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BRS YEAR 2 > Neuro - Cerebral Vasculature > Flashcards

Neuro - Cerebral Vasculature Flashcards

1
Q

Body weight of brain

A

2%

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2
Q

Cardiac output of brain

A

10-20%

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3
Q

Liver glucose of brain

A

66%

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4
Q

Oxygen consumption of brain

A

20%

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5
Q

Two main arteries suppling brain

A

Vertebral arteries and internal carotid arteries

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6
Q

Path of vertebral arteries

A

Travel up the neck via the transverse cervical process (protected) and enter via the foramen magnum

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7
Q

Path of internal carotid

A

Common carotid emerges from the brachiocephalic/arch of aorta and bifurcates at the level of the laryngeal prominence. The internal carotid then travels via the carotid canal into the cerebral cavity.

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8
Q

Advantage of circle of willis anastomotic circuit?

A

If the carotid artery is obstructed - there may be compensation from the posterior supply

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9
Q

What is the problem with the circuit from circle of willis?

A

There is weak compensation due to the posterior communicating artery connecting the anterior and posterior supplies

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10
Q

What is the main branch of the internal carotid?

A

Middle cerebral artery

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11
Q

Describe how blood is drained in the brain

A

From cerebral veins, into venous sinuses and then into the internal jugular vein back to the SVC

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12
Q

What are sinuses

A

Vessesl carrying venous blood from the brain to the internal jugular vein, formed between the meningeal and the periosteal layers of dura mater

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13
Q

What is the fold of dura separating the two hemishperes

A

Falx cerebri

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14
Q

What is the fold of dura separating the cerebellum hemishperes

A

Falx cerebelli

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15
Q

What dural layer separates cerebellum from cerebrum

A

Tentorium cerebelli

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16
Q

Pathway of sigmoid sinus

A

Travels out the cranial cavity through the jugular foramen and is continuous with the internal jugular vein

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17
Q

What are the 4 types of intracranial haemorrhage

A

Extradural
Subdural
Subarachnoid
Intracerebral

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18
Q

Onset of extradural haemorrhage

A

Rapid onset due to high arterial pressure

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19
Q

What commonly causes extradural haemorrhage

A

Often trauma related

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20
Q

if the pterion is hit, what artery is at risk of haemorrhage?

A

Middle meningeal artery - main supply to the meninges

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21
Q

How do we treat an extradural haemorrhage?

A

Urgen burr hole surgery or craniotomy

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22
Q

What does extradural haemorrhage look like on CT

A

Lemon shaped - blood is limited by the sutures of the skull

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23
Q

What is the onset of a subdural haemorrhage?

A

Slow onset

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24
Q

Why is a subdural haematoma slow onset

A

Due to space between the dura and the arachnoid layer, and also because of the low venous pressure

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25
Q

What does subdural haematoma look like on CT

A

Banana shaped - blood not limited by the sutures of the skull

26
Q

When does a sub arachnoid haemorrhage occur?

A

When aneurysms rupture

27
Q

Where does blood fill with a sub arachnoid haemorrhage

A

Subarachnoid space

28
Q

What location in the brain is most commonly affected by sub arachnoid haemorrhage

A

Circle of Willis

29
Q

What is an aneurysm

A

Weakness in the blood vessel wall - often congenital and benign. In patients with hypertension, aneurysm may rupture and blood can fill SAS

30
Q

Where does blood fill in an intracerebral haemorrhage

A

In the substance of the brain itself

31
Q

What patients are more prone to an intracerebral haemorrhage

A

Patients with hypertension

32
Q

What is the onset of a intracerebral haemorrhage

A

Spontaneous

33
Q

Why is an extradural haemorrhage a surgical emergecny

A

Blood pressure can build up rapidly and can cause function deficit to shut down cardiorespiratory system, thus resulting in death.

34
Q

What is another name for a stroke?

A

Cerebrovascular accident

35
Q

CVA definition

A

Rapid developing focal disturbance of brain function with presumed vascular origin and lasting longer than 24 hours

36
Q

What does a rapid onset mean in clinical presentation?

A

Often means that the cause is vascular, but we should rule out other causes first

37
Q

What is the most common type of stroke?

A

Thrombo embolic stroke (85%)

38
Q

What is the other type of stroke?

A

Haemorrhagic stroke (15%)

39
Q

What is a TIA?

A

Rapid developing focal disturbance of brain function often presumed vascular in origin, but resolves completely within 24 hours

40
Q

What can a TIA be a sign of?

A

An oncoming stroke

41
Q

What is infarction?

A

Degenerative changes that occur when a tissue loses blood supply (death)

42
Q

What is cerebral ischaemia?

A

Lack of sufficient blood supply to nervous tissue resulting in permanent brain damage if blood flow is not quickly restored

43
Q

What is the difference between anoxia and ischaemia?

A

Anoxia is a loss of oxygen, however ischaemia involves not only a loss of oxygen but a loss of glucose and everything else in the blood

44
Q

What is thrombosis?

A

Formation of a blood clot (thrombus). Can be from stasis or material from other parts e.g. from the heart, ending up in the brain.

45
Q

What is an embolism?

A

When a small vessel is obstructed by material carried from a large vessel e.g. a thrombus from the internal carotid ending up in the brain

46
Q

Iatrogenic example of an embolism

A

Air from an IV injection

47
Q

Epidemiology of strokes

A

3rd most common cause of death
100,000 deaths in Uk/year
50% of survivors left permanently disabled
70% show obvious neurological deficit

48
Q

Signs of stroke?

A

Face fallen on one side
Can’t raise both arms and keep them there
Slurred speech

49
Q

Risk factors for stroke? (5)

A 
Age 
Hypertension 
Diabetes mellitus 
Cardiac disease 
Smoking

DCASH

50
Q

Which cerebral artery has the biggest perfusion field

A

MCA

51
Q

What does the MCA supply

A

Deep structures in the brain e.g. deep motor structures.
Outer brain surface
Anterior temporal lobe

52
Q

What does the ACA supply

A

Mid line structures all the way to the parietal occipital fissure.
Structures at the top of the brain

53
Q

What does the PCA supply

A

Occipital lobe and inferior temporal lobe

54
Q

What artery presents with a classic stroke

A

MCA

55
Q

What does an ACA result in (3)

A

Contralateral paralysis
Abulia
Inappropriate social behaviour

56
Q

What limb is affected with ACA stroke

A

Legs

57
Q

What does MCA stroke present with

A

Maybe complete contralateral hemiplegia
Contralteral hemisensory deficit
Hemianopia
Aphasia (if left sided lesion)

58
Q

Why may MCA stroke cause complete hemiplegia

A

MCA supplies deep motor structures

59
Q

What does a PCA stroke present with

A

homonymous hemianopia

visual agnosia

60
Q

What is abulia?

A

Lack of judgement, intellect and executive function

BRS YEAR 2 (37 decks)

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