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Review Cards for NSGY Self Assesment > export_blood supply to the cns > Flashcards

export_blood supply to the cns Flashcards

1
Q

What are the three main proximal arteries/trunks that come off the subclavian vessels?

A
  1. Vertebral artery
  2. Thyrocervical trunk
  3. Costocervical trunk
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2
Q

Following the bifurcation and before where do the ECA and ICA lie in relation to each other?

A

The ECA lies anteromedial to ICA at this point.

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3
Q

What are the major branches of the ECA?

A
  1. Superior Thyroid - larynx and upper thryoid.
  2. Ascending pharyngeal - nasopharynx/oropharynx
  3. Lingual - tongue/floor of mouth
  4. Facial - face
  5. Occipital - posterior scalp/meninges
  6. Posterior auricular - pinna, EAC, scalp.
  7. Superficial temporal - scalp/ear
  8. Internal maxillary - gives off MMA and acc mening

SALFOPS MAX.

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4
Q

What is the relationship of the cervical carotid artery to IJV.

A

CCA enters the carotid canal anteromedial to the IJV and is separated from it by cranial nerves 9, 10 and 11.

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5
Q

What are the segments of the ICA?

A

Cervical
Petrous

Cavernous

Cerebral/Clinoidal

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6
Q

Normal cerebral blood flow vs ischemic penumbra vs irreversible neuronal death.

A

Normal = 50
Ischemic penumbra= 8-23

Irreverisble neuronal death <8ml/100g of brain tissue.

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7
Q

What is the course of the petrous ICA?

A

Enters the carotid canal anterior to the IJV/jugular fossa, and lies behind the eustachian tube. Exits the canal at the petrous apex superior to the cartilage filled FORAMEN LACERUM.

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8
Q

Branches of the petrous ICA?

A

Caroticotympanic artery.

Vidian Artery/artery of the pterygoid canal.

Periosteal arterial branches.

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9
Q

Course of the intracavernous ICA?

A

Carotid canal and terminates at the entrance to the subarachnoid space adjacent to the anterior clinoid.

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10
Q

Relationship of the cavernous ICA to nervous structures in the cavernous sinus?

A

Its is covered by the trigeminal ganglion. CN 6 lies inferolaterally, CN 3, 4, 51 and 52 are lateral within the lateral dural wall.

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11
Q

What are the three arterial trunks of the intracavernous ICA?

A
  1. Meningohypophyseal (posterior trunk)
  2. Inferolateral/ artery of the inferior cavernous sinus.
  3. Medial trunk/McConnell’s capsular ateries
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12
Q

What are the branches of the meningohypophyseal trunk?

A
  1. Tentorial artery/artery of Bernasconi and Cassinari. Supplies the tentorium.
  2. Inferior hypophyseal artery - neurohypophysis.
  3. Dorsal meningeal artery - supplies CN 6 and the clivus.
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13
Q

What does the inferolateral trunk/artery of the cavernous sinus supply?

A

Inferolateral wall of the cavernous sinus.
Tentorium

CN 3, 4, 6 and the gasserian ganglion via the foramen ovale and spinosum.

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14
Q

Anastomses of the inferolateral trunk of the cavernous ICA?

A
  1. With the maxillary artery.

2. With the MMA and opthalmic artery.

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15
Q

What does the medial trunk of the cavernous ICA /McConnells capsular arteries supply?

A

The anterior and inferior pituitary gland.
The anterior capsular artery courses medially over the sellar roof.
The inferior capsular artery courses inferomedially and supplies the sellar floor.

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16
Q

What are the branches of the clinoidal/intradural ICA?

A
  1. Opthalmic
  2. Superior hypophyseal
  3. Posterior communicating
  4. Anterior choroidal
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17
Q

Couse of the opthalmic artery?

A

First intracranial ICA branch; rarely may arise of the MMA.
Arises superomedial or anteromedial to the ICA and under the anterior clinoid process. Initially inferolateral to CN 2 and medial to CN III and 6.

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18
Q

Aneurysms just distal to the opthalmic artery point where?

A

Aneurysms just distal to the opthalmic artery, arise from the superior wall of the ICA and point upward against the optic nerve.

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19
Q

Branches of the opthalmic artery?

