Vascular Structures - Anterior Circulation Flashcards
what is the flow of anterior circulation? right and left
right: L ventricle to ascending aorta to brachiocephalic artery to right common carotid to right internal carotid artery
left: L ventricle to ascending aorta to aortic arch to L common carotid to L internal carotid
what arteries are part of the anterior circulation
anterior cerebral artery, middle cerebral artery, anterior choroidal artery, anterior communicating artery, posterior communicating and opthalmic
where is the anterior cerebral artery ACA and what does it supply
runs in longitudinal fissure above corpus callosum
supplies medial frontal and parietal lobes
corpus callosum
hypothalamus
limbic - cingulate gyrus
what are the branches off the ACA
callosomarginal and pericallosal
anterior cerebral artery syndrome? whats impacted?
mainly lower extremity
contralateral hemiparesis/hemiplegia –> motor cortex
contralateral hemisensory loss –> sensory area
apraxia –> supplemental motor area, corpus callosum
problems w bimanual tasks –> corpus callosum
cognitive deficits –> frontal cortex
slowness, difficulty executing tasks, no spontaneity, motor inaction –> prefrontal cortex
transcortical aphasia –> supplemental motor area
contralateral grasp reflex –> corpus callosum, frontal lobe
urinary incontinence, lack of emotion regulation –> ant cingulate gyrus, hypothalamus
treatment for ACA
structure environment, offer encouragement, empathy and extra time, CKC exercises, bimanual activites, function based training
where is the middle cerebral artery MCA and what does it supply
runs in sylvian fissure
2/3 cortex lateral frontal and parietal lobes insular cortex medial and lateral temporal lobes basal ganglia internal capsule (all descending motor tracts) limbic structures
divisions of MCA and what do they supply
stem: lenticulostriate arteries –> insular cortex, basal ganglia, internal capsule
superior division –> lateral & inferior frontal, anterior and lateral parietal
inferior division –> temporal lobe and poles (limbic)
middle cerebral artery syndrome? whats impacted?
mainly upper extremity, facial droop, lack of movement in hand/arm
contralateral paresis –> motor cortex/int capsule
contralateral sensory loss –> sensory cortex/int capsule
motor speech impairment –> brocas
receptive speech impairment –> wernickes
global aphasia –> brocas and wernicks
perceptual deficits –> parietal sensory association cortex
apraxia –> premotor or parietal cortex
visual deficits –> optic radiation in int capsule
loss conjugate gaze –> frontal eye fields/descending tracts
pure motor hemiplegia (lacunar stroke) –> upper portion of int capsule
what happens when the lenticulostriate artery is blocked?
lacunar infarct
pure motor hemiparesis when int capsule is involved,
significant motor control and planning deficits when basal ganglia is involved
when the left MCA is effected, what is shown
aphasia dysarthria R hemiparesis/sensory loss R visual field defect difficulty reading/writing/calculating affect normal cautious
when the right MCA is effected, what is shown
language intact dysarthria L hemiparesis/sensory loss neglect of L visual field/L visual field cut spatial disorientation flat affect impulsive
MCA treatment
incorperate speech strategies into activites, UE functional strengthening, sensory reintegration is key
where is the anterior choroidal artery and what does it supply
comes off internal carotid artery
supplies choroid plexus of lateral ventricles optic tract deep structures of telencephalon posterior int capsule basal ganglia
what happens if a blockage of anterior choroidal artery?
since supplying choroid plexus it will effect CSF production
