: Blood Supply To The Brain (Blair)

Front 1

Which portions of the CNS does the anterior spinal artery supply?

Back 1

1. Ventral medial portion of medulla
2. Anterior 2/3 of spinal cord

Front 2

The posterior spinal arteries supply which portion of the spinal cord?

Back 2

Posterior 1/3 of medulla

Front 3

The artery of Adamkiewicz is usually found at which level of the spinal cord?

It provides blood to which regions of the body?

Back 3

L2

*Lower thoracic and upper lumbar segments

Front 4

Describe the general, major effects that result from occlusion of the anterior spinal artery

check to see of this is spinothalamic syndrome

Back 4

1. Reduced pain/temperature sensation
2. Weakness bilaterally

(damage to the anterolateral portions of the spinal cord--> spinothalamic and corticospinal tracts)

Front 5

Occlusion of one posterior spinal artery will have what kind of effect?

Back 5

IPSILATERAL effects:
1. Reduction of touch/vibratory sense
2. Possible weakness of muscles in the lower half of the body

Front 6

List the 4 arteries that supply the medulla

Back 6

1. Vertebral artery
2. Posterior inferior cerebellar
3. Posterior spinal
4. Anterior spinal

Front 7

Which artery supplies the ventrolateral medulla?

Back 7

Vertebral artery

Front 8

Which arteries supply most of the dorsolateral medulla as well as the inferior cerebellum?

Back 8

Posterior inferior cerebellar arteries (PICAs)

Front 9

Which arteries supply blood to the ventromedial portion of the medulla?

Back 9

Anterior spinal arteries

Front 10

What is the major motor structure in the lower medulla affected by occlusion of the anterior spinal artery?

Back 10

Pyramidal decussation-motor nerves cross right to left a lesion above the decussation causes contra lateral motor signs b/c they have not crossed yet. at or below the decussation causes ipsilateral symptoms

Front 11

The vagus and glossopharyngeal nerves exit the medulla in the territory of which artery?

Back 11

PICA

Front 12

Which syndrome is associated with contralateral weakness, loss of discriminative touch, position, and vibration, and ipsilateral weakness of the tongue?

Back 12

Medial medullary syndrome
(anterior spinal artery)

Front 13

Which syndrome is associated with loss of pain/temperature sensation from the contralateral body and ipsilateral face, ipsilateral loss of hearing, nystagmus, and ataxia, and hoarseness?

Back 13

Lateral medullary syndrome
(Wallenberg's syndrome)

Front 14

Which arteries supply the pons?

Back 14

paramedial, short and long circumference branches of the basilar art

Front 15

Which portions of the pons are supplied by AICA and superior cerebellar artery?

Back 15

AICA--> dorsolateral portion of the CAUDAL pons
Superior cerebellar --> dorsolateral portion of the ROSTRAL pons

Front 16

Which syndrome may present with the following symptoms?
Contralateral weakness of body, loss of discriminative touch, position, vibration.
Ipsilateral weakness of lateral rectus muscle and facial weakness
Paralysis of conjugate gaze toward side of lesion

Back 16

Medial pontine syndrome
(paramedian branches of basilar artery)

Front 17

Lateral medullary syndrome is also known as?

Back 17

Wallenberg's syndrome

Front 18

Ventral pontine syndrome is also known as?

Back 18

Millard-Gubler syndrome

Front 19

Ventral pontine syndrome is due to problems with which arterial branches?

Back 19

Paramedian and short circumferential branches of basilar artery

Front 20

Medial pontine syndrome is due to a problem with which arterial branches?

Back 20

Paramedian branches of basilar artery

Front 21

Which syndrome may present with the following signs:
Contralateral weakness of body
Ipsilateral weakness of lateral rectus muscle
Ipsilateral facial weakness

Back 21

Ventral pontine syndrome
(Millard-Gubler syndrome)

Front 22

Lateral potine syndrome is due to a problem with which arteries?

Back 22

Long circumferential branches of basilar artery

Front 23

Which of the following syndromes presents with the following problems?
Ataxia, unsteady gait, nystagmus, vertigo
Loss of pain/temp from ipsilateral face and contralateral body
Facial weakness, chewing weakness
Paralysis of conjugate gaze

Back 23

Lateral pontine syndrome

Front 24

Locked-in syndrome is caused by occlusion of which artery?

Back 24

Basilar artery
(reduces flow of paramedian and short circumferential arteries BILATERALLY)

Front 25

Which movements/sensations are still intact in locked-in syndrome?

Back 25

Vertical eye movements
Sensation is intact, and the patient is conscious, but unresponsive to stimuli except for eye movments

Front 26

Bilateral paralysis of body and facial muscles are signs of which syndrome?

Back 26

Locked-in syndrome

Front 27

Branches of which 3 major arteries supply the midbrain?

Back 27

1. Basilar
2. Posterior cerebral
3. Internal carotid

Front 28

List 7 arteries that supply the midbrain

Back 28

1. Superior cerebellar
2. Posterior cerebral
3. Posterior communicating
4. Quadrdigeminal
5. Medial posterior choroidal
6. Thalamogeniculate
7. Anterior choroidal

Front 29

Which 2 arteries perfuse the ventromedial portion of the midbrain throughout its extent?

Back 29

1. Posterior cerebral artery
2. Posterior communicating artery

Front 30

Which 2 arteries supply the dorsal portion of the midbrain at the level of the inferior colliculus?

Back 30

1. Superior cerebellar
2. Quadrigeminal

Front 31

Which 2 arteries supply the dorsal portion of the midbrain at the level of the superior colliculus?

Back 31

1. Medial posterior choroidal
2. Quadrigeminal

Front 32

At the junction of the midbrain and thalamus, which artery supplies the most lateral portions of the midbrain?