A

Ocular branch - CRA and cilliary artery which supply the retina, choroid and optic nerve.
Orbital branches - lacrimal artery and muscular artery.

Extraorbital branches - several, have an extensive anastamotic network with the ECA via the ethmoidal and anterior falcine artery for collateral flow during ICA occlusion.

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20
Q

Superior hypophyseal arteries - course and area supplied?

A

Arise of the posteromedial intradural ICA and course beneath the optic nerve to supply the anterior pituitary, pituitary stalk and tuber cinereum

Also supply the optic nerve and chiasm.

Contribute to the hypophyseal portal system with the inferior hypophyseal ateries.

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21
Q

Aneurysms off the posteromedial intradural ICA point where?

A

Inferiorly and medially.

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22
Q

PcommA - course?

A

Arises from the posterior intradural ICA courses above CN III to join the horizontal PCA segment.

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23
Q

What does the PcommA supply?

A

Via seven perforators it supplies:
1. posterior hypothalamus,

  1. anterior thalamus,
  2. subthalamic nucleus,
  3. posterior limb of the internal capsule.
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24
Q

What is the largest perforator off of the PcommA?

A

Anteior thalamoperforating artery - terminates between the mamillary bodies and optic tracts.

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25
Q

What is a fetal PCA?

A

When the PcommA is the same diameter as the PCA - thus the occipital lobes are supplied by the ICA as opposed to the posterior/vertebrobasilar circulation.

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26
Q

PcommA/ICA aneurysms point where?

A

Arise off the posterior wall of the ICA and point posteriorly to CN III. the Pcomm usually lies inferomedially to the aneurysm, while the anterior choroidal should lie superolaterally.

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27
Q

Anterior choroidal artery - course?

A

Arises from the posteromedial ICA 2mm distal to the Pcomm. CISTERNAL segment courses posteromedially within the suprasellar cistern under the optic tract before turning posteromedially around the uncus.
INTRAVENTRICULAR segment - continues on - runs through the crural and ambient cisterns to enter the choroidal fissure of the temporal horn.

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28
Q

Anterior choroidal artery - supply?

A
  1. Inferior optic chiasm, posterior optic tract, optic radiattions and lateral geniculate body.
  2. Uncus, parahippocampal gyrus and amygdala.
  3. Choroid plexus in the temporal horn and atrium.
  4. Basal ganglia - globus pallidus medius, tail of caudate, internal capsule.
  5. Subthalamus, lateral ventroanterior, ventrolateral thalamic nuclei.
  6. Cerebral peduncle, upper red nucleus, substantia nigra.
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29
Q

AchA/ICA aneurysms.

A

Lie superior/superolateral to the origin of the AchA.

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30
Q

What are the main segments of anterior cerebral artery?

A

A1 - horizontal/precommunicating segment
A2 - vertical/postcommunicating segment

A3 - distal ACA and cortical branches

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31
Q

What arteries branch of the A1 segment?

A

The only arteries which branch off of the A1 segment are the MEDIAL LENTICULOSTRIATE arteries.

There are about 1-12 of these.

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32
Q

What do the medial lenticulostriate arteries supply and what is their course?

A

They course posterosuperiorly through the anterior perforated substance to supply the 1. optic nerve, 2. anterior hypothalamus, 3. septum pellucidum, 4. anterior commissure, 5. pillars of the fornix and the anteroinferior striatum.

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33
Q

The anterior communicating artery is located where?

A

Located in the cistern of the lamina terminalis.

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34
Q

The perforators that arise off of the AcommA supply what?

A
  1. Infundibulum
  2. Optic chiasm
  3. Subcallosal area
  4. Preoptic hypothalamus

Major peforators include the subcallosal artery and the medial artery of the corpus callosum

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35
Q

Describe A1/AcommA aneurysms - where they occur and where they point?

A

Arise where the dominant A1 bifurcates and they usually point to the CONTRALATERAL SIDE.

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36
Q

What are the major branches of the A2 segment?

A
  1. Recurrent artery of Heubner/medial distal striate artery.
  2. Orbitofrontal artery
  3. Frontopolar artery
  4. Anterior internal frontal artery
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37
Q

Course and vascular territory of the recurrent artery of Heubner?

