M1: Arterial Circulatory Sys Flashcards

1
Q

describe the tunica intima

A

inner most layer of a vessel

made of endothelial cells and c-tissue

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2
Q

describe the tunica media

A

middle layer

made of smooth muscles arranged circularly around the vessel
thickest layer

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3
Q

describe the tunica adventicia

A

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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4
Q

what are the 3 classifications of arteries based on size

A

arterioles
small and medium arteries
large, elastic arteries

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5
Q

describe arterioles

what controls their resistance levels

A

the primary point of resistance to blood flow

smooth muscle controls resistance and vessel contraction

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6
Q

describe sm and med. arteries

A

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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7
Q

describe large arteries

A

includes the AO and its largest branches

larger amounts of elastic fibers and less smooth muscle

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8
Q

the brain is directly supplied by which 4 vessels

A

2 internal carotids

2 vertebral arteries

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9
Q

which vessels supply the central nervous sys

A

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

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10
Q

what are the branches of the innominate artery

A

right CCA

right subclavian

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11
Q

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

A

ECA has branches extracranially and the ICD doesn’t

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12
Q

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

A

L sternoclavicular joint

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13
Q

does the CCA have any branches

A

no

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14
Q

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

A

upper border of the thyroid cartilage

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15
Q

the ICA supplies the majority of which circulation in the brain

A

anterior circulation

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16
Q

does the ICA have any branches extracranially

A

no

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17
Q

first branch off the ICA

where does this branch occur

A

ophthalmic artery, occurs at the carotid siphon

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18
Q

intrecranially, the ICA bifurcates into which vessels

A

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

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19
Q

what is the carotid siphon

A

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

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20
Q

3 segments on the carotid siphon

A

inferior to superior:

parasellar - proximal curve
genu - bend
supraclinoid - distal curve

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21
Q

another name for carotid siphon

A

cavernous ICA

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22
Q

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

A

genu

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23
Q

what are the 3 branches of the ophthalmic artery

A

supraorbital artery - most lateral branch

frontal artery

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

24
Q

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

A

ECA

25
Q

does the ECA usually supply blood to the brain

A

no

26
Q

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

A

if there’s an occlusion in the ICA

branches of the ECA may anastamose w/ the ICA or vertebral arteries to provide collateral flow

27
Q

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

A

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

28
Q

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

A

superior thyroid

29
Q

what is the typical location of the ECa in the neck

A

Anterior and medial to the ICA

30
Q

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

A

Those branches in communication w/ the ophthalmic artery

31
Q

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

A

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

32
Q

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

A

Posterior circulation

33
Q

Describe the location of the vertebral arteries

How do they travel in the body

A

Lie in the transverse foramina of the upper cervical vertebrae

Cephalad and anterior

34
Q

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

A

Basilar artery

35
Q

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

A

4

Pons and cerebellum

36
Q

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

A

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

Base of brain

37
Q

Which structure is the most important part of intracranial collateral circulation

Why?

A

Circle of Willis

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

38
Q

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

A

Circle of Willis

39
Q

The circle of Willis is formed by which arteries

A

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

40
Q

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

A

No

41
Q

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

A

MCA

42
Q

Which variation of the C of W is the most common

A

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

43
Q

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

A

25%

44
Q

How many different configurations of the C ofW are there

A

9

45
Q

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

A

Yes, due to collaterals

46
Q

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

A

Increased volume
Increased velocity
Reversing flow
Altering pulsatility

47
Q

Can locating collaterals help detect the level of obstruction

A

Yes

48
Q

What is the most common variant of the upper extremity arterial system

What are 2 other variants

A

Common origin of brachiocephalic and L CCA of the AO arch

High origin of radial artery
Duplicated brachial artery

49
Q

Is stenosis common for arteries is the upper extremities

A

No

50
Q

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

What is 1 other variant

A

Hypoplasia/aplasia of the anterior tibial artery

Anomalous location of the dorsal is pedis artery

51
Q

Collateral routes for a distal AO and bilateral CIA obstruction

A

Thoracic and abdo wall arteries
Mesenteric arteries
Lumbar arteries

52
Q

Collateral routes for unilateral CIA obstruction

What is the most common

A

Contralateral iliac or FA collaterals via pelvic arteries

Hypogastric

53
Q

Collateral routes for EIA and CFA obstruction

A

Ipsilateral pelvic and femoral artery branches

54
Q

Collateral routes for deep FA obstruction

A

Prox ipsilateral Pelvic and Sfs

Distal SFA pop artery

55
Q

Collateral routes for SFA and pop artery obstruction

A

Deep femoral branches

Pop to tibioperoneal trunk

56
Q

Collaterals for tibioperoneal trunk obstruction

A

Prox calf branches

Distal peroneal branches to ATA and PTA

57
Q

Review anatomy from notes

A

1