Arteries/Vessels

Question 1

ophthalmic artery

Answer 1

ophthalmic artery is the chief artery of the orbit and is usually the first branch of the ICA. It courses diagonally through the optic canal in an
antero-lateral direction below the optic nerve.

Question 2

The posterior communicating artery (PCoA)

Answer 2

The posterior communicating artery (PCoA) is located between the ICA the posterior cerebral arteries. Its ganglionic or penetrating branches supply the internal capsule and the basal ganglia

Question 3

Anterior Choroidal Artery

Answer 3

Anterior Choroidal Artery is a small artery near the
junction of the posterior communicating and ICA.

It supplies the choroid plexus of the lateral ventricle, internal capsule, basal ganglia, thalamus and rostral midbrain.

The anterior choroidal artery is prone to thrombosis due to its long course in the subarachnoid space. In elderly persons, it is also a frequent cause of vascular insufficiency to the globus pallidus and hippocampus.

Question 4

Anterior Cerebral Artery (ACA)

Answer 4

Anterior Cerebral Artery (ACA) is next to the olfactory and optic nerves

is the terminal branch of the internal carotid.

It may anastomose with the posterior cerebral artery via the pericallosal artery.

This artery provides important collateral circulation between the anterior and posterior circulations. The ACA has the highest incidence of cerebral aneurysms (35%).

Question 5

5 branches of anterior cerebral a

Answer 5

1. Penetrating Branches
2. anterior communicating branches
3. cortical branches of ACA
4. anterior pericossal
5. callosalmarginal a.

Question 6

located just proximal to the anterior communicating artery. penetrates the anterior perforating substance and supplies the internal capsule and the corpus striatum (globus pallidus, putamen and caudate).

Answer 6

Penetrating Branches. The Recurrent artery of Heubner is considered

one of the medial striate arteries.

Question 7

connects the two anterior cerebral arteries.

Answer 7

Anterior communicating artery (ACoA) connects the two anterior cerebral arteries. I t may be absent or hypoplastic. Approximately 25% of all cerebral aneurysms occur here.

Question 8

1. occlusions may result in contralateral paresis and/or paraesthesia of the leg and foot.
   
   1. supplies the anterior 2/3 of the medial side and supero-lateral portion of the hemisphere
2. courses in the cingulate sulcus
3. located in the callosal sulcus

Answer 8

1. Anterior Cerebral A: cortical branches supply paracentral lobule: responsible for control of lower extremity motor function. Branches of the ACA frequently supply the paracentral lobule region, occlusions may result in contralateral paresis and/or paraesthesia of the leg and foot.
   
   1. supplies the anterior 2/3 of the medial side and supero-lateral portion of the hemisphere.
2. Anterior pericallosal artery is located in the callosal sulcus; may anastomose with the posterior callosal artery, which is a branch of the posterior cerebral.
3. Callosomarginal artery courses in the cingulate sulcus.

Question 9

25% of all cerebral aneurysms occur here

Answer 9

Middle Cerebral Artery (MCA) is a large artery that is the lateral continuation of the ICA. About 25% of all cerebral aneurysms occur along the MCA.

Question 10

MCA penetrating branches

Answer 10

1. At the base, its branches are called medial and lateral striate or thalamostriate arteries.
2. These small, important arteries supply parts of the internal capsule, corpus striatum and thalamus. One of the lateral striate arteries, the artery of cerebral hemorrhage, is especially prone to rupture.

Question 11

MCA Cortical branches.

Answer 11

Central artery (Rolando), Frontal branches

Question 12

Central artery (Rolando)

Answer 12

is located in the central sulcus and supplies the primary motor and somesthetic cortices. Thrombosis of this artery would result in contralateral spastic paralysis and/or, paraesthesia of the face and upper 1⁄2 of the body.

Question 13

is located in the central sulcus and supplies the primary motor and somesthetic cortices.

Answer 13

central artery (rolando), cortical branch of the MCA

Question 14

Thrombosis of this artery would result in contralateral spastic
paralysis and/or paraesthesia of the face and upper 1⁄2 of the body.

Answer 14

Central artery (Rolando) from the Middle Cerebral Artery (MCA)

25% of all cerebral aneurysms occur along the MCA.

Question 15

supplies the premotor and prefrontal cortices, and Broca’s speech area in the dominant hemisphere.

Answer 15

Frontal branches of the MCA supply the premotor and prefrontal cortices, and Broca’s speech area in the dominant hemisphere.