A

Arises distal to the AcommA and courses back to the A1 and then enters the anterior perforating substance.

Supplies the 1. head of the caudate, 2. anterior limb of the internal capsule, 3. anterior putamen and globus pallidus. 4. septal nuceli 5. inferior frontal lobe.

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38
Q

Vascular territory of the orbitofrontal artery?

A
  1. Gyrus rectus.
  2. Medial orbital gyri.
  3. Olfactory bulb and tract.
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39
Q

Vascular territory of the frontopolar artery?

A
  1. Medial frontal lobe.

2. Lateral surface of the superior frontal gyrus.

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40
Q

Vascular territory of the anterior internal frontal artery?

A

Anterior medial frontal lobe

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41
Q

What are the major branches of the A3 segment?

A
  1. Callsomarginal
  2. Pericallosal
  3. Middle internal frontal
  4. Posterior internal frontal
  5. Paracentral
  6. Superior parietal
  7. Inferior parietal
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42
Q

Vascular territory of the callosomarginal?

A

Cingulate gyrus and paracentral lobule

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43
Q

2nd most common site for ACA aneurysms is?

A

The junction of the CALLOSOMARGINAL and PERICALLOSAL arteries.

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44
Q

Vascular territory of pericallosal artery?

A

Medial parietal cortex and the precuneus.

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45
Q

Vascular territory of middle internal frontal artery?

A

Medial frontal cortex

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46
Q

Vascular territory of posterior internal frontal artery

A

Medial posterior frontal cortex

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47
Q

Vascular territory of paracentral artery

A

Medial cortex around the central sulcus

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48
Q

Vascular territory of superior parietal artery?

A

Medial superior parietal lobe

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49
Q

Vascular territory of inferior parietal lobe

A

Medial inferior parietal lobe.

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50
Q

What are the segments of the MCA

A

M1
M2

M3

M4

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51
Q

What are the branches of the M1 branch?

A
  1. Uncal Artery (may come off the distal ICA)
  2. Temporopolar artery
  3. Anterior temporal artery
  4. Lateral lenticulostriate arteries
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52
Q

What is the course of the M1 segment?

A

The M1 segment/horizontal segment, extends horizontal and lateral beneath the anterior perforated substance, proximal to the bifurcation or trifurcation.

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53
Q

What is the course of the M2 segment?

A

This is the insular segment of the MCA and extends from the bifurcation to the genu, which courses around the island of Reil and heads posterosuperiorly into the Sylvian fissure.

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54
Q

What are the major trunks off of the M2 segment?

A

The SUPERIOR and INFERIOR trunks.

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55
Q

What are the branches off of the SUPERIOR TRUNK of the M2.

A
  1. Orbitofrontal branch
  2. Prefrontal branch
  3. Precentral branch
  4. Central branch
  5. Anterior parietal branch
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56
Q

What are the branches off of the inferior trunk of the M2 segment

A
  1. Posterior parietal branch
  2. Angular branch
  3. Temporooccipital branch
  4. Posterotemporal branch
  5. Middle temporal branch
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57
Q

What is the vascular territory of the uncal artery?

A

Uncus and underlying white matter

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58
Q

What is the vascular territory of the temporopolar artery?

A

Anterior pole of the superior, middle and inferior temporal gyri.

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59
Q

What is the vascular territory of the anterior temporal artery?

A

Anterior pole of the superior, middle and inferior temporal gyri.

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60
Q

What is the vascular territory of the lateral lenticulostriate artery?

A
  1. Substantia innominata
  2. Ant. commissure
  3. Putamen
  4. Globus pallidus
  5. Internal capsule
  6. Head and body of the caudate
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61
Q

What is the vascular territory of the orbitofrontal branch of the M2?

A

Orbital portion of the middle and inferior frontal gyri and the inferior pars orbitalis

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62
Q

What is the vascular territory of the prefrontal branch of the M2?

A
  1. Superior pars orbitalis,
  2. pars triangularis,
  3. anterior pars opercularis,
  4. most of the middle frontal gyrus.
63
Q

What is the vascular supply of the precentral branch fo the M2

A
  1. Posterior pars opercularis.
  2. Middle frontal gyrus.
  3. Inferior and middle portions of the precentral gyrus.
64
Q

What is the vascular supply of the central branch of the M2?

