Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

USAHS Neuroanatomy Test 2 > Unit 5: Vasculature > Flashcards

Unit 5: Vasculature Flashcards

1
Q

Anterior Circulation

A

Internal Carotid Arteries (ICA)

  • The common carotid artery splits into the internal carotid and the external carotid in the cervical region.
  • The internal carotid enters the skull through the carotid canal in the temporal bone. Then moves forward through the cavernous sinus then enter the brain near the optic chiasm and it divides to become the anterior cerebral artery and the middle cerebral artery.
  • The anterior cerebral artery supplies the medial surface of the hemispheres and around the corpus callosum. The middle cerebral artery supplies the lateral surface of the hemispheres.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Posterior Circulation

A

Vertebral arteries

-The vertebral artery branches off of the subclavian artery and passes through the foramen in the transverse process of the cervical vertebrae. It then enters the skull through the foramen magnum and runs along the lateral aspect of the medulla.
-The two vertebral arteries converge at the level of the pons to become the basilar artery. Before they merge they each have a branch that comes off that merge and become the anterior spinal artery which descends down the spinal cord. Also off of the vertebral arteries are the posterior inferior cerebellar arteries (PICA) which provides circulation to the cerebellum and medulla.
-Vertebrals merge to form the Basilar artery -runs along the pons and then divides into two posterior cerebral arteries.
-There are several branches off the basilar artery including the pontine arteries which are numerous, small arteries that supply the pons.
-The labyrinthine artery branches off low on the pons then follow the facial and vestibulocochlear nerve through the internal acoustic meatus to supply the internal ear.
-The anterior inferior cerebellar artery (AICA) also branches off the basilar here by the low pons and routs back to feed the anterior and inferior portions of the cerebellum.
The superior cerebellar artery branches off the basilar at the top of the pons (just below the posterior cerebral artery) and supplies the superior portion of the cerebellum.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Anterior and Posterior Circulation (image)

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Vascular Territories of the 3 Main Cerebral Arteries

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Circle of Willis (image)

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Circle of Willis

A
  • At the level of the interpeduncular fossa is a circuit of connecting vessels which is important in maintaining circulation to the brain especially if a vessel becomes blocked.
  • The circle is comprised of the two internal carotid arteries, the anterior and posterior communicating arteries, anterior cerebral arteries, and posterior cerebral arteries.
  • The anterior communicating arteries connect the internal carotid arteries to the anterior cerebral arteries and the posterior communicating arteries connect the internal carotid to the posterior cerebral arteries.
  • This circle allows blood to circulate through the two circulations (carotid and vertebral).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Caudate, Putamen and Internal Capsule (circulation to different areas)

A

Supplied by the striate branches of the middle cerebral artery.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Thalamus (circulation to different areas)

A

Supplied by the thalamic branches of the posterior cerebral artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Midbrain (circulation to different areas)

A

Supplied by the posterior cerebral, superior cerebellar and basilar arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Pons (circulation to different areas)

A

Supplied by the basilar as well as the anterior inferior and superior cerebellar arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Medulla (circulation to different areas)

A

Supplied by the vertebral, anterior and posterior spinal and the posterior inferior cerebellar and basilar arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Cerebellum (circulation to different areas)

A

Supplied by the superior cerebellar, the anterior inferior cerebellar and the posterior inferior cerebellar arteries.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Anterior Cerebral Artery (circulation to different areas)

A

Blood supply to the medial surfaces of cerebral hemispheres - frontal and parietal lobes as well as part of the basal ganglia and the corpus callosum.

  • Supplies mist of cortex on anterior, medial surface, from frontal to anterior parietal lobes
  • Includes: anterior limb od internal capsule, basal ganglia (putamen, caudate nucleus)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Middle Cerebral Artery (circulation to different areas)

A

Blood supply to the lateral surface of the cerebral hemispheres- frontal, parietal, temporal lobes as well as the inferior surface of frontal and temporal lobes.

  • Supplies above Sylvian fissure (superior division) to include lateral frontal lobe; cortex below Sylvian fissure including lateral temporal and parietal lobes (inferior division); majority of cortex on dorsolateral convexity of brain
    includes: Basal ganglia (globus pallidus and caudate nucleus)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Posterior Cerebral Artery (circulation to different areas)

A

Blood supply to the medial and inferior surface of the temporal and occipital lobes as well as the thalamus and hypothalamus.
-Off of posterior circulation/end of basilar
-Main supplier to inferior and medial temporal and occipital
Includes: thalamus, posterior limb of internal capsule (larger infarcts that involves small penetrating vessels) splenium of corpus callosum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Spinal Cord Circulation

A
  • The spinal cord is supplied by two posterior spinal arteries and one anterior spinal artery. The two posterior spinal arteries branch off the vertebral artery.
  • The posterior spinal arteries travel down on the posterior surface of the spinal cord near the posterior nerve roots.
  • The anterior spinal artery was formed by the merging of the two arteries that branched off the vertebral arteries. The anterior spinal artery descends down the anterior surface of the spinal cord in the anterior median sulcus (fissure). The anterior spinal artery supplies the anterior 2/3 of the spinal cord while the posterior spinal arteries supply the posterior 1/3.
  • At each segment of the spinal cord there is branching to create the segmental spinal arteries.
17
Q

Cerebrovascular Accident (CVA)

A

A traumatic event involving the arterial supply to the brain which may be caused by vascular changes in primary arteries supplying the brain. A thrombus, or an embolus may cause a region of the brain to develop an infarct; the end result being a declared CVA.

