Cerebrovascular Review Ch. 18,19, 22

Question 1

anterior circulation: ICA

Answer 1

distributes blood to the anterior brain, the eyes, forehead, nose

Question 2

ICA branches

Answer 2

ophthalmic artery, anterior cerebral artery, middle cerebral artery

Question 3

Majority of the blood in the ICA

Answer 3

70-80% flows from the common carotid artery

Question 4

carotid siphon

Answer 4

a significant curve of the distal ICA

Question 5

ECA branches

Answer 5

superior thyroid artery, ascending pharyngeal a., lingual a., facial a., occipital a., posterior auricular a., superficial temporal a., and maxillary a.

Question 6

anterior circulation: ECA supplies blood to

Answer 6

neck, face, scalp

Question 7

posterior circulation

Answer 7

rt. and left vertebral arteries, basiliar artery, and circle of willis

Question 8

periorbital circulation

Answer 8

branches of the ophthalmic artery- supraorbital artery, frontal artery, and nasal artery

Question 9

Supraorbital artery (from ICA to ECA)

Answer 9

ICA-ophthalmic a.-supraorbital a- superficial temporal a.- ECA

Question 10

Frontal artery (from ICA to ECA)

Answer 10

ICA- ophthalmic a. - frontal a.- superficial temporal a.- ECA

Question 11

Nasal artery (from ICA to ECA)

Answer 11

ICA- ophthalmic a. - frontal a. - nasal a. - angular a.- facial a. - ECA

Question 12

Tunica intima

Answer 12

inner layer of a vessel

a single layer of endothelial cells with a base membrane and connective tissue

Question 13

tunica media

Answer 13

middle layer of a vessel

thick layer of smooth muscles and collagenous fiber

Question 14

tunica adventitia

Answer 14

a thin fibrous layer of connective tissue and some smooth muscle fibers
contains the vasa vasorum

Question 15

vasa vasorum

Answer 15

supplies blood to the walls of the larger arteries

transports oxygen and nutrients as well as removing waste products

Question 16

Q= (P) * r^4 / 8nL

Relationship of flow vs. pressure gradient and size of the vessel

Answer 16

flow is directly proportional to pressure gradient and size of the vessel

Question 17

flow vs. viscosity and length of a vessel

Answer 17

flow is inversely proportional to viscosity and length of a vessel

Question 18

velocity and energy losses

Answer 18

velocity increases at a stenosis

this acceleration increases energy losses

Question 19

turbulence is detected by

Answer 19

spectral broadening which is a wide range of very low to very high frequency shifts

Question 20

TIA

Answer 20

transient ischemic attack, a fleeting neurologic dysfunction without lasting effects, symptoms do not last more than 24 hours

Question 21

RIND

Answer 21

reversible ischemic neurologic deficit, lasts longer than a TIA but resolves in time

Question 22

VBI

Answer 22

vertebrobasilar insufficiency, usually causes bilateral visual blurring or paresthesia and complaints of vertigo, ataxia and drop attacks

Question 23

CVA

Answer 23

cerebrovascular accident, produces a permanent neurologic deficit

Question 24

Risk factors for cerebrovascular disease

Answer 24

diabetes mellitus, hypertension, smoking and hyperlipidemia

Question 25

most common mechanisms of cerebrovascular insufficiency

Answer 25

ischemia and hemorrhage

Question 26

three leading causes of ischemia

Answer 26

atherothrombotic pathology, cardiogenic, and lacunar strokes

Question 27

atherothrombotic pathologies

Answer 27

alterations in perfusion secondary to an atheromatous plaque resulting in stenosis, occlusion, or thromboembolic event

Question 28

cardiogenic pathologies

Answer 28

usually responsible for cerebrovascular ischemia are altered cardiac function and most often an embolism

Question 29

lacunar strokes/ infarction

Answer 29

a small circumscribed loss of brain tissue caused by an occlusion of one of the small penetrating arteries in the brain

Question 30

the second most common mechanism of cerebrovascular insufficiency

Answer 30

hemorrhage, may be the result of hypertension, ruptured aneurysm, or trauma

Question 31

fatty streak

Answer 31

a thin layer of lipid material on the intimal layer of the artery

Question 32

fibrous plaque

Answer 32

an accumulation of lipids that is covered by more lipid material, collagen, and elastic fiber deposits

Question 33

complicated lesion

Answer 33

fibrous plaque that contains fibrous tissue, more collagen, calcium, and cellular debris

Question 34

ulcerative lesion

Answer 34

deterioration of the normally smooth surface of the fibrous cap

Question 35

embolism

Answer 35

a foreign substance or piece of a thrombus that moves through the circulatory system until it lodges in a distant blood vessel

Question 36

source of an embolism

Answer 36

heart, atherosclerotic plaque

Question 37

Thrombosis

Answer 37

composed of platelets trapped within a network of fibrin, one of the most common causes of a stroke

Question 38

aneurysm

Answer 38

an abnormal localized dilatation of a blood vessel due to congenital defects or weakness of the vessel wall

Question 39

cerebrovascular signs and symptoms | affected artery: ICA

Answer 39

contralateral weakness, paralysis, numbness, and or sensory changes; ipsilateral amaurosis fugax and or a bruit, may have aphasia if in the dominant hemisphere, occasionally altered level of consciousness

Question 40

cerebrovascular signs and symptoms | affected artery: middle cerebral

Answer 40

aphasia or dysphasia, severe contralateral hemiparesis or hemiplegia (more severe in face and arm rather than leg if upper division MCA occluded) dysarthria, behavioral changes, confusional state, agitated delirium ( if lower division MCA occluded)

Question 41

cerebrovascular signs and symptoms | affected artery: anterior cerebral

Answer 41

contralateral hemiparesis (especially in leg) incontinence, loss of coordination, impaired motor and sensory functions

Question 42

cerebrovascular signs and symptoms | affected artery: vertebrobasilar

Answer 42

numbness around lips and mouth, diplopia, poor coordination, dysphagia, vertigo, amnesia and ataxia

Question 43

cerebrovascular signs and symptoms | affected artery: posterior cerebral

Answer 43

dyslexia, coma (paralysis usually absent)