A
  1. Superior postcentral gyrus.
  2. Upper central sulcus.
  3. Anterior part of the inferior parietal lobule.
  4. Anteroinferior region of the superior parietal lobule.
65
Q

What is the vascular supply of the anterior parietal branch of the M2?

A
  1. Superior parietal lobule.
66
Q

What is the vascular supply of the posterior parietal branch of the M2?

A
  1. Posteriorsuperior parietal lobule
  2. Inferior parietal lobule.
  3. Inferior supramarginal gyrus
67
Q

Occlusion of the posterior parietal branch of the M2 causes:

A

Cortical sensory loss and hemianopsia.

68
Q

What is the vascular territory of the angular branch?

A
  1. Posterior aspect of the superior temporal gyrus.
  2. Supramarginal gyrus.
  3. Angular gyri.
  4. Lateral occipital gyrus
69
Q

What is the vascular territory of the temporooccipital gyrus.

A
  1. Posterior superior temporal gyrus.
  2. Posterior middle and inferior temporal gyri.
  3. Inferior lateral occipital gyri.
70
Q

What is the vascular territory of the posterotemporal branch?

A
  1. Middle and posterior portion of the superior temporal gyri.
  2. Posterior 1/3 of the middle temporal gyri
  3. Posterior inferior temporal gyri.
71
Q

Occlusion of the posterotemporal branch of the M2 causes:

A

Wernicke’s aphasia and hemianopsia.

72
Q

What is the vascular territory of the m iddle temporal branch?

A
  1. Superior temporal gyrus
  2. Central portion of the middle temporal gyrus
  3. Middle and posterior portions of the inferior temporal gyri.
73
Q

What are the segments of the PCA

A
  1. P1 - Precommunicating segment
  2. P2 - Ambient segment.
  3. P3 - Quadrigeminal segment.
  4. P4- Terminal Cortical branches
74
Q

What is the course of the P1 segment?

A

The P1/precommunicating segement runs from the tip of the basilar artery to the PcommA origin within the INTERPEDUNCULAR cistern.

75
Q

What is the course of the P2 segment.

A

The P2/ambient segment extends from the PcommA to the dorsal aspect of the midbrain.

76
Q

What is the course of the P3 segment?

A

The P3 or quadrigeminal segment extends from the lateral portion of the QUADRIGEMINAL cistern to the CALCARINE fissure.

77
Q

What are the major branches off of the P1 segment?

A
  1. Posterior thalamoperforating arteries.
  2. Medial posterior choroidal arteries.
  3. Meningeal branches.
78
Q

The meningeal branches off of the P1 segment supply…?

A
  1. The tentorium

2. Falx

79
Q

Course of the medial posterior choroidal arteries?

A

The medial posterior choroidal arteries travel anteromedially along the roof of the third ventricle

80
Q

What is the vascular territory of the medial posterior choroidal arteries?

A
  1. Midbrain tectum
  2. Posterior thalamus
  3. Pineal gland
  4. Tela choroidea
81
Q

Course of the posterior thalamoperforating arteries?

A

From the basilar artery and P1, where they then travel through the posterior perforated substance behind the mamillary bodies.

82
Q

What is the vascular territory of the posterior thalamoperforating arteries?

A
  1. Thalamus
  2. Hypothalamus
  3. Subthalamus
  4. CN III and IV (midbrain region)
83
Q

What are the branches of the P2 segment?

A
  1. Lateral posterior choroidal artery.
  2. Thalamogeniculate artery
  3. Cortical branches
84
Q

Course of the lateral posterior choroidal artery?

A

Courses over the pulvinar artery and through the choroidal fissure.

85
Q

What is the vascular territory of the lateral posterior choroidal artery?

A
  1. Posterior portion of the thalamus and the choroid plexus - temporal horn and atrium.
86
Q

What is the vascular territory of the thalamogeniculate artery?

A
  1. Medial geniculate body.
  2. Lateral geniculate body
  3. Pulvinar
  4. Superior colliculus.
  5. Crus cerebri
87
Q

What is the vascular territory of the cortical branches off of the P2 segment?

A

The inferior portion of the temporal lobe

88
Q

What are the branches of the P2 segment?

