Unit 1_Vasculature Flashcards
Where is main blood supply to brain from?
Internal Carotid and Vertebral Arteries
What develops posterior circulation in the brain?
Two Vertebral Arteries
What develops anterior circulation in the brain?
Internal Carotid Artery (off of Common Carotid Artery)
What circulations communicate via Circle of Willis?
Carotid and Vertebral-Basilar Circulations
How do the major arteries which supply the brain communicate with each other?
Circle of Willis
What structure roughly occupies the ventral surface of the diencephalon, and is formed by the single anterior communicating artery, two anterior cerebral arteries, two internal carotid arteries, two posterior communicating arteries and the two posterior cerebral arteries?
Circle of Willis
In addition to Circle of Willis collateral circulation can occur where?
At edges of the distribution of cerebral arteries
What are the main brain artery distributions of the Circle of Willis?
Anterior communicating artery
Anterior cerebral artery
Internal carotid artery
Posterior communicating artery
Posterior cerebral artery
What are the main brain artery distributions of the Internal Carotid Artery?
Anterior cerebral artery
Internal carotid artery
Middle cerebral artery
Posterior communicating artery
Anterior choroidal artery
This artery arises at the bifurcation of the common carotid artery in the neck. It passes through the carotid canal in the skull and proceeds through the cavernous sinus into the middle cranial fossae. At the level of the rostral midbrain just lateral to the optic chiasm, it bifurcates to form the middle cerebral and anterior cerebral artery.
Internal Carotid Artery
Knowledge of the distribution of cerebral arteries is crucial in order to understand the associated neurological signs and symptoms. The brain is supplied with blood through 4 large trunks; the paired internal carotid arteries and the paired vertebral arteries.
Vascular Anatomy
What artery is the first intracranial branch of the internal carotid artery and it supplies the eye and orbital contents, frontal scalp, and parts of the nose? Note it does not actually supply any brain tissue.
Opthalmic artery
What artery arises just proximal to the terminal bifurcation and runs backward to join the posterior cerebral artery forming part of the Circle Of Willis? It forms part of a collateral supply.
Posterior communicating artery
What branch comes off either the tail end of the internal carotid artery or off of the middle cerebral artery? It supplies parts of the basal ganglia, thalamus, and midbrain, and more importantly the posterior portion of the internal capsule. This artery is very susceptible to occlusion.
Anterior choroidal artery
Branches heading towards cortex send branches to where?
The brainstem and other deep structures as they pass by
What branches of the Middle Cerebral Artery supply some of the structures related to the basal ganglia and the internal capsule?
Superficial (cortical) branches
Deep (lenticulostriate) branches
What are white matter tracts/primarily axon bundles that transmit information through a projection fiber pathway from the cortex down through the spinal cord, or out to the periphery?
Internal Capsule
If a patient has an MCA stroke, what symptoms will we notice?
Motor and sensory deficits that are common in the trunk and in the upper extremity, deficits in speech function, and visual challenges
What makes up the rostral portion of the circle of willis?
Anterior Cerebral Artery
If a patient has an ACA stroke, what symptoms will we notice?
Visual impairment, deficits in the leg mobility
What two arteries fuse to form the basilar artery?
Basilar artery ends by forming the two posterior cerebral arteries
Two vertebral arteries
What three arteries supply blood to the cerebellum?
Superior cerebellar artery (arises from basilar artery)
Anterior inferior cerebellar artery (arises from basilar artery)
Posterior inferior cerebellar artery (PICA; arises from vertebral artery)
What does the end of the basilar artery form?
Two posterior cerebral arteries
What artery that supplies the cerebellum is prone to having occlusions?
Posterior Inferior Cerebellar Artery (PICA)
- PICA strokes
What structures does the posterior cerebral artery supply blood to?
The brainstem and the occipital lobe
What is a very common brainstem type impairment when patients have posterior circulation issues?
Bulbar signs and symptoms, caliculi, cranial nerve impairments (III, IV, VI) influencing eye movement and vision.
What artery runs down the ventral median sulcus/fissure, supply blood flow throughout the rest of the cardiovascular system from the anterior portion, the spinal cord gives off vessels that travel around the vertebral bodies and into the spinal canal?
Anterior spinal artery
What artery provides much more blood flow in the spinal cord - anterior spinal artery or posterior spinal artery?
Anterior Spinal Artery
What is the most common source of vascular pathology that practitioners encounter?
Strokes involving cerebrovascular accident (CVA)
What is a term that refers to a syndrome that results in sudden neurological signs and symptoms due to disease processes in the cerebral blood vessels?
cerebrovascular accident (CVA)
How can strokes be classified?
occlusive (80% of strokes, due to blockage, ischemic) or hemorrhagic (due to ruptured vessels)
Following a stroke, the insufficiency of blood supply that follows can produce what?
ischemic damage
What is an area of ischemic damage where the cellular components die?
An area of Infarction
What does the size of the infarction depend on?
The size of the vessel affected, the presence of anastomoses, and the time elapsing before complete occlusion.
Occlusive strokes are generally due to ____________ or __________ (diet related) and most hemorrhagic strokes are associated with ____________ (high blood pressure). Both types of stroke are preventable with modifications in life style.
atherosclerosis or thrombosis
hypertension
What are the neurological signs and symptoms a patient is experiencing a stroke?
F (Face drooping) A (Arm weakness) S (Speech difficulties) T (Time to call)
What drug can reduce clotting in patients that have had an occlusive stroke?
TPA
What is a syndrome that resembles stroke, has little or no tissue damage, focal with rapid recovery (within minutes but no more than 24 hours)?
Transient ischemic attack (TIA)
What occurs when blood enters the subarachnoid space? The most common cause is rupture of an aneurysm on a cerebral artery, affects the vessels that directly supply brain tissue and it occurs suddenly with a high incidence of mortality.
Subarachnoid hemorrhage
What is a congenital malformation of cerebral arteries and veins? These malformations increase in size with age and are also at risk for hemorrhage. Aneurysms are balloon-like swellings of arterial walls and they occur most frequently at arterial bifurcations. Many can be surgically corrected if caught in time.
Arteriovenous Malformation (AVM)
What term is routinely used to describe the anatomical and physiological complex that controls the movement of substances from the extracellular fluid of the body to the extracellular fluid of the brain? It encompasses a blood-CSF barrier component and is made up of pieces of astrocytes.
blood brain barrier
What glia cell is responsible for maintaining the blood brain barrier and transporting nutrients to the neurons in the CNS?
Astrocytes
