Neuro - Circulatory System Mod 4

Front 1

Carotid system – responsible for ___ of the blood supply to the ______ and the __________

Back 1

80%
diencephalon
telencephalon

Front 2

Common carotid splits into?

Back 2

internal and external carotid

Front 3

External supplies blood to the ?

Back 3

facial muscles, forehead, oral, nasal and orbital cavities

Front 4

Internal supplies blood to the ?

Back 4

brain, interfaces with the Circle of the Willis and then branches further into the (3):

Front 5

Internal branches into (3)?

Back 5

Anterior Cerebral Artery
Posterior Cerebral Artery
Middle Cerebral Artery

Front 6

1. Anterior Cerebral Artery (ACA) – provides blood supply to the medial portion of the ____ and _____lobes and 80% of the ____ ____. Connected to the other portions by the _______ _______ _______

Back 6

frontal, parietal
corpus callosum
anterior communicating artery

Front 7

2. MCA (middle cerebral artery) - provides blood supply to the ?

Back 7

lateral surface of the cerebral hemispheres, including language areas, basil ganglia, sensory motor and pre-motor areas, runs along the lateral sulcus.

Front 8

MCA - Most common affected by:

Back 8

stroke or CVA –aphasia/hemiparesis

Front 9

Water Shed Areas ?

Back 9

overlapping coverage of blood supply to the brain; safety mechanism

Front 10

The PCA is part of the

Back 10

Basilar System

Front 11

PCA (posterior communicating artery) - provides blood supply to the

Back 11

occipital and temporal lobes; comes off the basilar artery,

Front 12

most often an emboli from the heart comes through this pathway and may damage the thalamus

Back 12

PCA

Front 13

The PCA comes off the

Back 13

basilar artery,

Front 14

Blood Brain Barrier (BBB) Functions

Back 14

Physical barrier
Maintains homeostasis

Front 15

what can penetrate the BBB?

Back 15

Lipids (ethanol and caffeine) penetrate the barrier

Front 16

What can't penetrate the BBB?

Back 16

Water soluable (Na and K) difficult to penetrate

Front 17

Radiologic Imaging -4

Back 17

Xrays
– Cerebral angiography( inject dye, look for stenosis/blockage)
– Mylelograms
– Computerized tomography (CT scan),

Front 18

Non-radiologic Imaging Studies -2

Back 18

MRI
fMRI

Front 19

• Electrophysiological Studies - 2

Back 19

– Electroencephalogram (EEG) brain, electrodes detect electrical activity, indirect method
– Electrocardiogram (EKG) heart, records electrical activity of the heart

Front 20

• Tissue/Fluid Analysis

Back 20

– Lumbar puncture (CSF)
– biopsies

Front 21

Ischemic CVA (2 types)

Back 21

thrombotic and embolic

Front 22

Thrombosis is?
accounts for % of CVAs
slow or fast?
normal location?

Back 22

– 60% of Ischemic CVAs
– Stationary blockage associated with arteriosclerotic cardiovascular disease, usually larger vessels
– Insidious (slow) onset c/b tias, dizziness, blurred vision, tingling in extremities
- plaque blockage normally is located bifurcation of the internal and external carotid

Front 23

70% Blockage, critical, _____ occurs

Back 23

hypoxia

Front 24

90% Blockage, critical, _____ occurs

Back 24

anoxia

Front 25

• Embolism
accounts for % of CVAs
slow or fast?
normal location?

Back 25

– 20% of ischemic cvas
– Blockage from foreign matter migration into smaller vessels
– Abrupt onset
- usually Cardiogenic origin *comes from the heart

Front 26

transient ischemic attack ?

Back 26

(TIA) is an episode in which a person has stroke -like symptoms for up to 1-2 hours

Front 27

Effects of Ischemic Stroke

Back 27

– Neuron necrosis (blood deprivation), since the neurons require constant nourishment
– Edema with potential increased ICP
– Absence of neurotransmitters
- Swelling, can cause further damage, perhaps death
– Diaschisis- is a sudden loss of function in a portion of the brain connected to but at a distance of a damaged area

Front 28

Hemorrhagic CVA
accounts for % of CVAs
slow or fast?
normal location?

Back 28

rupture of a blood pressure, causing displacement, pressure of the brain
– 20% of all CVAs
– Types and causes
• Extra or intra -cerebral classification
• Abrupt or insidious onset possible

Front 29

Vertebral basilar system – responsible for __% of the blood supply to the ?

Back 29

20

brain stem, cerebellum, spinal cord, and the occipital and temporal lobes (posterior inferior areas of the brain).

Front 30

Venous System ?? works how? drains?

Back 30

– valveless, works on gravity. The small internal veins in the brain drain into larger veinous sinuses with in the dura mater. Drains into the right and left jugular vein, then into the lungs to be re-oxygenated.

Front 31

venous system functions: (2)

Back 31

• Maintains pressure
• Reabsorption of csf

Front 32

What has a Wreath shaped structure

Back 32

COW

Front 33

COW - Wreath shaped structure benefits

Back 33

benefits:
• allows equalization of blood pressure that enters the brain;
• Equalizes the distribution of the blood flow (similar to a traffic circle)

Front 34

Ischemic Recovery Factors

Back 34

– Neuro stabilization in first 2 wks
– Function and recovery greatest in first 4 wks
– Lang recovery greatest in first 3 months
– Neuro recovery up to 6 mos post onset

Front 35

Factors involved in stroke recovery

Back 35

• Insult Issues
– Location of infarct
– Size of infarct (diffuse = large, focal = small)
– Diaschisis – amount, less is better
– Secondary factors
• Patient Issues
– Age
– Handedness (right vs. left)
– Hemispheric dominance
– Pre-morbid status

Front 36

dTI

Back 36

white matter

Front 37

fMRI

Back 37

blood/oxygen level
more oxygen - more activity

Front 38

MEG

Back 38

Magnetoencephalography
newer MRI

Front 39

PET

Back 39

advantages between healthy and ill (cancerous) tissue (rainbow glow pic)