Cerebral Arteries

Front 1

Which artery supplies the Pons?

Back 1

Branches from the Basilar artery supply the pons. Describe Cushing's triad (Cushings Reflex)

Hint 1

If mean arterial pressure is less than intracranial pressure as is the case with increased pressure from hemorrhage in brain, the hypothalamus kicks in. In emergency medicine people look out for these symptoms: hypothalamus increases sympathetic drive causing vasoconstriction and increased contractility to right the pressure difference. The carotid body senses the pressure change and trys to compensate via the vagus. This causes bradycardia. The intracranial pressure causing all of this pushes like a tonsilar hernia and affects the medulla, the result is irregular breathing. Look for wide pulse pressure.

Front 2

The Basilar Artery, at the center of things, is supplied by which two arteries?

Back 2

The basilar is made up of the left and right vertebrals from the left subclavian and brachiocephalic respectively.
* Remember BCS bowl game

Front 3

The anterior communicating connects which two arteries in the circle?

Back 3

Anteriocebral branches from the internal carotid

Front 4

The posterior communicating artery of the circle of Willis connects which two arteries?

Back 4

Internal carotid and posterior cerebral.

It's easy the anterior connects the anteriors. the posterior connects posterior to internal carotid.

Front 5

Deep Branches of what artery supply the Putamen?

Back 5

The Deep branches of the MCA supply the Putamen.

Front 6

The head of the caudate is supplied by deep branches of what artery?

Back 6

ACA deep branches supply the head of the caudate. notice the anatomy. caud-put-thal with the capsule seperating the thal and put

Front 7

The lenticulostriate arteries supply which structures?

Back 7

Putamen and Caudate. LS arteries are deep MCA branches

Front 8

MCA or ACA: I supply the anterior temporal lobe

Back 8

MCA

Front 9

MCA or ACA: I supply the medial aspects of the parietal lobe and frontal.

Back 9

ACA

by medial I mean close to the Great hemispheric sulcus so supperior on sagital view.

Front 10

The genticulate formation of the hippo and the internal capsule are supplied by this artery

Back 10

Anterior Choroidal, don't sleep! on it.

Front 11

WATER SHED CLOCK:

on coronal section the major water sheds are at 4:05 and 7:55 and represent which arteries?

Back 11

The hour hands are on the MCA-PCA. the Minute hands are on the ACA-MCA

Front 12

WATER SHED CLOCK TIME:
On axial section
5:05
6:55

Back 12

Hours MCA-PCA
Min ACA MCA

Note this informs the area supplied by the ACA goes to the midline and so does the PCA's.

Front 13

The posterior circulation is supplied by what arteries?

Back 13

Vetebrobasilar. they come up through the foramina on the transverse processes of the verterbrae

Front 14

What is the leading cause of hemorrhagic stroke?

Back 14

Subarachnoid Hemorrhage

From what?

Hint 14

Berry Aneurysm.

Recall the branch points of the posterior circulation are most often affected.

Front 15

Where do most Berry Aneurysms arise?

Back 15

Anterior Circulation branch points: Anterior and posterior Communicators. The latter at the junction of the PCA and IC.

Which CN are most often compressed?

Hint 15

CN II and CN III

Front 16

I most commonly occur on a hemisphere and can cause bleeding.

Back 16

AVMs. Atrioventricular malformations.

What are AVMs?

Hint 16

Nests of directly connected veins and arteries without intervening capilaries.

Front 17

Watch out for this cause of stroke which originates in the walls of large arteries at branch points.

Back 17

Thrombus.

Front 18

Anterior Circulation and Posterior Circulation Thrombus result in CONTRALATERAL upper limb, Lower limb or face weakness or sensory loss.

Which circulation is associated with apraxia?

Back 18

Anterior.
also aphasia and agnosia

Front 19

Anterior Circulation and Posterior Circulation Thrombus result in CONTRALATERAL upper limb, Lower limb or face weakness or sensory loss.

Which circulation is associated with ataxia and hemianopsia

Back 19

Posterior:
think cerebellum. also the majority of the cranial nerve deficits will be seen in this circulation.

Front 20

Who is at risk for lacunar infarcts?

Back 20

Diabetics! weakening of deep branches

Front 21

Man in a barrel distribution? what is this

Back 21

Weakness/Anesthesia in arm and shoulder

Anesthesia in trunk

Weakness/Anesthesia in legs

Why?

