Peripheral Vascular System Flashcards
At what level does the common carotid artery bifurcate?
C4
What is clinically important characteristic of the central retinal artery?
End artery
What is an example of a visceral-visceral collateral circulation?
SMA: middle colic
IMA: left colic
What is an example of a visceral-systemic collateral circulation?
Abdominal aorta: lower anterior intercostals
External iliac: deep circumflex
What 2 structures does the vertebral artery pass through to get to the brain?
Transverse foramen (C6-C1) and then foramen magnum
Outline mechanism and anatomical principles of varicose veins
Anastomoses between deep and superficial veins.
Deep: anterior and posterior tibial veins + fibular vein to popliteal vein…
Superficial: short (popliteal) and long (femoral) saphenous veins
Incompetent valves, blood flows back into superficial veins
What muscle divides the subclavian artery into 3 parts?
anterior scalene
What anastomosis occurs at the greater trochanter (femur)?
Internal iliac: superior/inferior gluteal
External iliac: medial/lateral circumflex
What artery is related in Hunter’s canal?
Popliteal artery
What trunk from the subclavian artery supplies in and around the scapular?
Thyrocervical trunk
What does the posterior tibial artery branch into?
Lateral and medial plantar artery?
At what point does the femoral artery become the popliteal artery?
adductor hiatus in the adductor magnus
What are the 5 branches of the internal carotid artery?
Ophthalmic
Middle Cerebral
Anterior cerebral (via anterior communicating)
Anterior choroidal
Posterior communicating
What is an example of a structural abnormality related to the arterial circulation in the upper limb?
Trauma to axillary artery e.g. dislocated shoulder joint or fractured shaft of humerus
What is the main branch of the basilar artery?
posterior cerebral artery
Level of bifurcation of the brachial artery?
head of the radius
Outline Subclavian Steal syndrome
Block in subclavian artery.
Numbness in arm and tingling sensation + pulselessness
Clinical complication of early bifurcation of the brachial artery?
Ulnar artery descends superficial to flexor muscles (rather than deep) and can be mistaken for superficial vein resulting in intra arterial injection
What is the curve in the MR angiogram called?
Carotid siphon
When does the subclavian artery become the axillary artery?
After the 1st rib
What are the main branches of the inferior mesenteric artery?
Sigmoid
Left colic
What are 3 branches of the internal thoracic artery?
Anterior intercostal
Musculophrenic
Superior epigastric
What does the anterior tibialis artery continue as?
Dorsalis pedis
What are the branches of the 1st part of the subclavian artery?
Internal thoracic
Vertebral
Inferior thyroid
Dizziness and subclavian steal syndrome?
Affected side; blood will flow down vertebral artery to arm and collateral circulation
Reduced blood flow to brain –> dizziness
Contralateral vertebral blood flow normal
What are the main branches of the superior mesenteric artery?
Right colic
Ileocolic
Middle colic
What are the collateral circulations when there is a block in the descending aorta e.g. aortic stenosis or coarctation of aorta ?
posterior intercostal –> anterior intercostal –> superior epigastric
internal thoracic –> superior epigastric
external iliac –> inferior epigastric
At what level is the aortic bifurcation?
L4
What is the clinical relation of the middle meningeal artery?
Pterion extradural hemorrhage
What are the main branches of the coeliac artery?
Left gastric
Splenic
Common hepatic
What are the 3 branches of the deep femoral artery?
Medial circumflex femoral
Perforating
Lateral circumflex femoral
What is the surface anatomy of the dorsalis pedis?
Lateral to the extensor hallicus longus tendon
What are some of the lobes the the posterior cerebral artery supplies?
Occipital
Inferior/medial temporal
Thalamus
Through what does the internal carotid enter the brain?
Carotid canal
What is the scapular anastomosis and what arteries are involved?
Collateral circulation when there is a block in either the subclavian or axillary artery.
Dorsal scapular + suprascapular (thoracocervical trunk) + Subscapular (axillary)
What surface of the brain does the middle cerebral artery supply and what lobes?
Lateral - temporal and parietal
Briefly outline collateral circulation of a block in the internal carotid/ophthalmic artery?
External carotid via facial artery will try and contact the ophthalmic artery
What are the branches of the 2nd part of the axillary artery?
lateral thoracic
What are the branches of the 1st part of the axillary artery?
superior thoracic
What two systems contribute to the Circle of Willis?
Vertebral artery and internal carotid artery
Cubital Fossa acronym MAT
Median nerve
Artery brachial
Tendon biceps
What are the branches of the 3rd part of the axillary artery?
anterior and posterior humeral circumflex
subscapular
Where is the tibiofibular trunk?
Posterior, top of leg derived from popliteal artery
What is the ophthalmic artery a branch of?
Internal Carotid
What functions are lost with a blocked MCA
Speech
Motor
At what point does the external iliac artery become the femoral artery?
Mid inguinal point
What is the clinical implication of SMA thrombosis and clinical presentation?
Intestinal arteries occlusion
Presentation: intestinal obstruction
When does the axillary artery become the brachial artery?
Lower border of the teres major
What collateral circulation is at the lower thigh?
Anastomosis between the perforating arteries and the popliteal artery
What function is affected when the PCA is blocked?
Vision
What is middle meningeal artery a branch of?
Maxillary artery
What is the difference between the carotid sinus and carotid body?
Carotid sinus: regulates blood pressure
Carotid body: regulates acid-base balance
What are some of the branches of the ophthalmic artery?
Central retinal
Lacrimal
Supraorbital
Posterior Cillary
Muscular branches (supply extrocular muscles)
Ethmoid
What is the vertebral artery a branch of?
1st part of the subclavian artery
What are the 2 dominant collateral circulations?
Systemic-systemic vessels
Systemic-visceral (visceral-visceral) arteries
Where does the Circle of Willis sit?
Base of the brain: within the interpeduncular cistern of the subarachnoid space
What is the most distal branch of of the subclavian artery?
Dorsal scapular
What is the main branch of the femoral artery?
Profunda femoris
What are the 2 terminating branches of the internal carotid artery?
Middle cerebral
Ophthalmic
What is the inferior epigastric artery a branch of?
External iliac artery
What gives rise to posterior intercostal arteries?
Descending aorta
What nerve does the central artery go through?
Optic nerve
What are the most common levels for intercostal collateralisation in abdominal aorta occlusion?
T11 and T12
What is the superficial temporal artery a branch of?
External Carotid