A
  1. Posterior temporal artery
  2. Parietooccipital artery
  3. Calcarine artery
  4. Posterior pericallosal artery
89
Q

What is the vascular territory of the posterior temporal artery?

A
  1. Posterior temporal lobe
  2. Occipitotemporal gyri
  3. Lingual gyri.

Anastomoses with the MCA

90
Q

What is the vascular territory of the parietooccipital artery?

A
  1. Posterior 1.3 of the medial hemispheres.
  2. Cuneus
  3. Precuneus
  4. Superior occipital gyrus
  5. Precentral and superior parietal lobules.

Anastomoses with the ACA

91
Q

What is the vascular territory of the calcarine artery?

A
  1. Occipital pole and the visual cortex.

Anastomoses with the MCA

92
Q

What is the vascular territory of the posterior pericallosal artery?

A
  1. The splenium of the corpus callosum

Anastomoses with the ACA.

93
Q

What is the location of the parietooccipital and calcarine arteries?

A

They are found in the parietooccipital and calcarine sulci respectively.

94
Q

The PCA has how many segments

A

4

95
Q

What are the segments of the PCA

A
  1. Pre-communicating
  2. Ambient
  3. Quadrigeminal
  4. Terminal cortical
96
Q

Course of the P1 segment

A

This is the pre-communicating segment and it extends from the tup of the basilar artery to the to PcommA origin within the interpeduncular cistern

97
Q

Branches of the P1 segment

A
  1. The posterior thalamoperforator arteries.
  2. Medial posterior choroidal arteries
  3. Meningeal brances.
98
Q

Posterior thalamoperforator arteries

A

Arise from the basilar artery and P1 and travel through the posterior perforated substance.

They supply the thalamus, hypothalamus and subthalamus and midbrain - cranial nerves 3 and 4.

99
Q

Medial posterior choroidal arteries

A

Travel anteromedially along the roof of the third ventricle.

Supply the midbrain tectum, posterior thalamus, pineal gland and tela choroidea of the third ventricle.

100
Q

Course of the P2 segment

A

This is the ambient segment and extends from the Pcomm A to the dorsal aspect of the midbrain.

101
Q

What are the branches of the P2 segment

A
  1. Lateral posterior choroidal artery - supplies the posterior thalamus and choroid plexus
  2. Thalamogeniculate arteries - supplies the medial geniculate body, lateral geniculate body, pulvinar and superior colliculus.
  3. Cortical branches - supplies the inferior portion of the temporal lobe.
102
Q

What is the course of the P3 segment.

A

Course - Extends from the lateral portion of the quadrigeminal cistern to the anterior limit of the calcarine fissure.

103
Q

What are the branches of the P3 segment

A
  1. Posterior temporal artery - supplies the posterior temporal, occipitotemporal lobes and the lingual gyri.
  2. Parietooccipital artery - located in the parieto-occipital sulcus where it supplies the cuneus, precuneus, superior occipital gyrus and SPL.
  3. Calcarine artery - supplies the occipital pole and the visual cortex
  4. Posterior pericallosal artery - supplies the splenium of the corpus callosum.
104
Q

Origin, course and vascular territory of the Anterior AChA

A
  1. ICA
  2. Runs throught the choroidal fissue
  3. Supplies the choroid of the LV. Hippocampus, amygdala, uncus.

GP, Tail of the caudate, putamen.

VL thalamus

Posterior limb of the IC

Optic tract, optic radiation and LGN

105
Q

The medial and lateral posterior ChA’s arise from what artery

A

The PCA

106
Q

Vascular territory of the medial PChA’s

A

Pineal gland, tectum, thalamus, choroid plexus of the third ventricle

107
Q

Vascular territory of the lateral posterior ChA’s

A

Enter the choroidal fissure and anastomoses with the AChA’s

108
Q

What are the 4 groups of penetrating arteries off of the circle of Willis.

A
  1. Anteriomedial - Arise of the ACA/Acomm
  2. Anterolateral - Arise off of the MCA/RAH
  3. Posteromedial - Arise off of the PCA
  4. Posteriolateral - Arise off of the PCA
109
Q

Vascular territory of the anteromedial penetrating arteries

A

Anterior hypothalamus
Preoptic nucleus

Supraoptic nucleus

110
Q

Vascular territory of the anterolateral arteries

A

Head of the caudate
Putamen

Claustrum

Internal and external capsule.

