Neurovasculature Flashcards by Libby Sarra

what are the two main divisions of neurovasculature

Carotid circulation
Vertebrobasilar circulation (aka vertebral-basilar system)

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what does the brain need?

great deal of oxygen and glucose from the blood

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4 major arteries supplying majority of CNS from heart

yes,
2 vertebrals
2 IC

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why is it important to have 4 major supplies to the CNS from the heart?

important because if 1 or 2 gets occluded, can still get enough blood to brain to survive and do ok
can survive on 2 of them

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ascends from the left ventricle of the heart

aorta

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arise from the aorta and subclavian arteries

CC and vertebral arteries

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anterior supply

carotid

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posterior supply of blood to the head

vertebral

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branch off from the subclavian arteries and provide about 20% of the blood supply to the CNS

vertebral arteries

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blood supply brainstem, cerebellum, parts of the diencephalon, spinal cord, occipital and temporal lobes

vertebral

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blood to brain, eyes, etc

internal carotid

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blood to face and mouth

external carotid

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~80% of the blood supply to the telencephalon and diencephalon

internal carotid arteries

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supplies areas of the cerebellum, medulla and choroid plexus of the 4th ventricle

Posterior inferior cerebellar arteries

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spinal cord (posterior side)
2

Posterior spinal arteries

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anterior SC
single one

Anterior spinal artery

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is one va larger than the other?

yes, the left is

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supply inferior portion of cerebellum including the flocculus

Anterior inferior cerebellar arteries

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supply superior cerebellum, much of the caudal midbrain and rostral pons

Superior cerebellar arteries (SiCA)

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supply caudal diencephalon, medial occipital lobe and inferior temporal lobe

at the level of the midbrain—posterior cerebral arteries

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arteries around to back of pons and Anterior Inferior Cerebellar a. to Cochlear Nuculeus

circumferential

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supply SOC into pons tissue

Penetrating arteries

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supply to Inferior Colliculus and some MGB at pons

Superior Cerebellar a. and Posterior Cerebral a

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directly from basilar artery or from anterior inferior cerebellar artery

Internal auditory or labyrinthine arteries

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Begins at upper border of the thyroid cartilage and ascends to reach the base of the skull

internal carotid

Enters at the carotid canal (aka lacerum)

internal carotid

what branches off of the IC and divides into the many branches

opthalamic artery

gives rise to middle cerebral arteries and anterior cerebral arteries, as well as posterior communicating arteries (More with Circle of Willis)

internal carotid

arises opposite the upper border of the thyroid cartilage, inclines backwards to space between the neck and condyle of the lower jaw and the external auditory meatus

external carotid

Divides into temporal and internal maxillary arteries

external carotid

Branches—supply the neck, face and base of skull

external carotid

what is our safety valve?

circle of willis

provides main blood supply to the lateral surface of cerebral hemispheres.

Middle cerebral artery

supply the superior, posterior and inferior borders. supply the medial portion of the cerebral hemispheres.

Anterior and posterior cerebral arteries s

supply the temporal lobe.

Middle and posterior cerebral arteries

what is a water shed area?

one artery ends and the next picks up

blood supply midline of longitudinal fissure

anterior cerebral artery

blood supply of midline of temporal lobe

posterior cerebral artyer

blood supply around the lateral fissure

middle cerebral artery

anastomosis

interconnections

why do we have the circle of willis? How is it made?

signs of a stroke

B = Balance: Sudden loss of balance E = Eyes: Loss of vision in one or both eyes F = Face: Face droops on one side A = Arms: Arm drops when both arms are raised S = Speech: Speech is slurred or sounds different T = Time: Time to get help immediately

do we always know what causes SNHL?

no, evidence that ~40% maybe from vascular deficits

decusations of pyramid

go across the two sides of medulla

olives

bulges on side of medulla

what is angiography

medical imaging technique used to visualize the inside, or lumen, of blood vessels and organs of the body, with particular interest in the arteries, veins, and the heart chambers

cavities formed by the endosteal and meningeal layers of the dura mater

venous sinuses

all sinuses join together and dump out into

the jugular vein

abnormalities with blood supply

Degrees of variation or normal in neurovasculature Vascular plasticity Reorganization of blood flow due to longstanding atherosclerotic disease

what makes the plasticity in our blood supply?

circle of willis

weakened arterial walls that balloon (look like berries) and can rupture and cause intracranial bleeding

berry aneurysms

a large network of blood vessels

plexus

large amounts of blood escapes into surrounding tissues without clotting

hemorrhage

small amounts of blood that escape into surrounding tissues causing bruising

hematoma

a foreign body (blood clot) that travels within the body and can constrict blood flow

embolus

a blood clot, a lesion attached to the inner vessel wall, can block partially or fully the flow of blood.

thrombus

most common cause of neurological deficits

Cerebrovascular disease and accidents

what can cause malfunction and death of neurons

reduction in blood flow

necrotic region of tissue

infarct

abrupt incident of vascular insufficiency

stroke

loss of blood supply due to mechanical blockage

ischemic stroke

blood clot within a vessel (attached)

thrombus

a bit of foreign matter, such as a blood clot or atherosclerotic plaque carried in the bloodstream (could be detached thrombus)

embolus

minutes to hours, usually from an emboli that is broken down

transient ischemic stroke (mini stroke)

a localized mass of blood outside of blood vessels that is relatively or completely confined within an organ or tissue, a space or potential space; the blood is usually clotted.

Hematoma

an escape of blood through ruptured or unruptured vessel walls

Hemorrhage

what can have symptoms like a stroke?

Hemorrhages

where would damage be more dangerous?

more dangerous becasue BS has a lot of life manageing functions (automatic things) and can go into a coma with life threatening supra could just affect a little of something

what can cause neurovasculature damage?

hemmorrhages Small arteries may rupture Spontaneously—increased chance with hypertension

localized dilation of a blood vessel

aneurysm

an aneurysm is

subarachnoid hemorrhage

classically occur where cerebral arteries branch off of the circle of Willis

berry aneurysm

Arteriovenous malformations

Arteries and veins tangle together and blood is shunted from arteries to the veins Delicate walls may lead to intracerebral hemorrhages Caused during development Can enlarge with age and can result in stealing of blood from areas or hemorrhaging

symptoms of AVM

Seizures Headache or pain in one area of the head Muscle weakness or numbness in one part of the body Severe headache Weakness, numbness or paralysis Vision loss Difficulty speaking Confusion or inability to understand others Severe unsteadiness

blood brain barrier

helps to protect our CNS tight junctions of the endothelial cells that line the capillaries in the CNS Stopping most macromolecules from entering or leaving the CNS Lipid-soluble substances and glucose can cross

blood CSF barrier

macromolecules can reach the choroid plexus but the capillaries do not come in direct contact with CSF so there is a barrier

arachnoifd barrier layer

arachnoid cells tightly zipped together with tight junctions to stop diffusion between the subarachnoid space and the extracellular fluids of the dura mater ones something enters that subarachnoid space, it will stay until sucked into arachnoid villa into venus sinous

CSF-Brain interface

CSF bathes the brain and there are not cells with tight junctions so macromolecules move freely between the CSF and intercellular spaces

what makes up circle of willis?

posterior communicating arteries (2) Anterior communicating artery (1) connected carotid and V-B vasculature