Neuro Exam 1 - Lecture 3

Front 1

Autoregulation

Back 1

The process by which blood flow through arteries in the CNS is kept constant

Front 2

Supplied by the anterior choroidal artery

Back 2

Blood supply to the Optic Tract and parts of the Internal Capsule

Front 3

a. What is the origin of the Recurrent Artery of Heubner?

b. What is supplied by the Recurrent Artery of Heubner?

c. What does the Anterior Cerebral Artery give rise to?

d. What does the Anterior Cerebral Artery supply?

Back 3

a. Anterior Cerebral Artery

b. Parts of the Corpus Striatum and Internal Capsule

c. Recurrent Artery of Heubner and Anterior Communicating Artery

d. Medial and superior surfaces of the frontal and parietal lobes. Corpus striatum and Internal Capsule

Front 4

a. What does the middle cerebral artery supply?

b. What functions are dependent on this blood supply?

Back 4

a. Lateral surface of the frontal, parietal, and temporal lobes

b. Motor and Somesthetic areas for the face, trunk, upper limbs, and language areas, and the geniculocalcarine tract

Front 5

a. What is the blood supply to the spinal cord?

b. What is the largest branch of the vertebral artery?

c. Where does the Posterior Choroidal Artery branch off from?

d. What does the Posterior Choroidal Artery connect with and what does it supply?

Back 5

a. Branches of the vertebral and radicular arteries

b. Posterior inferior cerebellar artery (PICA)

c. Posterior Cerebral Artery

d. Posterior communicating artery and it supplies the occipital lobe, inferior surface of the temporal lobe, and parts of the hippocampal formation

Front 6

a. Where do the central arteries branch from?

b. What do the central arteries supply?

c. Where are common sources of subarachnoid hemorrhage?

d. Where do the superior cerebral veins drain into?

e. Where does blood from the inferior surfaces of the cortex and interior of the brain drain into?

Back 6

a. The 3 Cerebral Arteries

b. Internal structures of the Cerebral Hemisphere and Diencephalon

c. Sites of arterial bifurcation in and near the circle of Willis

d. Superior Sagittal Sinus

e. Great cerebral vein --> Straight Sinus

Front 7

a. How much of the body weight is the brain?

b. How much of the cardiac output does it receive?

c. What percentage of the oxygen consumption is by the brain?

d. How long can you be without cerebral circulation before becoming unconscious?

e. What is responsible for more neurological disorders than any other category of disease process?

Back 7

a. 2%

b. 17%

c. 20%

d. 10 seconds

e. Lesions of vascular origin

Front 8

a. Where do the blood streams of the Internal Carotid System and the Basilar System meet?

b. What will cause the blood to mix?

c. In the Circle of Willis, what amount of pressure is necessary to maintain sufficient circulation for no tissue death to occur following infarction?

d. When will a transient ischemic attack occur?

Back 8

a. In the posterior communicating arteries

b. A change in pressures caused by a blockage

c. 50% of normal

d. When an adjustment time is required before collateral circulation can reach a level that supports normal functioning

Front 9

a. What is the mechanism of the brain's autoregulation?

Back 9

a. Blood flow is to be maintained at a constant rate, so in higher pressure situations, the vessels contract to restrict flow. In low pressure situations, blood vessels relax to increase flow.

Front 10

a. What are the 3 main Vessels supplying the cerebrum?

b. What are the 2 main Vessels supplying the cerebellum?

c. What is a major cause of subarachnoid hemorrhage and what characterizes the cause?

Back 10

a. Anterior Cerebral, Middle Cerebral, Posterior Cerebral

b. Superior Cerbellar and 2 Inferior cerebellar arteries

c. Berry aneurysms - 30% of cases - Anterior Communicating Artery Aneurysm

Front 11

a. Between which blood vessels does the Occulomotor Nerve come out?

