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describe the tunica adventicia

outer layer

made of c-tissue, nerve fibers and vasa vasorum (network of small vessels that supply the walls of vessels)
in contact w/ surrounding tissue

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what are the 3 classifications of arteries based on size

arterioles
small and medium arteries
large, elastic arteries

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describe arterioles

what controls their resistance levels

the primary point of resistance to blood flow

smooth muscle controls resistance and vessel contraction

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describe sm and med. arteries

all arteries except the AO and its largest branches…

they have a well developed smooth muscle layer, and are more elastic and fibrous than arterioles

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describe large arteries

includes the AO and its largest branches

larger amounts of elastic fibers and less smooth muscle

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the brain is directly supplied by which 4 vessels

2 internal carotids

2 vertebral arteries

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which vessels supply the central nervous sys

the great vessels off the AO:
brachiocephalic/innominate
Left CCA
Left subclavian

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what are the branches of the innominate artery

right CCA

right subclavian

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whats the best way to tel the ECA from the ICA when scanning

ECA has branches extracranially and the ICD doesn’t

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when the L CCA branches from the AO arch, which joint does it pass under

L sternoclavicular joint

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does the CCA have any branches

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Anatomically, where does the CCA branch into the ICA and ECA

upper border of the thyroid cartilage

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the ICA supplies the majority of which circulation in the brain

anterior circulation

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does the ICA have any branches extracranially

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first branch off the ICA

where does this branch occur

ophthalmic artery, occurs at the carotid siphon

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intrecranially, the ICA bifurcates into which vessels

Middle cerebral artery (MCA) and anterior cerebral artery (ACA)

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what is the carotid siphon

an intercranial, tortuous area of the cervical ICA that is divided into 3 segments

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3 segments on the carotid siphon

inferior to superior:

parasellar - proximal curve
genu - bend
supraclinoid - distal curve

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another name for carotid siphon

cavernous ICA

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which part of the cavernous ICA does the ophthalmic artery branch from

genu

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what are the 3 branches of the ophthalmic artery

supraorbital artery - most lateral branch

frontal artery

nasal artery - most medial branch ending near the bridge of the nose

the branches of the ophthalmic artery all communicate w/ branches of which artery

ECA

does the ECA usually supply blood to the brain

when may the ECA supply blood to the brain, how would this work

if there's an occlusion in the ICA branches of the ECA may anastamose w/ the ICA or vertebral arteries to provide collateral flow

what will happen to flow in the ophthalmic artery if the ECA is being used to supply blood to the brain

flow in the ophthalmic artery will be reversed and will instead be used to feed the brain

whats the first extracranial branch off the ECA thats often seen when doing carotid exams

superior thyroid

what is the typical location of the ECa in the neck

Anterior and medial to the ICA

Which branches of the ECA are the most important in the case of collateral circulation

Those branches in communication w/ the ophthalmic artery

Which branches of the ECA are important in the case of collateral circulation

Those branches in communication w/ the ophthalmic artery (MOST IMPORTANT) The branches that interconnect b/w the muscular branches of the occipital and vertebral arteries

The vertebral arteries supply blood to which ‘circulation’ of the brain

Posterior circulation

Describe the location of the vertebral arteries How do they travel in the body

Lie in the transverse foramina of the upper cervical vertebrae Cephalad and anterior

Which artery do the vertebral arteries join to form in the head

Basilar artery

The Basilar artery has how many branches and what do they supply

4 Pons and cerebellum

Which arteries form the circle of Willis and where is it located in the brain

Confluence of the cerebral branches of the ICAs and the vertebral arteries Base of brain

Which structure is the most important part of intracranial collateral circulation Why?

Circle of Willis B/c it connects the anterior and posterior circulation of the brain when needed

Which arterial vessels in the brain are a common site of aneurysm formation

Circle of Willis

The circle of Willis is formed by which arteries

Anterior, middle and posterior cerebral arteries, joined by ant and pos communicating arteries

Under norm conditions, is flow detectable in the ant and pos communi arteries

Which artery in the circle of willis supplies the majority of blood to the cerebral hemispheres

MCA

Which variation of the C of W is the most common

Absence of hypoplasia of 1 or more of the communicating artery’s

Approximately what % of the population has a norm C of W

25%

How many different configurations of the C ofW are there

In the extremities at rest, can total blood flow be norm in the presence of severe stenosis/occlusion

Yes, due to collaterals

4 ways obstruction of an artery can alter flow in collateral pathways

Increased volume Increased velocity Reversing flow Altering pulsatility

Can locating collaterals help detect the level of obstruction

Yes

What is the most common variant of the upper extremity arterial system What are 2 other variants

Common origin of brachiocephalic and L CCA of the AO arch High origin of radial artery Duplicated brachial artery

Is stenosis common for arteries is the upper extremities

What is the most common variant of the lower extremity arterial system What is 1 other variant

Hypoplasia/aplasia of the anterior tibial artery Anomalous location of the dorsal is pedis artery

Collateral routes for a distal AO and bilateral CIA obstruction

Thoracic and abdo wall arteries Mesenteric arteries Lumbar arteries

Collateral routes for unilateral CIA obstruction What is the most common

Contralateral iliac or FA collaterals via pelvic arteries Hypogastric

Collateral routes for EIA and CFA obstruction

Ipsilateral pelvic and femoral artery branches

Collateral routes for deep FA obstruction

Prox ipsilateral Pelvic and Sfs | Distal SFA pop artery

Collateral routes for SFA and pop artery obstruction

Deep femoral branches | Pop to tibioperoneal trunk

Collaterals for tibioperoneal trunk obstruction

Prox calf branches | Distal peroneal branches to ATA and PTA

Review anatomy from notes