111
Q

Vascular territory of the posteromedial arteries

A

Hypophysis, infundibulum, tuberal hypothalamus

112
Q

Vascular territory of the posterolateral arteries.

A

Caudal thalamus - geniculate bodies, pulvinar, lateral nucleus and lateral ventral nucleus.

113
Q

Course of the vertebral arteries

A

Arise off of the subclavian and enter the foramen transversarium at C6, turn lateral at C2 and travel posteriorly along the atlas entering the skull via the foramen magnum.

114
Q

Vascular territory of the vertebral arteries.

A

Supply the pyramids inferior olivary nucleus, cranial nerves 10 and 12, and the reticular formation.

115
Q

Posterior spinal artery

A

Arises off of the vertebral artery and supplies the gracile and cuneate fasciculi and the inferior cerebellar peduncles.

116
Q

Anterior spinal artery

A

Arises off of the vertebral artery and supplies the pyramid, medial lemniscus, MLF, olive, vagal and hypoglossal nuclei.

117
Q

Vascular territory of PICA

A
  1. Choroid plexus of the fourth ventricle
  2. Posterior lateral medulla
  3. Tonsils
  4. Vermis
  5. Posterior inferior cerebellar hemispheres
118
Q

Segments of PICA

A
  1. Anterior medullary segment
  2. Lateral medullary segment - supplies CN 9-11.
  3. Tonsillomedullary segment
  4. Telovelotonsillar segment
  5. Hemispheric branches.
119
Q

What are the 6 named branches of the basilar artery

A
  1. AICA
  2. Labyrinthine artery
  3. Paramedian artery
  4. Pontine artery
  5. Superior cerebellar artery
  6. Paired PCAs
120
Q

Features of AICA

A

AICA crosses the 6th cranial nerve and CPA cistern to the IAC, passing anteroinferiorly to the 7th and 8th cranial nerves. It supplies the 7th and 8th cranial nerves, inferolateral pons, middle cerebellar peduncles, flocculus and anterolateral hemispheres.
It gives off the internal auditory artery, the recurrent perforating artery and subarcuate artery.

121
Q

Course and vascular territory of the SCAs

A

The SCA’s travel posterolaterally around the pontomesencephalic junction below the tentorium.

They supply the superior vermis, cerebellar hemispheres, deep cerebellar white matter and dentate nuclei.

122
Q

The paramedian and pontine arteries supply the –>

A

Ventral pons.

123
Q

Vascular supply to the striatum

A
  1. Lenticulostriate
  2. RAH
  3. Anterior AChA
124
Q

Vascular supply of the Anterior limb of the IC

A

RAH and lateral lenticulostriates

125
Q

Vascular supply of the genu of the IC

A
  1. ICA perforators

2. Lateral lenticulostriates

126
Q

Vascular supply of the posterior limb of the IC

A
  1. Anterior AChA’s

2. Pcomm

127
Q

Vascular supply of the thalamus

A
  1. PCA -> posterior thalamoperforators, thalamogeniculate arteries and medial posterior ChA’s
  2. Rostrally the anterior thalamoperforators.
128
Q

Vascular supply of the medulla

A

Anterior and posterior spinal arteries.

PICA and the vertebral arteries.

129
Q

Vascular supply of the pons

A
  1. Basilar paramedian branches.
  2. Short and long circumferential branches.
  3. SCA
130
Q

Cerebellum vascular supply

A

The inferior, middle and superior cerebellar peduncles are supplied by the PICA, AICA and SCA’s respectively. Those three arteries also supply of the fourth ventricle.

131
Q

Features of the superior sagittal sinus

A

It extends from the foramen cecum to the internal occipital protuberance.
Drains predominantly into the right transverse sinus

132
Q

Inferior sagittal sinus

A

Cortical veins from the medial hemisphere join to form the ISS to join great cerebral vein of Galen to form the straight sinus which in turn drains into the torcula and from there the left transverse sinus.

133
Q

The transverse sinus

A

Originates from the confluence of sinus and courses laterally then curves down the occipitopetrosal junction to become the sigmoid sinus.