Back 11

a. Superior Cerebellar Artery and Posterior Cerebral Artery

Front 12

a. How many mL per 1000g of brain weight does the brain get per minute?

b. How many mL of blood does the brain get per minute and how much oxygen does the brain consume in one minute?

c. How many mL of oxygen are used by the entire brain in one minute?

d. Does the oxygen consumption rate of the brain ever change?

Back 12

a. 54mL/1000g

b. 740mL blood circulation and 3.3mLO2/1000g brain tissue consumed

c. 4.6 mL

d. No

Front 13

a. What is the artery path from the heart to the brain?

b. What does the external carotid artery supply?

c. Can blockage of the external carotid artery cause a stroke?

d. What is the path of the internal carotid artery?

e. How can plaque buildups in the Internal Carotids be detected?

Back 13

a. Aorta --> Subclavian Arteries --> Common Carotid and Vertebral --> Internal and External Carotid

b. The face

c. No. It does not supply any blood to the brain

d1. Ascends along one side of the neck, pass behind the ear and into the temporal lobe, and enter the subarachnoid space.
d2. Then they run posteriorly to the medial end of the fissure of Sylvius, where they bifurcate into 2 main branches (anterior cerebral artery and middle cerebral artery)

e. Sonogram (non-invasive) or Angiograms (invasive). A Bruit can also be heard with a stethoscope sometimes.

Front 14

a. What are the terminal branches of the Internal Carotid Artery?

b. Where does the Petrous Segment of the Internal Carotid travel?

c. Where does the Cavernous segment of the internal carotid run? What does it supply?

d. Where does the Supraclinoid Segment run? What are its branches?

e. What does the Ophthalmic Artery supply? What does it anastomose with? Occlusion of what can be taken care of by this anastomosis?

Back 14

a. Anterior Cerebral, Middle Cerebral, and Posterior Communicating Arteries

b. From the base of the skull to the apex of the petrous bone. Enters cranial vault via foramen lacerum

c. Through cavernous sinus w/ Abducens Nerve. Supplies posterior pituitary via Meningohypophyseal Artery

d. Begins after penetration of dura. Goes until bifurcation into Anterior and Middle Cerebral Arteries. Branches are Ophthalmic, Posterior Communicating, and Anterior Choroidal

e. Globe, Orbit, Frontal Scalp, Frontal and Ethmoidal sinuses. Anastomoses with Maxillary artery branches. Occlusion of proximal carotid.

Front 15

a. What is the last branch to originate from the Internal Carotid?

b. What is the path of the Cisternal Segment of this branch?

c. What is the path of the Plexal Segment of this branch?

Back 15

a. Anterior Choroidal Artery

b. (Pictured) Passes posterior to supply the Optic Tract, POSTERIOR LIMB OF INTERNAL CAPSULE, branches to midbrain, and lateral geniculate nucleus

c. Supplies Choroid plexus of anterior portion of temporal horn of lateral ventricles

Front 16

1.What are the terminal branches of the internal carotid?

2. Through which foramen does it enter the skull?

3. What is the course that it takes once it gets into the skull?

Back 16

1. Anterior cerebral artery and middle cerebral artery

2. Foramen Lacerum

3. Goes into the dura, arches back around, pierces the dura again, and supplies the orbit (Ophthalmic Artery)

Front 17

1. Where does the petrous segment of the internal carotid run?

2. Through which foramen does it enter the skull?

Back 17

1. Extends from base of skull to apex of petrous bone

2. Enters cranial vault via foramen lacerum.

Front 18

Where does the Cavernous sinus segment supply and what nerve does it run with?

Back 18

Runs with Abducens Nerve

Branch: Meningohypophyseal Artery - Supplies Posterior Pituitary

Front 19

1. What is the path of the anterior choroidal artery?

2. What does the anterior choroidal artery supply?

3. What artery does the anterior choroidal artery anastomose with and where?

Back 19

1. Passes back along the optic tract and the choroid fissure at the medial edge of the temporal lobe.

2a. Sends branches to the optic tract, uncus, amygdala, hippocampus, globus pallidus, lateral geniculate body, and ventral part of the internal capsule.
2b. Subthalamus, Ventral Thalamus, Rostral Midbrain, Choroid plexis in the temporal horn of the lateral ventricle.

