Ch2 Vascular anatomy

Question 1

Where does Artery of Heubner arise from?

Answer 1

Junction of ACA and ACom in 60%, A2 in 25% and A1 in 15%

Question 2

Where does the ACAs lie in relation to the optic nerves?

Answer 2

Superior

Question 3

What does the anterior choroidal artery supply?

Answer 3

GPi, Post. limb of internal capsule and choroid plexus

Question 4

What demarcates A2 becoming A3?

Answer 4

Callosomarginal branch

Question 5

What demarcates A3 becoming A4?

Answer 5

3 cm posterior to the genu

Question 6

What are the distal MCA branches?

Answer 6

Superior trunk: Orbitofrontal Prefrontal Precentral Postcentral Anterior parietal Posterior parietal (Angular branch) Inferior trunk: Anterior, middle and posterior temporal

Question 7

Branches of P1

Answer 7

Posterior thalamopeduncular perforators Long and short circumflex arteries

Question 8

Branches of P2

Answer 8

Hippocampal Anterior temporal Inferior temporal Posterior medial choroidal artery Posterior lateral choroidal

Question 9

Where is P3?

Answer 9

Quadrigeminal cistern

Question 10

Branches of P4?

Answer 10

Parieto-occipital and calcarine

Question 11

What does Bovine circulation mean?

Answer 11

Both common carotids arise from a common trunk off the aorta

Question 12

Branches of the ECA?

Answer 12

SALFOPSI: Superior thyroid Ascending pharyngeal Lingual Facial Occipital Posterior auricular Superficial temporal Internal maxillary

Question 13

Where is the anterior choroidal artery in relation to the Pcom?

Answer 13

Distal

Question 14

What are the segments of the ICA?

Answer 14

Based on the Cinicinnati system: Cervical, Petrous, Lacerum, Cavernous, Clinoid, Opthalmic, Communicating

Question 15

Define the cervical segment of the ICA

Answer 15

Carotid bifurcation to Carotid canal (no branches!)

Question 16

Define the petrous segment of ICA

Answer 16

Carotid canal to Fr. Lacerum

Question 17

What are the 3 segments of the petrous carotid?

Answer 17

Verticle, posterior and horizontal segments

Question 18

Define the lacerum segment of ICA

Answer 18

Above Fr. lacerum to petrolingual ligament

Question 19

Define the cavernous segment of the ICA

Answer 19

Petrolingual lig to prox dural ring

Question 20

Define the clinoidal segment of ICA

Answer 20

Prox to distal dural rings

Question 21

What is Sheehan’s syndrome?

Answer 21

Post-partum infarction of the posterior pituitary

Question 22

Why is DI rare in Sheehan’s syndrome?

Answer 22

Stalk is spared

Question 23

How can you differential ACh from PCom on angio?

Answer 23

PCom is proximal, larger and runs straight back. Usually bifurcates.

Question 24

What is the point of the angiogram called where the ACh enters the ventricle?

Answer 24

Plexal point

Question 25

What forms the anterior spinal artery?

Answer 25

Branches from the right and left vertebral arteries

Question 26

What contributes blood to the anterior spinal artery?

Answer 26

Radiculomedullary arteries C3 from vert; C6 from deep cervical A and C8 from costocervical trunk

Question 27

What does the Artery of Adamkiewicz supply?

Answer 27

Supplies T8 to conus (located on the left in 80%). Is a radiculomedullary branch of the segmental intercostal artery. Has a diameter of 1 mm.

Question 28

Where is the thoracic watershed area?

Answer 28

T4/5

Question 29

What is the arcade called where the anterior and posterior spinal arteries anastomose as the conus?

Answer 29

Arcade of Lazorthes

Question 30

What vessel is this?

Answer 30

Artery of Adamkiewicz shows a characteristic hairpin loop as it enters the anterior spinal artery.

Question 31

What is the blood supply to the thalamus?

Answer 31

Anterior thalamus by Tuberthalamic A (aka polar A) from the PCom Lateral thalamus from P2 posterior thalamogeniculate A. Medial thalamus from P1 paramedian A Posterior thalamus from the posterior medial choroidal from the P2. A of Percheron is a variant where both paramedian A arise from a single P1 perforator and infarction results in bilateral thalamic infarcts. Causes altered mental status, vertical gaze palsy and memory impairment.

Question 32

Which brainstem nucleus controls swallowing?

Answer 32

Nucleus ambiguus in the ventrolateral medulla contributes motor neurons to CN9 and 10 to larynx and pharynx. Note: Nucleus solitarius receives senstation from CN7, 9 and 10

Question 33

What is the cerebellar homunculus?

Answer 33

Head is represented between the primary and horizontal fissures with legs being furthest away from this