Hint 21

This is usually from a massive internal carotid stroke. MCA causes arm trunk problems. ACA causes leg problems

Front 22

Doctor, my symptoms started with this dark shade comming down over my left eye. then i couldn't see! What is this

Back 22

The shade was lowered for love...Amore...Amaurosis fugax. This is caused by TIA or loss of blood flow to the retina.

Hint 22

TIA or no flow to retina.

Front 23

In all areas of the spinal cord, this circulation is constant. Where is it not?

Back 23

The anterior spinal artery is constant. aorta is responsible for most others.

The Lumbar and Sacrum is from a radicular artery: of Adamkiewicz

Front 24

In all areas of the spinal cord, this circulation is constant. Where is it not?

Back 24

The anterior spinal artery is constant. aorta is responsible for most others.

The Lumbar and Sacrum is from a radicular artery: of Adamkiewicz

Front 25

These layers TDG are analogous to which layers of the CNS?

Back 25

DAP. gimmee some dap boyeee. Elevations in Ig in the CSF imply what?

Hint 25

Auto immune process...Think Muscular Sclerosis before you think about anything else.

Front 26

An issue where the eye on one side is affected but the body on the other side is

Back 26

Central. Kernohan's phenomenon happens when hematomas causes a herniation which compresses things around the tentoral notch.

Front 27

What is the organum vasculom?

Back 27

It is a circumventricular organ of the 3rd ventricle. It monitors the osmolarity and along with the Subfornical organ of the 3rd ventricle influences angiotensin ii and vasopressin.

Front 28

What is the area postrema

Back 28

it sits at the end of the 4th ventricle and samples for things that should cause vomiting vis CTZ.

Front 29

3rd CVO
4th CVO

Back 29

Organum vasculum and Subfornicate: BP

Area postrema: CTZ

Front 30

I link the 3rd and 4th ventricles

Back 30

Cerebral Aqueduct
or The Sylvian duct. Besides the ventricles, where is the CSF? How can the brain be 'bathed' if it is just the ventricles?

Hint 30

Subarachnoid space!

Front 31

There are subarachnoid villi up into the ventricles, but there are only two places where the subarac and CSF communicate.

Back 31

Both are in the 4th ventricle

Megendie and Luschka

Front 32

400-500 ml of CSF is made per day, but the ventricles only contain 25ml. Where does the rest go?

Back 32

Arachnoid Granulations. that poke up like polys into the superior venous sinus. thus the venous circulation is the final destination.

Front 33

Both normal pressure and communicating hydrocephalus is caused by what?

Back 33

Mal absoprtion: Failure of the Arachnoied Granulations

Hint 33

70% of the CSF is secreted by the choroid plexus and 30% is metabolic waste discharged by the CNS.

Front 34

Where do CSF obstructions occur?

Back 34

Babes: Sylvius
Everybody else: Lushka Magendie, and Monro
Babies with hydrocephalus have these three Ws

Hint 34

Wacky, wet, wobbly

Front 35

Anrnold Chiari herniation appears with this

Back 35

Syringomyleia. these are cysts that form in the spinal cord.

Front 36

Dandy-Walker. how to think about it

Back 36

Fourth ventricle gets so big that it obliterates the vermis.

Front 37

Arnold Chiari is a congenital herniation of what?

Back 37

Cerebellar tonsils the foramen magnum. or a vermis herniation. It is associated with syringomyelia.

Front 38

What does coarctation mean?

Back 38

Narrowing as in the aorta. Check femoral pulse

Front 39

Why does a subdural ematoma look like crescent?

Back 39

Shearing forces severe bridging veins at low pressure. Unlike in the epidural where there are adhesions between the dura and the skull, the subdural can spread it self out more.

Front 40

Why does a epidural hematoma look like a lense or a finger pushing in on the brain?

Back 40

The dura has adhesions to the calvaria and the blood is high pressure arterial blood.

Front 41

Signs of brain hernia.

Back 41

dilated pupil from III issues. hemiperisis.
Tosilar hernias compress the medulla and its breathing centers causing death.
Subfalcine happens in such a way as the ACA is compromised, making things worse.

Front 42

These two circumventricular organs are secretory

Back 42

The median eminence (makes the vasopressin that the Neurohypophysis secretes)

The pineal gland (melatonin, seratonin, chocytikinin)