#06

Question 1

The arterial supply to the spinal cord is largely a, while the blood supply of the
brain is b

Answer 1

a: segmental
b:regional

Question 2

Almost all venous blood drains into the a and then into the b

Answer 2

a: dural sinuses
b: internal jugular vein

Question 3

Because they lack anastomoses with adjoining vessels, occlusion of most cerebral vessels
(by thrombus, etc.) leads to

Answer 3

regional ischemia and tissue death

Question 4

The internal carotid artery (ICA) is a branch of the a. The artery then loops superiorly and posteriorly before dividing into its terminal braches: b,c.

Answer 4

a: common carotid artery
b: anterior cerebral artery
c: middle cerebral artery

Question 5

The vertebral arteries are branches of the a. The two vessels then anastomose to form the b. B is the main blood supply to c and is connected to the carotid system via the arterial d

Answer 5

a: subclavian artery.
b: basilar artery
c: pons and midbrain
d: Circle of Willis

Question 6

The basilar artery
typically ends by
bifurcating into paired a, which continue into the b

Answer 6

a:posterior cerebral
arteries (PCA),
B:

Question 7

In total, the vertebrobasilar circulation supplies:
* The spinal cord (via a)
* The medulla (via b)
* The pons (via c)
* The midbrain (mainly via d)
* The cerebellum (via e)
* The thalamus (via f)
* Inferior temporal lobe and occipital lobe (f)

Answer 7

a: anterior and posterior spinal arteries
b: the vertebral artery and its branches
c: the basilar artery and its branches
d: the posterior cerebral artery – PCA
e: PICA, AICA, and SCA branches
f: PCA

Question 8

After supplying the midbrain, the PCA supplies the a and ends in the inferior and lower lateral surfaces of the b and medial surface of the c. Calcarine branches of PCA supplies the d, so strokes involving PCA typically result in e

Answer 8

a: thalamus
b: temporal lobe
c: occipital lobe
d: visual cortex (which is mapped on either side of the calcarine sulcus)
e: prominent visual
deficits.

Question 9

Mq is frequently involved in

Answer 9

hemorrhagic strokes

Question 10

ACA supply the portions of the primary motor and sensory cortices dedicated
to

Answer 10

the lower limb and perineum, trunk, as well as proximal parts of the upper extremity, feet

Question 11

a can compensate for decreases in blood flow in
one or other of the circulations.

Answer 11

the Circle of Willis

Question 12

Ischemic strokes

Answer 12

Blood supply is interrupted to a focal area of the brain with damage due to loss of oxygen
and essential nutrients

Question 13

TIA = “transient ischemic attack”

Answer 13

o Sudden onset focal signs
o Short duration <24 hours, recently proposed <1 hour
o No brain injury on imaging

Question 14

watershed zones

Answer 14

Watershed zones are border zones between the territories of two cerebral arteries, such as
between anterior and middle cerebral arteries, or between middle and posterior cerebral
arteries. These areas of non-overlap are susceptible to ischemic stroke

Question 15

Shoulder and upper trunk areas of motor cortex are vulnerable in the

Answer 15

MCA/ACA watershed
zone. Bilateral infarct here (grey regions below) results in inability to abduct arms and flex
elbows:

Question 16

2 major types of hemorrhagic strokes

Answer 16

• Intracranial hemorrhage
  o Bleeding directly into brain tissue
  o Results from hypertensive hemorrhage (leads to hyperplasia within the vessel wall, causes “breaks”), atherosclerosis, brain
  tumors, or certain medications
  o Focal deficits
• Subarachnoid hemorrhage
  o Bleeding surrounding brain tissue
  o Results from arteriovenous
  malformation (AVM), trauma, or
  ruptured aneurysm
  o Mass effect and subsequent herniation are risks

Question 17

Most cerebral
aneurysms occur in the

Answer 17

vicinity of the circle of Willis, commonly in the anterior circulation

Question 18

vertebral arteries supply

Answer 18

spinal cord
PICA, ASA, PSA, vertebral artery

Question 19

The great radicular artery (of Adamkiewicz) is important for supplementing the supply of the

Answer 19

lower thoracic and upper lumbar cord

Question 20

Basilar artery ends in a, which supply

Answer 20

a: paired posterior cerebral arteries
the midbrain, thalamus, and posterior parts of the cerebral cortex

Question 21

M1 supply

Answer 21

basal ganglia

Question 22

MCA supplies sensory and motor areas associated with

Answer 22

face and upper body

Question 23

ACA supplies sensory and motor areas associated with

Answer 23

trunk and lower body

Question 24

Anterior choroidal artery (AChA) supplies:

Answer 24

Choroid plexus of lateral ventricles
Optic tract
Small part of thalamus
Small part of basal ganglia
Hippocampus (with PCA)
Amygdala
Posterior limb of internal capsule

Question 25

M2 (Superior covers a, Inferior covers b)

Answer 25

a lateral frontal lobe
b Parietal and Temporal lobes

Question 26

 PICA

Answer 26

Dorsal and lateral medulla, posterior inferior cerebellum

Question 27

AICA

Answer 27

anterior inferior cerebellum, lateral pons