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Year 1: 06. Neuro Exam 2 > Lecture 3: Blood Supply, Hemorrhage, and Herniation > Flashcards

Lecture 3: Blood Supply, Hemorrhage, and Herniation Flashcards

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1
Q

Where does blood supply to the anterior cerebrum come from?

A

Internal Carotid Artery

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2
Q

Where does blood supply to the posterior cerebrum come from?

A

Vertebral Artery

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3
Q

What are the four parts of the Internal Carotid Artery?

A
  • Cervical Part
  • Petrous Part
  • Cavernous Part
  • Cerebral Part
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4
Q

Label the parts of the Internal Carotid Artery

A
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5
Q

What are the three parts of the Vertebral Artery?

A
  • Cervical Part: passes through cervical transverse foramina
  • Atlantic Part: passes throgh foramen magnum
  • Intracrainal Part
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6
Q

Label the sections of the Vertebral Artery

A
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7
Q

What is vertebral basilar insufficiency?

What causes it?

A

Reduced blood flow from Vertebral Artery

  • Extreme hyperextension of head
  • Extreme head rotation (Bowhunter Syndrome)
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8
Q

What is subclavian steal syndrome?

A

Subclavian artery steals blood from vertebral artery

  • Occlusion of subclavian artery causes retrograde flow of blood from vertebral artery
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9
Q

What arteries make up the Circle of Willis?

A
  • Anterior Cerebral Artery
  • Internal Carotid Artery.
  • Posterior Cerebral Artery
  • Anterior communicating Artery
  • Posterior Communicating Artery

Middle Cerebral Artery is not part of it!

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10
Q

Label the Circle of Willis

A
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11
Q

Where does lenticulostriate arteries come from?

What do they supply

A

Middle Cerebral Artery

Posterior limb of internal capsule + basal ganglia

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12
Q

Where do anterior choroidal arteries come from?

What do they supply?

A

Distal part of Internal Cartoid Artery

Supplies forebrain and midbrain:

  • Choroid plexus of the lateral ventricle and third ventricle
  • Optic chiasm and optic tract
  • Internal capsule
  • Lateral geniculate body
  • Globus pallidus
  • Tail of the caudate nucleus
  • Hippocampus
  • Amygdala
  • Substantia Nigra
  • Red Nucleus
  • Crus Cerebri
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13
Q

Where do labyrinthine arteries come from?

What do they supply?

A

Basilar Artery or AICA

Inner ear

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14
Q

What arteries from the Circle of Willis can compress CN II?

A
  • Internal Carotid Artery
  • Anterior Cerebral Artery
  • Anterior Communicating Arteries
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15
Q

What arteries from the Circle of Willis can compress CN III?

A
  • Posterior Communicating Artery
  • Posterior Cerebral Artery
  • Superior Cerebellar Artery

First pupil will be affected then motor functions

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16
Q

What symptoms can CN III compression cause?

A

First pupil (dilated) will be affected then motor functions

Parasympathetic functions affected first!

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17
Q

What arteries from the Circle of Willis can compress CN V?

A

Abberant branches of Superior Cerebellar Artery

Can Cause Trigeminal Neuralgia

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18
Q

What arteries from the Circle of Willis can compress CN VI?

A
  • Labyrinthine Artery
  • Anterior Inferior Cerebellar Artery
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19
Q

What arteries from the Circle of Willis can compress CN VII?

A

Abberant branches from the Anterior Inferior Cerebellar Arteries

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20
Q

What is the clinical significance of border zones?

A

Watershed areas that are susceptible to damage in times of sudden systemic hypotension or hypoperfusion

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21
Q

An anterior watershed infarct can result in what?

A

Motor and sensory defects, especially in lower limbs

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22
Q

A posterior watershed infarct can result in what?

A

Visual disturbance and language issues

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23
Q

What arteries is the Anterior watershed area located between?

Study These Flashcards
A

Anterior Cerebral Artery

Middle Cerebral Artery

24
Q

What arteries is the posterior watershed area located between?

