Stroke/ Arteries

Question 1

major arterial supply to the cerebrum

Answer 1

The internal carotid artery and the vertebral arteries provide the arterial supply to the cerebral hemispheres and deep cerebral structures
The internal carotid system and the vertebral system are connected by the cerebral arterial circle of willis
Each major blood vessel extends long/circumferential branches and short/penetrating branches

Question 2

blood brain barrier

Answer 2

endothelial cells line the microvasculature of the brain form a barrier between the circulation and the interstitial fluid, its a physical, transport, and metabolic barrier

the endothelial cells that line the vessels are composed of complex tight junctions and lack of pinocytic vesicles

Question 3

Movement of substances across the BBB

Answer 3

Paracellular aqueous path- severly limited by tight junctions
Transcellular lipophilic path- O2, Co2, ethanol, barbituates
Transport proteins- nutrients, wastes, Ldopa, chemo, may or maynot be energy dependent
REceptor mediated transcytosis- insulin, transferrin
Adsorptive transcytosis- plasma proteins

Question 4

Pathology of BBB

Answer 4

Down-regulating proteins that contribute to the tight junstion

Break down the basal lamina surrounding the capillaries

Up-reguating or down-regulating transporter proteins
Influencing the secretions of astrocytes

Question 5

Circumventricular organs

Answer 5

areas of the brain that lack the BBB

Question 6

superior cerebral veins

Answer 6

drain superolateral and medial surface of the cerebral hemispheres, empty into trolard and superior sagittal sinus

Question 7

middle cerebral veins

Answer 7

located in lateral fissure, drains lateral surfaces of the cerebral hemispheres
empty into cavernous sinus

Question 8

inferior cerebral veins

Answer 8

located on the orbital surfaces of the frontal lobes and the inferior surfaces of temporal lobes
Orbital vv- empty into superior sagittal sinus
Temporal veins- empty into cavernous sinus via middle cerebral veins

Question 9

Superior anastomotic veins

Answer 9

veins of Trolard- connect superficial middle cerebral with superior sagittal sinus

Question 10

Inferior Anastomotic veins of labbe

Answer 10

connect the superficial middle cerebral vein to the transvese sinus

Question 11

Deep internal veins of cerebrum

Answer 11

Basal veins- formed by anterior cerebral veins

Great vein of Galen- formed by R and L internal cerebral veins

Question 12

stroke

Answer 12

acute onset, focal neurologic deficit (should be unilateral, finite domain motor/sensory/language, usually does NOT alter consciousness), Cerebrovascular cause

Hemorrhagic 15% but ISCHEMIC is 85%

Question 13

Types of stroke

Answer 13

Subarachnoid hemorrhage (caused by rupture of blood vessels in the subarachnoid space…aneurysm, trauma)

ischemic is when theres an arterial occlusion with brain infarct

hemmorage appears very contrast compared to brain but ischemic is super dark

Question 14

ischemic penumbra

Answer 14

area of decreased but not dead tissue during ischemia can be saved if soon attended to (under 4.5 hours)

IV thrombolysis with tissue plasminogen activator (TPA)

Mechanical thrombectomy