Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/71

Click to flip

71 Cards in this Set

  • Front
  • Back

Main blood supply to the forebrain?

Internal carotid

What joints anterior and posterior circulation?

Posterior communicating arteries - bridge posterior cerebral arteries w/ internal carotid arteries

Variation in the circle of Willis

Normally there is no pressure differentialbetween posterior + anterior circulation


Ifperson did depend on communicating arteries → these will be very large

Small vessels coming off of circle of Willis?

ganglionic/ perforating / striate/central arteries that arise from major vessels in oradjacent to the circle (these penetrate and provide paramedian/short circumferential blood supply)

Four groups of perforating arteries

Anteromedial


Anterolateral


Posteromedial


Posterolateral

Anteromedial group of perforating arteries

-Originates from the anterior communicating artery + anterior cerebral artery


-Supplies: anterior hypothalamus, structures in the area of the optic chiasm, inferior part of anterior limb + genu of internal capsule


-Recurrent artery of Heubner: large artery, supplies head of the caudate nucleus

Blood supply to head of the caudate nucleus

Recurrent artery of Heubner (part of anteromedial group of perforating arteries)

Anterolateral group of perforating arteries

Originates from lateral part of the anterior cerebral artery + proximal part of middle cerebral artery


Includes Lenticulostriate arteries


Supply: superior part of internal capsule, basal ganglia

Posteromedial group of perforating arteries

Originate from posterior communicating artery + medial part of posterior cerebral artery and basilar bifurcation


Supplies: crus cerebri, middle and caudal portions of the hypothalamus, thalamus, subthalamic nucleus

Posterolateral group of perforating arteries

Originates from lateral part of posterior cerebral artery


Supplies: thalamus + choroid plexus

Arteries responsible for lacunar infarcts?

perforating arteries

Course of the anterior choroidal artery

Arises distal to the posterior communicating artery and follows the optic tract + cerebral peduncle as far as the lateral geniculate body then enters the choroid plexus of the lateral ventricle

What does the anterior choroidal artery supply?

Optic tract


Medial temporal cortex


Hippocampal formation


Caudal + inferior parts of lentiform nucleus


Inferior part of posterior limb of internal capsule - retro + sublenticular parts

Retro vs sublenticulate fibers

Optic radiations = start as retrolenticulatefibers Auditoryradiations = start as sublenticulatefibers

Inferior posterior limb of internal capsule supplied by...

Anterior choroidal artery

Superior part of the internal capsule (all 3 divisions) is supplied by the...

lenticulostriate arteries

Blood supply to inferior part of anterior limb and genu of IC?

Medial striate arteries

Medial striate arteries supply...

Medial striate arteries supply theinferior part of the anterior limb and the genu of the IC

Lenticulostriate arteries supply..

ALL superior parts of the internal capsule

Fibers extending up into the cortex from the internal capsule?

Corona radiata

Corona radiata

Small strokes in the internal capsule can result in _____

majorconsequences and can result in spastic paralysis and hemianesthesia due to the interruption of thecorticospinal and thalamocortical fibers

Blood supply to anterior and posterior hypothalamus? Blood supply to subthalamic nuclei?

Anterior hypothalamus: anteromedial group


Posterior hypothalamus: posteromedial group


Subthalamic nucleus: posterormedial group

Blood supply + structure indicated?

Blood supply + structure indicated?

Anterior hypothalamus - anteromedial group

Blood supply + structure indicated?

Blood supply + structure indicated?

Posterior hypothalamus - posteromedial group

Blood supply to subthalamic nucleus?

Posteromedial group of perforating arteries

Blood supply to the thalamus

Anterior thalamus (more medial): posteromedial group of perforating arteries


Posterior thalamus (more lateral): posterolateral group of perforating arteries


Posterior cerebral is main supplier here

Clinical relationship: blood supply to thalamus + internal capsule

Bloodsupply to the thalamus is largely separate from the internal capsule supply.However, the edema from vascular lesions may extend from the thalamus into theinternal capsule and vice versa as a result of their close proximity.

Transient deficit of thalamus (or other structures) likely due to...

compressive lesion from edema (not permanent structure defect)

Recurrent artery of Huebner supplies...

head of the caudate nucleus (from anteromedial perforating arteries)

What supplies the lateral aspect of the lentiform nucleus (putamen and GP) and body of the caudate nucleus?

Lateral striate/lenticulostriate arteries

What do the lateral striate/lenticulostriate arteries supply in the basal ganglia?

Lateral aspect of lentiform nucleus (putamen + GP) and body of the caudate nucleus

Anterior choroidal artery supplies what in the basal ganglia?

Ventrocaudal portions of the lentiform nucleus and amygdaloid nucleus

Posterolateral penetrating branches supply what in the basal ganglia?

Posterior thalamus

Posteromedial penetrating branches supply what in the basal ganglia?

Anterior thalamus

The oculomotor nerve travels between...

the posterior cerebral artery + the superior cerebellar artery

Cortical branches of the ACA

Pericallosal and callosomarginal aa. course inferior and superior to thecingulate gyrus respectively; callosomarginal artery supplies supplementary motor cortex (on medial side) and paracentrallobule

Blood supply to paracentral lobule?