3. At the lateral ventricle with the Posterior Choroidal Artery

Front 20

1. What does the posterior communicating artery connect?

2. What does it supply?

3. What is common occurrence at this site?

Back 20

1. Carotid system with Basilar system

2. Thalamus, Hypothalamus, Optic chiasm, and mamillary bodies

3. Aneurysms

Front 21

1. Where does the anterior cerebral artery run?

2. What are the 5 segments of the anterior cerebral artery?

Back 21

Above the Optic Chiasm to the medial surface of the cerebral hemispheres. Arches around the genu (horn) of the corpus collosum. (From internal carotid to the termination at the parieto-occipital sulcus)

Segment 1 – precommunicating segment
A2 – the infra callosal segment extends from the anterior communicating artery to the rostrum and genu of the corpus callosum
A3 – precallosal segment area around the corpus callosum
A4 – Supracallosal
A5 – post callosal
A4 and A5 are located superior to the corpus callosum and are separated by a line just caudal to the coronal sutures. A5 ends at the parietooccipital sulcus

Front 22

1. What does the anterior cerebral artery supply and what happens if it is damaged?

Back 22

1a. Medial Cortex - medial aspect of the motor strip and the sensory strip - Sensory and motor impairment in the lower body (incontinence or unilateral paralysis from the hip down)

1b. Supplies some parts of the frontal lobe and corpus striatum. - Blockage affects cognition and causes motor problems (Internal capsule and basal ganglia damage)

1c. Supplies most of the medial surface of the cerebral cortex (anterior three fourths), frontal pole (via cortical branches), and anterior portions of the corpus callosum.

Front 23

1. What are the perforating branches of the anterior cerebral artery and what do they supply?

Back 23

1. recurrent artery of Heubner and Medial Lenticulostriate Arteries - anterior limb of the internal capsule, the inferior portions of head of the caudate and anterior globus pallidus.

Front 24

What are the 4 branches of the anterior cerebral artery?

Back 24

1. A1 segment
2. Anterior communication artery
3. Recurrent artery of Heubner
4. Pericallosal artery

Front 25

What does the A1 Segment of the anterior cerebral artery supply and where does it run?

What is the bifurcation a common location for?

Back 25

From the internal carotid bifurcation to the anterior communicating artery, connecting both sides

Cerebral Aneurysms

Front 26

What does the Recurrent Artery of Heubner supply?

Back 26

Supplies the head of caudate and anterior inferior internal capsule

Front 27

What is the Pericollosal artery and what does it supply?

Back 27

Continuation of the anterior cerebral artery as it arches superiorly and posterior.
Supplies the medial surface of the cerebral hemispheres and corpus callosum

Front 28

1. Where does the middle cerebral artery deliver blood to and what is the function of those areas?

2. What happens if a patient has a blockage in the middle cerebral artery?

Back 28

1. The entire lateral aspect of each hemisphere. (Cortical areas involved in speech, swallowing, and language - Lateral motor strip, lateral sensory strip, Broca's area, Wernicke's area and Corpus striatum)

2. Aphasia, impaired cognition, corticohyposthesia (numbness) on the opposite side of the body. Hearing problems and sense of smell loss because of cut off supply to the temporal lobe

Front 29

Which is the largest of the two branches of the Internal Carotid Artery?

Back 29

70% of the time - Middle Cerebral

30% of the time - Anterior Cerebral

Front 30

Most common points for aneurysms

Back 30

1. Middle Cerebral
2. Middle Cerebral/Internal Carotid Junction
3. Anterior Communicating
4. Junction of Posterior Cerebral Artery Splitting from Basilar

Front 31

Where does a subhyaloid hemorrhage occur and what is the cause?

Back 31

In the eye. From a ruptured aneurysm in the middle cerebral artery