Back 32

Thalamogeniculate artery

Front 33

Considering the pattern of arterial supply, the midbrain can be divided into which 3 zones?

Back 33

1. Ventromedial
2. Ventrolateral
3. Dorsal

Front 34

Considering the pattern of arterial supply, the pons can be divided into which 3 vascular zones?

Back 34

1. Medial
2. Ventrolateral
3. Dorsolateral

Front 35

Considering the pattern of blood supply, the medulla can be divided into which 3 zones?

Back 35

1. Ventromedial
2. Ventrolateral
3. Dorsolateral

Front 36

The quadrigeminal artery is a branch of which artery?

Back 36

Posterior cerebral artery

Front 37

Medial midbrain (Weber) syndrome is due to a problem with which artery?

Back 37

Posterior cerebral artery
(paramedian branches of the P1 segment)

Front 38

Which syndrome results in the following signs?
Contralateral weakness of body
Ipsilateral oculomotor paralysis and pupillary dilation

Back 38

Medial midbrain (Weber) syndrome

Front 39

Claude syndrome (midbrain tegmentum lesion) is due to a problem with which artery?

Back 39

Posterior cerebral artery
(paramedian branches of the P1 segment)

Front 40

Which syndrome may present with the following signs?
Ipsilateral oculomotor paralysis and pupillary dilation
Contralateral ataxia and cerebellar signs
Contralateral reduction in discriminative touch/position

Back 40

Claude syndrome (midbrain tegmentum lesion)

Front 41

Medial midbrain syndrome is also known as?

Back 41

Weber syndrome

Front 42

Benedikt syndrome is a combination of which syndromes?

Back 42

Weber and Claude syndromes
(both are due to problems with the paramedian branches of the posterior cerebral artery)

Front 43

Which syndrome is defined as deficit in vertical gaze?
Are problems with upward gaze or downward gaze more common?

Back 43

Parinaud's syndrome
*Upward gaze more commonly affected

Front 44

What usually causes Parinaud's syndrome?

Back 44

Pineal tumor which damages the posterior commissure and surrounding regions

Front 45

The arterial system to the brain can be divided into which two systems?

Back 45

1. Internal carotid system
2. Vertebrobasilar system

Front 46

What is the first major branch of the internal carotid artery once it enters the subarachnoid space?

Back 46

Ophthalmic artery

Front 47

Which portions of the cerebral cortex are supplied by the anterior cerebral arteries?

Back 47

1. Anterior and superior portions of the medial cortex
2. Superior part of lateral hemisphere (including paracentral gyri)

Front 48

The primary sensory and motor cortices are supplied by which artery?

Back 48

Anterior cerebral artery

Front 49

What are the first (and very important) branches of the middle cerebral artery?
Which structures do they supply?

Back 49

Lenticulostriate arteries
*Supply internal capsule and basal ganglia

Front 50

Describe the portions of the cerebral cortex supplied by the superior and inferior divisions of the middle cerebral artery

Back 50

Superior division:
1. Frontal lobe
2. Superior 1/2 of parietal lobe

Inferior division:
1. Inferior 1/2 of parietal lobe
2. Part of the temporal lobe

Front 51

The posterior cerebral artery perfuses which portions of the brain?

Back 51

1. Medial temporal lobe
2. Occipital lobe
3. Part of midbrain and thalamus

Front 52

Describe the affects of occlusions to the anterior cerebral artery and middle cerebral artery on arm and leg paralysis.

Back 52

Anterior cerebral --> leg paralysis
Middle cerebral --> arm paralysis

Front 53

"Man in the barrel syndrome" can occur with a border zone infarction involving the territories of which arteries?

Back 53

Anterior and middle cerebral arteries

Front 54

Border zone infarctions involving the territories of the middle and posterior cerebral arteries commonly produce what kind of deficits?

Back 54

Visual deficits

Front 55

Describe, in general, the areas of the brain supplied by the internal carotid system and verebrobasilar system

Back 55

Internal carotid system --> cortex and internal capsule

Vertebrobasilar system --> brainstem, cerebellum, and occipital lobe

Front 56

List 5 deficits that result from damage to the internal carotid system

Back 56

1. Hemiparesis (contralateral body + face)
2. Hemisensory loss (contralateral body + face)
3. Homonymous hemianopia
4. Monocular vision loss
5. Aphasia or aprosodia

Front 57

Describe the different causes of hemianopsia with damage to the internal carotid and vertebrobasilar systems

Back 57

Hemianopsia with damage to ICA system is due to damage to lateral geniculate nucleus or optic radiation

Hemianopsia from vertebrobasilar system damage is due to damage to the occipital cortex or terminal parts of optic radiation

Front 58

What is the difference between hemiparesis and hemisensory loss that develops from damage to the internal carotid system and the vertebrobasilar system?

Back 58

ICA --> contralateral hemiparesis hemisensory loss to body AND face

Vertebrobasilar --> contralateral hemiparesis/hemisensory loss to BODY, ipsilateral to FACE

Front 59

List 5 deficits that result from damage to the vertebrobasilar system

Back 59

1. Hemiparesis (contralateral body, ipsilateral face)
2. Hemisensory loss (contralateral body, ipsilateral face)
3. Diplopia or homonymous hemianopia
4. Dysphagia/ dysarthria
5. Dysequeilibrium

Front 60

The cavernous sinus receives blood from which vein?

Back 60

Superficial middle cerebral vein

Front 61

The cavernous sinus drains into which two sinuses?

Back 61

Superior and inferior petrosal sinuses

Front 62

What are cisterns?
What do they contain?

Back 62

Enlargements of subarachnoid space

Contain:
1. CSF
2. Arteries
3. Veins
4. Cranial nerves