02. Blood Supply, Hemorrhage, and Herniation (Keim) Flashcards Preview

16. Neuro Test 2 > 02. Blood Supply, Hemorrhage, and Herniation (Keim) > Flashcards

Flashcards in 02. Blood Supply, Hemorrhage, and Herniation (Keim) Deck (44):
1

What two vessels supply the internal capsule of the basal nuclei?

Lenticulostriate arteries of the middle cerebral A.

Anterior choroidal A.

2

In the medulla, what is supplied by the posterior spinal artery?

Fasciculus cuneatus

Fasiculus gracilis

Gracile and cuneate nuclei

3

What is the common source of bleeding in an epidural hematoma?

Middle meningeal A

4

Diagnosis?

Bright white irregular blood = intracerebral hemorrhage

5

Name the sections of the vertebral A.

6

Diagnosis?

Lens shape = epidural hematoma

7

An aneurysm in which arteries can cause compression of the oculomotor nerve?

Posterior cerebral A

Superior cerebellar A

Posterior communicating A

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10

What deficits might we expect to find in a patient with a subfalcine herniation?

Motor and sensory loss to the lower extremity.

11

What artery connects the posterior and anterior circulation of the circle of Willis?

The posterior communicating A.

12

What is the clinical significance of "border zones" in the blood supply of the cortex?

 

What are the clinical symptoms associated with each?

Border zones are the areas between the regions of the anterior and middle, and middle and posterior cerebral arteries. These exist because of a lack of anastomosis between the anterior, middle, and posterior cerebral arteries – and are the areas most easily damaged by a hypotension / hypoperfusive event.

Because the lower limb portion of the homunculus is on the medial portion of the frontal and parietal lobes, anterior border zone ischemia can cause loss of motor control and sensation to the lower limb.

Likewise, damage to the posterior border zone causes visual disturbances and language issues.

13

What artery supplies the lateral pons?

The long circumferential branches of the basilar artery.

14

What artery may be compressed in a subfalcine herniation?

Anterior cerebral A.

15

What sx would we expect to see in a patient with a transtentorial herniation?

Vision issues due to ischemia of the occipital lobe – itself due to compression of the posterior cerebral artery.

16

What arteries make up the anterior circulation of the circle of Willis?

  • Internal carotid A.
  • Anterior cerebral A. (A1)
  • Anterior communicating A.
  • Anterior cerebral A. (A2)
  • Middle cerebral A
  • Lenticulostriate As
  • Anterior choroidal A.

17

In the midbrain, what is supplied by the quadrigeminal and superior cerebellar arteries?

Superior and inferior colliculi

18

What are the four parts of the internal carotid A?

 

Where are they located?

Cervical part – from the bifurcation to the cervical canal, anterior to the first three vertebrae.

Petrous part – in the petrous part of the temporal bone.

Cavernous part – in the cavernous sinus

Cerebral part

19

An aneurysm in which arteries can cause compression of the abducens nerve?

Anterior inferior cerebellar A

Labyrinthine A (aka internal acoustic A).

(Also the internal carotid A if the aneurysm occurs in the cavernous sinus.)

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22

What major structures might be compressed by a transtentorial herniation?

Oculomotor N.

Basilar A.

Posterior cerebral A.

23

What five arteries contribute to the anastomosis of the circle of Willis?

Anterior communicating A

Anterior cerebral A

Internal carotid A

Posterior communicating A

Posterior cerebral A

24

Diagnosis?

Aneurysm of a subarachnoid hemorrhage.

25

What portions of the cortex are supplied by the anterior, middle, and posterior cerebral arteries respectively?

26

In the medulla, what is supplied by the posterior inferior cerebellar artery?

The lateral medulla

27

What can cause Weber's syndrome?

Damage to the anteromedial branches of the basilar artery and posterior cerebral artery (P1), causing ischemia to the medial portions of the midbrain.

28

An aneurysm in which arteries can cause compression of the optic nerve?

Internal carotid A

Anterior cerebral A

Anterior communicating A

29

What happens in an uncal herniation?

 

What sx would we expect to see?

Uncus and parahippocampal gyrus are pushed over the edge of the tentorium cerebelli and into the tentorial notch.

This compresses the cerebral peduncle (recall that motor axons travel through there), and the oculomotor nerve. This causes contralateral hemiplegia and ipsilateral vision disturbances.

OR

Kernohan syndrome – which is a shift of the midbrain to the side, which causes a compression of the contralateral cerebral peduncle. This makes the hemiplagia appear on the same side as the vision disturbance.

30

What artery supplies the medial pons?

The paramedian branches of the basilar artery.

31

What arteries make up the posterior circulation of the circle of Willis?

  • Basilar A.
    • Anterior inferior cerebellar A.
    • Superior cerebellar A.
    • Posterior cerebral A.

32

Diagnosis?

Crescent shape = subdural hematoma

33

An aberration of what vessel can cause trigeminal nerve compression / neuralgia?

Superior cerebellar A.

34

What are the three parts of the vertebral A, and where are they located?

Cervical part – runs through the transverse foramina.

Atlantic part – perforates dura and arachnoid maters, as well as the atlantooccipital membrane.

Intracranial part – L and R vertebral As unite at the caudal border of the pons and forms the basilar artery.

35

In the medulla, what is supplied by the anterior inferior cerebellar artery?

Dorsal and ventral cochlear nuclei.

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38

In the forebrain, what is supplied by the anterior choroidal artery?

Optic tract

Hippocampal formation

Internal capsule

39

What is a tonsilar herniation?

 

What sx would we expect a patient to exhibit?

This is where the cerebellar tonsils press through foramen magnum.

This causes compression of the medulla and upper cervical spinal cord.

Since cardiac and respiratory centers are located in the medulla, breathing and heart rate can be affected, as well as the cranial nerves that are associated with the medulla.

40

Aberrent branches of what artery can compress the facial nerve?

Anterior inferior cerebellar A.

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What is the common site of impact in patients with an epidural hematoma?

Squamous temporal bone or pterion.

43

What vessel supplies the thalamus and geniculate nuclei of the forebrain?

The thalamogeniculate branches of the posterior cerebral artery.

44

In the medulla, what is supplied by the anterior spinal artery?

Lemniscus

Pyramids

Hypoglossal nucleus