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43 Cards in this Set
- Front
- Back
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What is the penumbra? |
An area of low cerebral blood flow surrounding the core of ischemic damage that can be preserved if blood flow is restored in a timely manner or collateral circulation is adequate |
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Which major blood vessels arise from the aortic arch? |
Brachiocephalic (innominate), left common carotid, and left subclavian artery; an anatomic variant is the bovine arch, in which there are 2 brachiocephalic arteries |
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Where do the common carotid arteries bifurcate? |
At approximately the cervical vertebral level 3 or 4 |
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What are the main branches of the intracranial carotid artery? (3) |
Ophthalmic, posterior communicating, and anterior choroidal artery (in order of occurrence) |
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The internal carotid artery bifurcates into? |
Anterior cerebral artery (ACA) and middle cerebral artery (MCA) |
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The recurrent artery of Heubner arises from which artery? |
Anterior cerebral artery (ACA); typically A2 or distal A1 |
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The recurrent artery of Heubner supplies which structures? |
Part of the head of caudate nucleus; can result in serious cognitive dysfunction because of the interconnections of the caudate head and frontal lobe |
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Name of a perforating branch that arise from M1? |
Lateral lenticulostriates; supply the basal ganglia and internal capsule |
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Percentage of population that have a full circle of Willis? |
30% to 35%; oftentimes, an A1 ACA (carotid terminus to anterior communicating segment), posterior communicating segment , or P1 (basilar terminus to posterior communicating segment) posterior cerebral artery (PCA) segment is missing |
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The vertebral arteries arise from? |
Their respective subclavian arteries |
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Where is the basilar artery formed? |
Pontomedullary junction |
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Where do the vertebral arteries enter the skull? |
Foramen magnum |
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Which arteries form the basilar artery? |
The vertebral arteries |
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Where does the basilar artery split and form the two PCAs? |
Interpeduncular fossa |
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Which arteries supply the pons? |
Median and paramedian perforating branches of the PCA |
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Anterior spinal artery supplies? |
Midline medulla, including pyramids, and caudally to ventrolateral spinal cord |
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Posterior spinal artery supplies? |
A portion of lateral medulla and caudally to posterior funiculus of spinal cord |
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Posterior inferior cerebellar artery supplies? |
Lateral medulla, inferior aspect of cerebellum |
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Striatium is supplied by? |
Lateral striate branches (MCA) |
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Head of caudate is supplied by? |
Recurrent artery of Heubner (ACA) |
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Head of caudate, anteriomedial portion is supplied by? |
Anterior choroidal artery |
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Lateral globus pallidus is supplied by? |
Lateral striate branches (MCA) and anterior choroidal |
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Medial globus pallidus is supplied by? |
Anterior choroidal and perforating branches (PCOM) |
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Internal capsule anterior limb is supplied by? |
Lateral striate branches (MCA) and medial striates (ACA) |
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Internal capsule genu is supplied by? |
Internal carotid artery branches and lateral striate branches (MCA) |
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Internal capsule posterior limb is supplied by? |
Lateral striate branches (MCA) and anterior choroidal |
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Anterior thalamus is supplied by? |
Anterior thalamoperforating branches (PCOM) |
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Medial thalamus is supplied by? |
Posterior thalamoperforating branches from P1 segment PCA and tip of basilar + posterior choroidal |
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Lateral thalamus is supplied by? |
Thalamogeniculate from P2 segment of PCA |
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Strokes due to hypoperfusion often result in lesions where? |
ACA-MCA or MCA-PCA borderzone infarctions |
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What is the artery of Adamkiewicz? |
A large, anterior, radicular artery at the level of T12, L1, or L2, a major source of blood to the lower thoracic and upper lumbar cord |
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Which nerves travel through the cavernous sinus? |
III, IV, VI + V1, V2 |
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Blood supply to the spinal cord emerges from? |
The anterior and posterior spinal arteries, which are branches of the vertebral artery |
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Which segments of the spinal cord are known as the watershed zone of the spinal cord? |
The thoracic and lumbar segments have fewer (2-4 arteries) that contribute to blood supply, making these segments a region more vulnerable to ischemia |
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What makes up the blood-brain-barrier? |
Capillaries that are nonfenestrated, joined through tight junctions. Surrounding the endothelium is a basement membrane and a layer of astrocytic foot processes |
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Normal cerebral blood flow in humans is approximately? |
50 to 60 mL/100g/minute |
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When blood flow decreases to ___ to ___, neuronal dysfunction occurs |
20; 40 mL/100g tissue/minute |
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Irreversible tissue damage occurs when the blood flow decreases to? |
Less than 10 to 15 mL/100g tissue/minute |
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In addition to lack of glucose and oxygen to the tissue, other mechanisms can contribute to cell death. Explain the role of glutamate |
Excess Glu release and impaired reuptake during ischemia result in elevations of calcium levels in the cytosol. Increased calcium in the cytosol then triggers release of proteases, lipases, endonucleases, and cytokines, which result in neuronal cell death |
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Time period that is considered the acute phase of an ischemic infarction |
1 day - 1 week; edema in the affected area. Microscopically, eosinophilic pyknotic neurons and neuropil vacuolation occur |
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How soon after an ischemic infarction is the inflammatory reaction seen? |
Within 1 to 3 days, followed by a mononuclear cell influx by 3-5 days |
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What is considered the subacute phase of an ischemic infarction? |
1 week - 1 month; shows tissue destruction and liquefactive necrosis |
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Where is atherosclerosis most common? |
At arterial bifurcations, such as the branch point of the internal and external carotid arteries |