18
Q

Infarct

A

An area of coagulation necrosis in a tissue due to local ischemia resulting from obstruction of circulation to the area, most commonly by a thrombus or an embolus.

19
Q

Thrombus

A

An aggregation of blood factors, primarily platelets and fibrin frequently causing vascular obstruction at the point of its formation.

20
Q

Embolism

A

The sudden blocking of an artery by a clot or foreign material which has been brought to its site of lodgement by the blood current

21
Q

Aneurysm

A

A sac formed by the dilation of the artery or vein

22
Q

Transient Ischemic Attack (TIA):

A

Events that are caused by arterial blood vessel changes which cause brief periods of noticeable neurologic changes, brief loss of vision, numbness in hands and feet, etc., followed by complete recovery in most cases.

23
Q

Aphasia

A

Loss of language (left cerebral hemisphere)

24
Q

Apraxia

A

Difficulty performing certain learned movements without loss of power, sensation, or coordination (right cerebral hemisphere)

25
Q

Agnosia

A

Loss of the ability to recognize the importance of sensory stimuli, i.e., tactile agnosia, the inability to recognize familiar objects by touch

26
Q

“Rule of 2’s”

A

The brain makes up 2% of the body weight The brain uses 20% of the oxygen taken in The brain uses 25% of the glucose
-15% of the cardiac output is sent to the brain.

27
Q

Anterior and posterior circulation come together at…

A

Circle of WIllis

  • Anastomotic ring connects the anterior and posterior circulation
  • Allows collateral circulation which allows for blood to fo through even if there is a blockage
28
Q

Ischemic Stroke

A

Mechanisms and treatment

  • 3rd leading cause of death in US and major cause of permanent disability
  • Stroke refers to both hemorrhagic and ischemic events
  • must be handled as emergency
29
Q

Stroke Mechanisms

A 
-Infarction of brain tissue
Types/Classification
-Embolic and ischemic
-Large vessel vs. small vessel infarcts (lacunar infarcts)
-Corticol vs. Subcortical Lesion
30
Q

Embolic

A

A piece of material could be a clot or anything that travels through bloodstream then lodges and occludes a vessel, usually originate from the heart from things like a-fib

31
Q

Ischemic

A

Do not have enough blood supply to the brain which leads to cell death of brain tissue of infarct

32
Q

Stroke Summary

A
  • Emboli usually cause large-vessel infarcts involving cerebral or cerebellar cortex, with sudden onset of maximal deficits
  • Lacunes are small vessel infarcts usually seen in chronic hypertension, usually affecting deep structures of the hemispheres and brainstem
  • Thrombosis occasionally occurs in large proximal vessels
33
Q

Stroke Risk Factors

A
  • Hypertension
  • Diabetes
  • Hypercholesterolemia
  • Cigarette smoking
  • Positive family history
  • Cardiac disease (valvular disease, atrial fibrillation, patent foramen ovale, low ejection fraction)
  • Prior history of stroke or other vascular diseases
  • More common as gets older
34
Q

Acute Management (Treatment and Diagnostic Workup of Ischemic Stroke and TIA)

A
  • Early intervention improves outcomes
  • History, exam, R/O hemorrhage w CT
  • Tissue plasminogen activator. (tPA) within 1st 4.5 hours of stroke onset if ischemic infarct (not hemorrhagic)
  • Asprin for non tPA eligible patients
  • Other future interventions are being investigate
35
Q

Diagnostic Evaluation (Treatment and Diagnostic Workup of Ischemic Stroke and TIA)

A
  • Blood flow in major cranial and neck vessels (MRA, doppler US, or CTA)
  • Cardio embolic sources investigated w/ electrocardiogram and echocardiogram
36
Q

Role of PT/OT (Treatment and Diagnostic Workup of Ischemic Stroke and TIA)

A
  • Neuroplasticity: How the brain can adapt or recover

- Preventative Measures: Modifiable risk factors

37
Q

Carotid Stenosis

A
  • Atheroscierotic disease leads to stenosis of ICA
  • Thrombi can embolize- TIA or infarct (MCA, ACA, and ophthalmic arteries)
  • Most associated with MCA symptoms (contralateral face-arm or face-arm-leg weakness, contralateral sensory changes, contralateral visual field deficits, aphasia, or neglect
  • ACA symptoms: Contralateral leg weakness
  • Physical Exam: Bruit
  • Severity determined by Doppler US and angiography as ‘gold standard’
38
Q

Carotid Stenosis Treatment

A

-Carotid endarterectomy (clean out artery)
-Angioplasry
-Stenting
Important to distinguish severe carotid stenosis from carotid occlusion

USAHS Neuroanatomy Test 2 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions