Vascular Structures - Posterior & Subcortical Circulation

Question 1

what is the flow of posterior circulation? right and left

Answer 1

right: L ventricle to ascending aorta to brachiocephalic artery to right subclavian artery to right vertebral artery
left: L ventricle to ascending aorta to aortic arch to L subclavian to L vertebral artery

Question 2

what arteries are part of posterior circulation

Answer 2

post cerebral arteries
basilar artery
superior cerebellar arteries
labyrinthine artery
ant inf cerebellar artery
post inf cerebellar artery
ant spinal arteries

Question 3

where does the posterior cerebral artery come off of and travel

Answer 3

most rostral

arises from basilar artery and travels posteriorly to occiput

Question 4

what are the PCAs superficial branches and what do they supply

Answer 4

anterior and posterior inf temporal arteries
calcarine arteries

middle and inf occipital lobes
inf temporal lobes

Question 5

what are the PCAs deep branches and what do they supply

Answer 5

tuberothalamic arteries
thalamogeniculate arteries
post choroidal arteries

subcortical structures: midbrain, thalamus, subthalamic region (basal ganglia)

Question 6

posterior cerebral artery syndrome?

Answer 6

contralateral homonymous hemianopsia –> visual cortex/optic radiation
cortical blindess –> bilateral occipital lobe
visual agonsia –> occipital lobe (dominant)
prosopagnosia –> visual association cortex
dyslexia –> dominant calcarine lesion & post corpus callosum
memory deficit –> lesion on temporal lobe (dominant)
topographic disorientation –> nondominant visual area

Question 7

damage to deep cerebral structures, like the thalamus would look like?

Answer 7

central post stroke thalamic pain –> ventral posterolateral nucleus of thalamus
involuntary movements –> subthalamic nucleus

Question 8

PCA treatment

Answer 8

gradually increase visual challenges, visual deficits can significantly impact balance, give visual breaks, may use external visual aids to assist in improvement

Question 9

what are the subcortical arteries and their branches?

Answer 9

vertebral artery branches –> posterior inferior cerebellar arteries, anterior spinal artery, posterior spinal arteries

basilar artery branches –> anterior inferior cerebellar arteries, labyrinthine arteries, pontine arteries, superior cerebellar, paramedian (medial) and circumferential (lateral) arteries

Question 10

where is the posterior inferior cerebellar arteries and what does it supply

Answer 10

arises at level medulla

supplies lateral medulla and inferior cerebellum

Question 11

anterior spinal artery

Answer 11

branches off vertebral

supplies medulla and anterior 2/3 of spinal cord

Question 12

posterior spinal artery

Answer 12

branches of PICA

supplies dorsal medial medulla posterior 1/3 of spinal cord

Question 13

anterior inferior cerebellar arteries

Answer 13

arises right after basilar artery forms at the level of the caudal pons

supplies lateral caudal pons and cerebellum

Question 14

labyrinthine

Answer 14

branches from AICA

enters internal acoustic meatus to cochlea and vestibular apparatus (inner ear)

Question 15

pontine artery

Answer 15

small circumferential and arteries

rostral lateral pons

Question 16

superior cerebellar artery

Answer 16

most rostral branch of basilar

supplies cerebellum and pons

Question 17

spinal cord circulation

Answer 17

anterior spinal artery –> anterior 2/3 cord, ventral median fissure

posterior spinal artery –> posterior 1/3 cord, more lateral

Question 18

segmental radicular arteries

Answer 18

anterior and posterior, very small
branches off descending thoracic aorta and enter via nerve roots

notable: great radicular artery of adamkiewicz –> major blood supply to lumbar and sacral cord