Callosomarginal artery (branch of ACA)

Cortical branching pattern of MCA

-STEM: has lenticulostriate arteries


-UPPER DIVISION: middle and inferior frontal gyri, pre and postcentral gyri


-LOWER DIVISION: superior and inferior parietal lobules and temporal gyri

_____ is the main blood supply to the midbrain and the thalamus

PCA

Cortical supply of the PCA

Branches across the inferior and medial surface of the occipital lobe + most of the temporal lobe


Calcarine artery supplies the primary visual cortex

Border zone deficits

Decreased blood flow or oxygenation (HTN, cardiac arrest, CO poisoning) can lead to infarcts in the border zone or watershed of large arterial territories

Common watershed deficit?

Between the ACA and MCA cortical branches- affect homunculus at proximal limbs/trunk

Man in the barrel syndrome

Watershed infarcts can produce proximal arm and leg weakness(“man in the barrel” syndrome) because the regions of homunculus involved ofteninclude the trunk and proximal limbs. (lower extremity and head are fine)

Causes of main the barrel syndrome

severesystemic hypotension related to CABG , hemorrhagic shock , and severeanaphylaxis

Venous drainage in the cortex

Capillaries


Intra-axial veins


Superfical veins (remember bridging veins) + Deep veins


Dural venous sinuses

Ultimate draining location of venous blood?

Ultimately everything is draining intothe jugular bulb which is the commencement of the internal jugular vein (found in jugular fossa)

Bridging veins - clinical correlation

Subdural hematoma - rupture of bridging vein between arachnoid and dura mater


Can result in extravasation of blood into the potential space between meningeal layers


Will cross suture lines

Deep cerebral veins - clinical correlation - venous angle

Venous angle - where internal cerebral vein and thalamostriate (terminal) vein meet -- marks the location of the interventricular foramen



Deep cerebral veins - clinical correlation - Great Cerebral Vein of Galen

Great cerebral vein of Galen - easily torn during blunt trauma to the head; joins inferior sagittal sinus by traveling through the quadrigeminal cistern (where it is vulnerable)


A tear will lead to a slow venous bleed in the SAS (starting in the quadrigeminal cistern)

Anterior cerebral artery occlusion - areas affected + signs/sx

-Motor area for lower body: paresis or paralysis of contralateral leg and foot


-Somatosensory cortex for lower body: sensory impairment (paresthesia/anesthesia) involving contralateral leg and foot


-Superior frontal gyrus (upper) and anterior cingulate gyrus (lower) bilaterally: urinary incontinence

Patient presents with paresis or paralysis of contralateral face, hand, and arm - area affected + blood supply?

Motor area for upper body - MCA

Patient presents with sensory deficits involving contralateral face, hand, and arm - area affected + blood supply?

Somatosensory cortex for upper body - MCA

Patient presents with expressive aphasia - area affected + blood supply?

Frontal lobe of dominant hemisphere (usually L) related to speech production - Broca's area - MCA

Patient presents with receptive aphasia, fluent aphasia - area affected + blood supply?

Superior temporal lobe areas of dominant hemisphere (usually L) related to interpretation of speech (Wernicke's)

Patient presents with contralateral neglect (hemi-neglect), agnosognosia - area affected + blood supply?

Parietal lobe of non-dominant hemisphere - MCA

Patients presents w/ transient loss of voluntary saccadic eye movement to contralateral side - area affected + blood supply?

Frontal eye fields in frontal lobe - MCA

Patient presents with superior quadranticanopsia- area affected + blood supply?

Optic radiation within temporal lobe (unilaterally) (Meyer Loop)


OR upper optic radiation unilaterally


MCA

Patient presents with homonymous hemianopsia - area affected + blood supply?

Optic tract (Anterior choroidal), LGN (Anterior choroidal), Optic radition (upper and lower on one side) - MCA

Patient presents with capsular (pure motor) hemiplegia - area affected + blood supply?

Upper portion of posterior limb of internal capsule + adjacent corona radiata - MCA

Patient presents with homonymous hemianopsia with macular sparing- area affected + blood supply?

Primary visual cortex (on contralateral side - superior and inferior) - PCA

Patient presents with thalamic syndrome - sensory loss (all modalities), spontaneous pain, dysesthesias- area affected + blood supply?

Ventral posterior nucleus of the thalamus (medial + lateral) in the territory of the thalamogeniculate artery - PCA

Patient presents with Hemiballismus- area affected + blood supply?

Subthalamic nuclei or its connections to globus pallidus (contralateral to side of presentation) - PCA

Patient presents with third nerve palsy (describe this appearance)- area affected + blood supply?

Eye down and out, ptosis, myosis


Oculomotor nucleus or nerve in midbrain - PCA

Patient presents with contralateral hemiplegia- area affected + blood supply?

Cerebral peduncle - PCA

Patient presents with Paralysis or paresis of vertical eye movement, slowed diminished response to light- area affected + blood supply?

Tectum of midbrain - PCA

Patient presents with decerebrate posturing - area affected + blood supply?

Upper motor neuron tracts in cerebral peduncle caudal to red nucleus of midbrain - PCA

Blood supply overlap @ parahippocampal gyrus

Posterior cerebral + anterior choroidal