Study These Flashcards
A

Middle Cerebral Artery

Posterior Cerebral Artery

25
What does the Anterior Cerebral Artery supply?
Most of the medial and superior surface of frontal and parietal lobes ## Footnote *Deals with midline structures (e.g. legs)*
26
What does the Middle Cerebral Artery supply?
Most of the lateral surface of frontal and parietal lobes and superior part of temporal lobe ## Footnote *Deals with lateral structures (e.g. arms)*
27
What does the Posterior Cerebral Artery supply?
Occipital Lobe and Inferior Temporal Lobe
28
What are the segments of the Anterior Cerebral Artery?
* A1: Precommunicating Segment * ICA to Anterior Communicating Artery * A2: Infracallosal Segment * Anterior Communicating Artery to rostram and genu of corpus callosum * A3: Precallosal Segment * Genu to caudal part of corpus callosum * A4: Supracallosal * Superior to corpus callosum * A5: Postcallosal * Caudal to Corpus Callosum
29
Label this diagram of the Anterior Cerebral Artery
30
What are the segments of the Middle Cerebral Artery?
* M1: Sphenoidal/Horizontal Segment * ICA to bifurcation at insula * M2: Insular Segment * Bifurcation at insula to circular sulcus of insula * M3: Opercular Segment * Circular sulcus or insula to external surface of lateral fissure * M4: Cortical Segment * On Cortex
31
Label this diagram.
32
What are the segments of the Posterior Cerebral Artery?
* P1: Basilar Birtucation to Posterior Communicating Artery * P2: Posterior Communicating Artery to midbrain * P3: Quadrigeminal Segment * Within quadrigeminal cistern * P4: Cortical Segment
33
Label this diagram
34
What does the Superior Cerebellar Artery supply?
Superior half of the cerebellum Parts of the midbrain
35
What does the Anterior Inferior Cerebellar Artery supply?
* Cerebellum * Flocculus * Middle cerebellar peduncle * Inferolateral portion of the pons * Cochlear nuclei
36
What does the Posterior Inferior Cerebellar Artery supply?
Lateral Medulla * Nuclei * Dorsal Motor Nucleus of Vagus * Medial Vestibular Nucleus * Inferior Vestibular Nucleus * Accessory Cuneate Nucleus * Solitary Nuclues * Spinal Trigeminal Nucleus * Nucleus Ambiguous * Tracts * Solitary Tract * Spinal Trigeminal Tract * Rubrospinal Tract * Anterolateral System
37
What brainstem structures does the Anterior Spinal Artery supply?
Medulla * Hypoglossal Nucleus * Medial Lemniscus (sensory tract) * Pyramid (motor tract) *Done by sulcal arteries*
38
What does the Posterior Spinal Artery supply?
Lower Medulla * Gracile fasciculi and nuclei * Cuneate fasciculi and nuclei
39
What does the Paramedian Branches of Basilar Artery supply?
Medial Pons * Abducens Nucleus and Nerve * Medial Longitudinal Fasciculus * Medial Lemniscus * Corticospinal Fibers
40
What does the Long Circumferential Branches of Basilar Artery supply?
Lateral Pons * Mesencephalic Nucleus and Tract * Spinal Trigeminal Nucleus and Tract * Facial Motor Nucleus * Anterolateral System
41
What supplies the superior and inferior colliculi?
**Superior Colliculus:** Quadrigeminal (*from PCA*) and Posterior Medial Choroidal Arteries (*from PCA*) **Inferior Colliculus:** Quadrigeminal and Superior Cerebellar Arteries
42
What supplies the lateral and medial geniculate bodies?
Thalamogeniculate Artery ## Footnote *From Posterior Cerebral Artery*
43
What supplies the spinal cord?
Posterior and Anterior Spinal Arteries
44
What are some important structures found in the subarachnoid space?
* CSF * Circle of Willis * Veins
45
What causes an epidural hematoma? What does it look like on an x-ray?
* Ruptured _Middle Meningeal Artery_: can be caused if hit at the pterion * Lens shaped hematoma on side of brain
46
Pt presents after MVC, states he hit the left side of his head and had momentary unconsciousness before waking up. After 6 hours in the ED, pt starts feeling nauseous and sleepy. What should you be concerned for?
Epidural or subdural hematoma
47
What causes a subdural hematoma? What does it look like on an x-ray?
* Bleeding of _bridging veins_ most commonly seen in babies and the elderly * Crescent shaped hematoma on side of brain
48
What causes a subarachnoid hemorrhage? What does it look like on an x-ray?
* Ruptured aneurysm from cerebral arteries mostly in post-menopausal women and people with hypertension * Spider like webs in middle of brain
49
What is the source of bleeding for an intracerebral/subpial hemorrhage?
Middle Cerebral Artery
50
What artery may be compressed in a Subfalcine herniation? What symptoms can manifest?
* Anterior Cerebral Artery can be compressed * Opposite lower extremity motor and sensory loss
51
What is this?
Subfalcine Herniation
52
What structures are compressed in a transtentorial herniation?
Upper brainstem CN III Maybe Basilar Posterior Cerebral Arteries
53
Patient presenting with contralateral hemiplesia and ipsilateral CN III palsy most likely has a hernia where?
Uncus (and portions of parahippocampal gyrus)
54
What structures are compressed in uncal herniations?
CN III Cerebral peduncles
55
What is Kernohan's Phenomenon?
Uncal herniation that shifts the midbrain Damage to CN III and cerebral peduncle on the other side so that all deficits are now on same side
56
What structures can be compressed in a tonsillar herniation?
Medulla: respiratory center Upper cervical Spinal Cord

Year 1: 06. Neuro Exam 2 (28 decks)

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