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16. Neuroscience Exam 2 > 2. Blood Supply, Hemorrhage and Herniation > Flashcards

2. Blood Supply, Hemorrhage and Herniation Flashcards

1
Q

What are the 4 parts of the interal carotid A?

A

cervical part (anterior to TP of upper 3 vertebrae)
petrous part
cavernous part
cerebral part

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2
Q

What three As does the cerebral part of the Internal carotid A divide into?

A

opthalmic A
anterior cerebral A
middle cerebral A

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3
Q

What are the 3 parts of the vertebral A?

A 
cervical part (through transverse foramina)
atlantic part
intracranial part
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4
Q

What is special about the atlantic and intracranial parts of the vertebral A?

A

atlantic: perforates dura and arachnoid and passes thru foramen magnum
intracranial: unites in cranium at the caudal border of pons, forming basilar A

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5
Q

What are the four components of the circle of willis?

A

anterior communicating artery
posterior communicating A
2- anterior cerebral As

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6
Q

What is NOT part of the circle of willis?

A

middle cerebral A

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7
Q

What would be in jepordy if there was an aneurysym of the anterior cerebral, ICA, or anterior communicating arteries?

A

CN II - optic

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8
Q

What would be at jepordy if there was an aneurysym of the posterior cerebral or superior cerebellar A (off basilar)?

A

CN III (would affect parasympathetics first)

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9
Q

What are two important branches off the vertebral A?

A

posterior inferior cerebellar A

anterior spinal A

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10
Q

If there was an abberant branch off the superior cerebellar A, what N could be affected?

A

CN V TRIGEMINAL

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11
Q

What arteries could compress CN VI (abducens)?

A

labyrinthine (internal acoustic) A

anterior inferior cerebellar A

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12
Q

What nerve could be compressed by an abberant (extra) branch off the anterior inferior cerebellar A?

A

CN VII Facial

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13
Q

What two branches comes off the middle cerebral A?

A

lenticulostriate As

anterior choroidal A

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14
Q

What artery supplies medial and superior surfaces of the frontal and parietal lobes?
What about the lateral surface of frontal and parietal lobes and superior temporal?

A

Anterior cerebral A

Middle cerebral A

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15
Q

What artery supplies the occipital lobe and infeiror temporal lobe?
What is unique about the three arteries to the cortex of the brain?

A

posterior cerebral A (off basilar)

anterior/middle/posterior don’t anastomose!

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16
Q

What are the areas that are border zones between arteries, which are susceptible to damage under conditions of hypotension or hypoperfusion?

A

anterior (motor/sensory to LL) and posterior (visual/language) watershed infarcts

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17
Q

What are the 5 segments of the anterior cerebral A, which are named according to their relation to the corpus callosum?

A

A1: Precommunicating segment (ICA to ant. communicating)
A2: infracallosal segment where rostrum and genu meet
A3: precallosal segment (arch around front)
A4: Supracallosal (above)
A5: Postcallosal (behind)

18
Q

After A3 of anterior cerebral A, it splits into two A, which are the?

A

pericallosal and callosomarginal branches

19
Q

what are the 4 segments of the middle cerebral A.?

A

M1: Sphenoidal/horizontal (ICA to bifurcation at insula)
M2: Insular Segment (bifurcation to circular sulcus)
M3: Opercular Segment (circular sulcus to surface of lateral fissure)
M4: Cortical Segment

20
Q

what are the four branches of the posterior cerebral A?

A

P1: basilar bifurcation to posterior communicating
P2: post communicating to midbrain
P3: Quadrigeminal Segment: within quadrigeminal cistern
P4: Cortical Segment

21
Q

What are the four main blood supplies to the medulla?

A

anterior spina A
posterior spinal A
posterior inferior cerebellar A
Anterior inferior cerebellar A

22
Q

What are the two main supplies to the pons and what are the syndromes associated with their occlusion?

A

Paramedian branches of basilar A (medial pontine synd)

Long circumferential branches of basilar A/branches of anterior inferior cerebellar A (lateral pontine syndrome)

23
Q

What are the two main supplies to the midbrain and the syndrome?

A

Paramedian branches of basilar bifurcation and P1 segment (webers syndrome)
Quadrigeminal and superior cerebellar A and posterior medial choroidal A (inf/sup colliculus)

24
Q

What are the three main supplies to the forebrain?

A

Thalamogeniculate branches of posterior cerebral A (thalamus, medial/lateral geniculate bodies)
Anterior choroidal A
Lenticulostriate As (internal capsule)

25
Q

The anterior spinal A supplies the dorsal and ventral horns (anterior/posterior) completely via which branch?

A

sulcal artery

26
Q

The posterior spinal A anastomoses with the anterior spinal artery to supply blood to the cortical spinal tract via which artery?

A

arterial vasocorona

27
Q

Epidural is between cranium and periosteal layer of the dura while the subdural and subarachnoid spaces are where?

A

Subdural between dura and arachnoid

Subarachnoid between arachnoid and pia where CSF, arteries and veins are found

28
Q

What artery is most commonly affected by trauma to pterion, leading to an epidural hematoma causing momentary unconsciousness followed by lucid period of hours to 1-2 days then unconsciousness and death?

A

middle meningeal A

29
Q

What types of hematoma occurs between dura and arachnoid mater due to head strike with fixed object? with a source of venous blood from cortical veins to superior saggital sinus?

A

subdural hematoma

30
Q

What is commonly seen upon MRI with epidural hematomas?

A

Lens shaped and smooth between bone and periosteal layer near foramen spinosum

31
Q

What type of hematoma can be seen on MRI as crescent shapped with jagged border, presenting with HA, nausea and vomitting?

A

subdural hematoma

32
Q

Subarachnoid hemorrhage is more common d/t rupture of aneurysm in circle of willis, with massive bleeding into CSF, what is the source of bleeding??

A

arterial bleed from cerebral A

33
Q

What type of hemorrhage is bleeding within the brain (stroke) usually due to middle cerebral A, hypertension or degernerative arterial disease?

A

intracerebral (Subpial) hemorrhage

34
Q

Herniation of the brain occurs due to increase intracranial pressure and are commonly caused by hemorrhage, tumors, trauma, abscess, or infection. What are the divisions of the brain (3)?

A 
supratentorial compartment (above cerebelli tentorium and divided into right and left by falx cerebri)
infratentorial compartment (below tentorium cerebelli)
tentorial notch (continuation of supra and infratentorial compartments)
35
Q

What herniation displaces brain tissue under the falx cerebri in the supratentorial compartment, compressing what (3)?

A

subfalcine/cingulate/falcine/falx herniation

can compress ACA, frontal and parietal lobes

36
Q

What herniation displaces the brain down toward the tentorial notch, compressing upper brainstem, CN III, basilar and posterior cerebral As?

A

Transtentorial/ Central herniation

occipital lobe problems such as vision

37
Q

What herniation is when the parahippocampal gyrus are extruded over the edge of the tentorium cerebelli and throuhg the tentorial notch, impinging the midbrain?

A

Uncal Herniation (uncus)

38
Q

Kernohan Syndrome occures with uncal herniation with shifting of midbrain, leading to what symptoms?

A

CNIII impinged, opposite cerebral peduncle compressed causing same side hemiplegia

39
Q

What is normally affected with uncus herniation without kernohan syndrome?

A

ipsilateral CNIII problems

contralateral hemiplegia

40
Q

What hernia occurs when cerebellar tonsils go through the foramen magnum, compressing the medulla and upper cervical spinal cord and can effect breathing and HR?

A

tonsillar herniation

16. Neuroscience Exam 2 (17 decks)

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