Vetebral Artery Flashcards

1
Q

Percentage of Blood to the Brain Supplied by Vertebral Artery?

A

20%

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2
Q

VBA System

A

2 Vertebral Arteries and 1 Basilar Artery

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3
Q

Basilar Artery

A

Formed by the two Vertebral Arteries joining each other at midline

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4
Q

Proximal Portion

A

First Portion

From Subclavian Artery to C6

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5
Q

Transverse Portion

A

Second Portion
From C6 to C2
Prone to compression from osteophyte formation

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6
Q

Suboccipital Portion

A

Third Portion
From C2 to Occiput
Vulnerable to compression and stretching at C1-C2 with rotation

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7
Q

Four Parts of Suboccipital Portion

A
  1. Within the transverse foramen of C2
  2. Between C2 and C1
  3. In the transverse foramen of C1
  4. Between the posterior arch of the atlas and entry into foramen magnum
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8
Q

Intracranial Portion

A

Fourth Portion
From foramen magnum to Basilar Artery at the lower border of pons
Prone to artherosclerotic plaques and stenosis

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9
Q

Branches of Vertebral Artery

A
  1. Meningeal Branch - Supply bone and dura matter
  2. Anterior Spinal Artery
  3. Posterior Spinal Artery
  4. Muscular Branch - Supply deep Suboccipital muscles
  5. Posterior Inferior Cerebellar Artery
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10
Q

Vertebrobasilar Insufficiency (VBI) due to

A
  • Atherosclerotic involvement
  • Sickle cell disease
  • RA
  • Arterial Fibroplasias
  • Arteriovenous fistula
  • Congenital Syndromes
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11
Q

VBI External Causes

A
  • Extracranial Compression

- Hyperextension of neck with or without rotation and side-bending

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12
Q

VBI Internal Causes

A
  • Atherosclerosis
  • Thrombosis
  • Arterial Fibrodysplasia
  • Arteriovenous Fistulas - Abnormal connection or passageway between an artery and a vein
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13
Q

Clinical Manifestations of VBI

A
  • 5 Ds A 3 Ns
  • Headache
  • Wallenberg/Horner Syndrome
  • Paraesthesia
  • Upper Motor Neuron signs
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14
Q

5 Ds A 3 Ns

A
  • Diplopia
  • Dizziness
  • Drop Attacks
  • Dysphagia
  • Dysarthria
  • Ataxia
  • Nausea
  • Numbness
  • Nystagmus
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15
Q

Stroke Risk Factors

A
  • Hypertension
  • Diabetes
  • Family history
  • Smoking
  • BMI > 30
  • Poor diet
  • Upper cervical instability
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16
Q

Incidence of Cervical Manipulation Causing VA Stroke

A

1/100,000

17
Q

Examination of the VA

A

Hold pre-mobilization position for 10 seconds

18
Q

Major Red Flags for VA Stroke

A
  • Worst Headache of life
  • Different headache than normal
  • Worst neck pain
  • Dizziness
19
Q

Horner’s Syndrome

A

Decreases pupil size, droopy eyelid, and decreased sweating on affected side

20
Q

Premanipulative Position Test

A
  • Side-bending, rotation, and extension
  • Look for symptoms
  • Hold position for 10 seconds
21
Q

Avoid When Performing Cervical Manipulation

A
  • Excessive Rotation
  • Non physiological movements
  • Aggressive forceful manoeuvres
22
Q

Absolute Contraindications for Manual Therapy

A
  • Infection
  • Acute circulatory problems
  • Malignancy
  • Open wounds
  • Recent fracture
  • Hematoma
  • Inappropriate end feel
  • Diabetes
  • Severe pain/extensive radiation of pain
23
Q

Relative Precautions for Manual Therapy

A
  • Joint inflammation
  • RA
  • Neurological signs
  • Osteoporosis
  • Pregnancy
  • Dizziness
  • Steroid use