134
Q

The sigmoid sinus

A

Courses along the posterior aspect/petromastoid portion of the temporal bone to become the superior jugular bulb at the jugular foramen and then the IJV. Receives blood from the inferior petrosal sinus.

135
Q

Petrosal sinuses

A

Superior petrosal sinus - receives veins from the pons, medulla, cerebellum and inner ear.

Inferior petrosal sinus - receives veins from the cerebellum and labyrinthine veins

136
Q

Straight sinus

A

Formed by the ISS and the Vein of Galen. Drains into the confluence of sinuses.

137
Q

Where does the cavernous sinus drain?

A

The superior and inferior petrosal sinuses.

It also communicates with the basilar, pterygoid and pharngeal venous plexuses.

138
Q

What are the three major superficial cerebral veins

A
  1. Superficial middle cerebral veins
  2. Superior anastomotic vein of Trolard
  3. Inferior anastomotic vein of Labbe
139
Q

Superficial middle cerebral vein

A

The course along the sylvian fissure and drain into the cavernous sinus, Trolard or Labbe

140
Q

Where do the veins of Trolard and Labbe receive venous drainage from and drain into respectively.

A

Trolard: SMVs from the Sylvian fissure to the SSS

Labbe: SMVs from the Sylvian fissure to the TS.

141
Q

What are the three major deep cerebral veins

A
  1. Internal cerebral veins
  2. Basal vein of Rosenthal
  3. Vein of Galen
142
Q

Features of the internal cerebral veins

A
  1. Located in the tela choridea of the roof of the third ventricle/velum interpositum and extend from the interventricular foramen and travel over the thalamus and posteriorly to the quadrigeminal cistern to help form the vein of Galen.
  2. The internal cerebral veins themselves are formed by the union of the thalamostriate, choroidal, septal, epithalamic and lateral veentricular veins.
143
Q

Features of the Basal vein of Rosenthal

A
  1. Drains the anterior and medial temporal lobe

2. Passes posterosuperiorly through the ambient cistern and joins the internal cerebral vein to form the vein of Galen.

144
Q

Features of the vein of Galen

A

Receives the
1. Internal cerebral veins

  1. Basal vein of Rosenthal
  2. Occipital veins
  3. Posterior callosal vein

It travels under the splenium and merges with the inferior sagittal sinus to form the straight sinus.

145
Q

How do the vertebral arteries supply the spinal cord

A

The give off the posterior spinal artery which supplies the posterior 1/3 of the cord - including the posterior horn and funiculi

They also give off two anterior spinal arteries which join at the medulla to enter the anterior median fissure as a single artery - the anterior median artery.

146
Q

Features of the sulcal arteries of the spinal cord

A

At each segment the anterior spinal artery gives off 5-9 sulcal arteries that course posteriorly in the anterior median fissure. Typically each sulcal artery will supply one half of the anterior 2/3 of the cord —> anterior horns, base of the posterior horns, the anterior funiculi and the lateral funiculi.

147
Q

What are the radicular arteries

A

The radicular arteries are derived from segmental vessels from the aorta.
They pass through the intervertebral foramen and divide into the anterior and posterior radicular arteries.

148
Q

What does the anterior ramus of the segmental artery supply.

A

The spinal cord

149
Q

What does the posterior ramus of the spinal cord supply

A

It supplies the DRG and nerve roots

150
Q

Artery of Adamkiewicz:

A

A single thoracic radicular artery which usually arises at T7 on the lest hand side.

151
Q

Spinal artery origins

A

The segmental arteries give off the spinal branches which pass through the intervertebral foramina and then give off the anterior or posterior radicular arteries which then anastomose with the anterior or posterior spinal arteries.

152
Q

Which areas of the spinal cord are most vulnerable to ischemia

A
  1. Border zones where blood supply comes from 1 source e.g T1-4 and L1.
  2. Areas between the intermediate and dorsal horns and lateral and posterior fasiculi.
153
Q

Venous drainage of the spinal cord.

A
  1. Follows the arteries.
  2. Anterior and posterior spinal veins which drain into the intervertebral veins.
  3. Anterior and posterior radicular veins.

Review Cards for NSGY Self Assesment (14 decks)

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