Question 16

Thrombosis results in expressive or Broca’s aphasia, a motor language disorder frustrating problem in initiation of speech motor patterns.

Answer 16

frontal branches of the MCA or the MCA itself

Question 17

MCA cortical branches

Answer 17

1. Central artery (Rolando)
2. Frontal branches
3. Temporal branches supply the primary auditory cortex. Vascular lesions in this area may result in the difficulty in localizing sounds.
4. Parietal branches supply the association cortex. Lesions in the superior and inferior parietal lobules can provide a variety of interpretive disorders such as body neglect, agnosia and apraxia.
5. Angular artery is the chief arterial supply to the supramarginal and angular regions.

Question 18

Obstruction of this artery in the dominant hemisphere may result in Wernicke’s aphasia, a receptive language disorder.

Answer 18

Angular artery is the chief arterial supply to the supramarginal and angular regions.

Although patients with Wernicke’s aphasia are quite fluent (talkative), they lack content or meaning in their spoken and written comprehension of language. Their language pattern tends to circumlocute with numerous inappropriate word choices and neologisms (new word creations).

Question 19

Lesions in the superior and inferior parietal lobules can provide a variety of interpretive disorders such as body neglect, agnosia and apraxia.

Answer 19

Parietal branches of the MCA

Question 20

Vascular lesions in this area may result in the difficulty in localizing sounds.

Answer 20

temporal branches of the MCA

Question 21

Patient is talkative: lacks content or meaning in spoken and written comprehension of language. Circumoculates, inappropriate word choices and new word formation

Answer 21

angular artery of the MCA thrombosed; Wernicke’s speech aphasia described

Question 22

supplies most of the central gray matter and the anteromedial portion of white matter of the spinal cord.

Answer 22

Anterior spinal artery (ASpA)

The anterior spinal artery is singular artery is located in the anteromedian sulcus, and supplies most of the central gray matter and the anteromedial portion of white matter of the spinal cord.

Question 23

characterized by central necrosis and cavitation of the spinal cord and the development of a syrinx.

Answer 23

1. Central Cord Syndrome.
2. Disruption of blood flow to the anterior spinal artery results in central cord syndrome: ischemia of central region of the spinal cord.
3. Thrombosis of the anterior spinal artery characterized by central necrosis and cavitation of the spinal cord and the development of a syrinx.

Question 24

These two conditions are distinguished by the onset and progression of the neurological signs and symptoms (s/s): one, an abrupt onset with some amelioration of s/s, and the other has a slow progressively worsening scenario.

Answer 24

1. CCS: abrupt onset with some amelioration of s/s,
2. syringomyelia: slow progressively worsening scenario.

Question 25

Posterior spinal arteries (PSpA): first name them and then describe them

Answer 25

1. Vertebral or PICA, anterior & posterior radicular a. branching from arteries in those regions, segmental medullary arteries
2. two posterior spinal arteries may be branches of either the vertebral or posterior inferior cerebellar arteries. (Vertebral or PICA)
   
   1. course in the postero-lateral sulci of each side
   2. supply the dorsal roots and about 75% of the posterior columns.
   3. supply the peripheral margins of the cord.
3. Anterior and posterior radicular arteries course with the ventral and dorsal rootlets, respectively.
4. Segmental medullary arteries supply the spinal cord via small anterior and posterior radicular branches of the ascending cervical, intercostal, and lumbar arteries.

Question 26

major supply to the inferior two-thirds of the spinal cord.

Answer 26

1. The great anterior artery of Adamkiewicz usually arises from the left inferior intercostal or superior lumbar arteries, and contributes to the anterior spinal artery.
2. It is the major supply to the inferior two-thirds of the spinal cord.
3. It may be compromised secondary to thoracolumbar fracture or surgical repair of abdominal aortic aneurysms (AAA).
4. Blood supply to the cervical and lumbar enlargements is fairly consistent. However, trauma to the spinal cord may interrupt the blood supply to the cord, especially in those vulnerable regions served by two arterial supplies.

Question 27

trauma to the spinal cord may interrupt the blood supply to the cord, especially in those vulnerable regions served by two arterial supplies. The result of ischemic necrosis is a partial or complete transection of the spinal cord. The areas that are most frequently involved are ……

Answer 27

adjacent to the enlargements at C2-3, T1-4 and L1.

Question 28

supplies the posterior inferior portion of the cerebellum, the posterolateral aspect of the medulla, and the choroid plexus of the fourth ventricle.

Answer 28

Posterior inferior cerebellar artery (PICA)

supplies the posterior inferior portion of the cerebellum, the posterolateral aspect of the medulla, and the choroid plexus of the fourth ventricle.

The posterior spinal arteries may be branches of the PICA or VA.

They course in the posterolateral sulci of each side, and supply the dorsal roots and about 75% of the posterior columns. These arteries along with the radicular arteries supply the peripheral margins of the cord.

Question 29

meningovascular infection of these arteries and their branches with a resultant irritation or destruction of the associated neuroanatomical structures.

Answer 29

The posterior spinal arteries may be branches of the PICA or VA. They course in the posterolateral sulci of each side, and supply the dorsal roots and about 75% of the posterior columns. These arteries along with the radicular arteries supply the peripheral margins of the cord.

Question 30

displacement of the PICA on angiograms

Answer 30

Clinically, displacement of the PICA on angiograms of the posterior cranial fossa may indicate the presence of a space-occupying mass such as a tumor. Thrombosis of the PICA results in LMS

Lateral Medullary (Wallenberg) Syndrome

Question 31

About 10% of all cerebral aneurysms occur here. how is it formed, and what are its terminal branches?

Answer 31

1. Basilar Artery (BA)
2. formed by the merging of the two vertebral arteries. About 10% of all cerebral aneurysms occur along the basilar artery. The terminal branches of the basilar artery are the posterior cerebral artery.
3. In the basilar artery, blood may flow from the anterior to the posterior circulation depending upon pressure differences in those circulations. The anterior circulation is supplied by the internal carotid artery and the posterior circulation is principally supplied by the vertebral arteries.

Question 32

Partial or complete obstruction of one or more of these arteries may change the direction or the volume of the blood flow in the unobstructed circulation

Answer 32

internal carotid and vertebral a.

Question 33

what specific vascular events are “autoregulated by the autonomic nervous system” in the cerebral vessel system?

Answer 33

Partial or complete obstruction of one or more of these arteries (internal carotid, vertebral/basilar a.) may change the direction or the volume of the blood flow in the unobstructed circulation—all of which is autoregulated by the autonomic nervous system and other factors.

Question 34

Thrombosis of the PICA

Answer 34

lateral medullary syndrome (wallenberg)

Question 35

Posterior Communicating Artery (PCoA)

Answer 35

Posterior Communicating Artery (PCoA) is located between the internal carotid and the posterior cerebral arteries. Its ganglionic or penetrating branches supply the internal capsule and the basal ganglia.

Question 36

the rostral terminal branch of the basilar artery, it’s penetrating branches, and its cortical branches

Answer 36

Posterior cerebral artery (PCA) is the rostral terminal branch of the basilar artery. Branches:

Penetrating Branches.

1. As the PCA passes through the superior cistern and incisura, it sends penetrating branches to the internal capsule, thalamus, choroid plexus of the lateral ventricle, and the upper midbrain.

Cortical Branches of the PCA

1. Temporal branches supply
2. Parieto-occipital artery
3. Calcarine artery
4. Posterior pericallosal artery

Question 37

Thrombosis of this artery results in contralateral homonymous hemianopia
with macular sparingdue to the destruction of the primary visual cortex

Answer 37

calcarine a. of the posterior cerebral a.

Question 38

Uncal herniation of this artery or thrombosis of this artery may cause an ischemic necrosis of the primary visual cortex (lingual and cuneus gyri), thereby resulting in contralateral homonymous hemianopsia with macular sparing.

Answer 38

PCA or calcarine a.

Question 39

located immediately posterior to the III nerve. It supplies the superior lateral portion of the cerebellum, the deep cerebellar nuclei, and portions of the pons and midbrain.

Answer 39

Superior cerebellar artery (SCA) is

Question 40

Anterior inferior cerebellar artery (AICA)

Answer 40

is located in the pontobulbar sulcus next to the VI, VII and VIII nerves, and the flocculus. It supplies the anterior inferior portion of the cerebellum, the superior and middle cerebellar peduncles,

Question 41

the chief artery to the internal ear

Answer 41

1. The labyrinthine artery, the chief artery to the internal ear, may be a branch of the AICA or a separate branch of the basilar artery.
2. Atherosclerosis or inflammation of the labyrinthine artery may irritate the vestibulo-cochlear apparatus (labyrinthinitis) and result in disturbances of equilibrium and/or hearing.