COSI 305 Exam 2: Blood Supply

What do the vertebral arteries go on to create?

The right and left vertebral arteries unite at the pontomedullary junction to form the basilar artery

• main pairs of arteries that are for our posterior system

• supplies about 20% of the blood supply to the circle of Willis

What are the three things the basilar artery branches off into?

1. Anterior Inferior Cerebral arteries

2. Pontine Arteries

3. Larbarynthine Arteries

Discuss the Anterior Inferior Cerebellar Arteries (AICA)

• Right and Left branches

• Deliver blood to the ANTERIOR INFERIOR CEREBELLUM

Discuss the pontine arteries.

• Right and Left branches inferior to the pons

• Deliver blood to the PONS

What is the largest artery that the basilar artery branches off into?

Basilar artery breaks into two bigger branches –

Superior Cerebellar Artery (paired)

Discuss the labyrinthine arteries.

• Right and Left branches

• Deliver blood to the INNER EAR

Discuss the superior cerebellar artery

Arises from the distal part of the basilar artery

Delivers blood to the superior cerebellum and the midbrain

Discuss the posterior cerebral artery.

• Terminal branch of the basilar artery

• Supplies the posterior cerebrum

  • midbrain, occipital lobe, temporal lobe, thalamus

• Can be broken into two segments

  • a) P1 segment

    • Part of the Circle of Willis

  • b) P2 segment

Discuss the posterior communicating arteries.

• From the posterior cerebral artery

• Connects the internal carotid artery and posterior cerebral artery

• NOT delivering blood directly to any structures

Discuss the middle cerebral artery

• Lateral terminal branch of the internal carotid found at the point of connection between the anterior cerebral and internal carotid arteries

• Delivers blood to PRIMARY MOTOR CORTEX, BROCA AND WERNICKE’S AREAS

Discuss the anterior cerebral arteries

• Branches of the internal carotid artery

Discuss the anterior communicating artery.

• No left and right

• A short vessel which connects the two anterior cerebral arteries

what does the external carotid supply?

muscles of the face and head

What comes off the left common carotid?

• External Carotid Artery

  • superior thyroid artery

  • lingual artery

  • maxillary artery

  • facial artery

  • occipital artery

  • superficial temporal artery

• Internal Carotid Artery

  • middle cerebral artery

  • anterior cerebral artery

  • posterior communicating artery

  • ophthalmic artery

What arises from the ascending aorta?

aortic arch (left subclavian system)

what two things are created from the aortic arch?

left common carotid artery and the brachiocephalic artery

what does the left common carotid create?

external and internal carotid arteries

what two arteries arise from the brachiocephalic artery?

• right common carotid

• right subclavian artery

What arises from the right subclavian artery?

• vertebral branches

• basilar artery

• posterior communicating artery

• circle of willis

What would a lesion to the Anterior Spinal Artery lead to?

• medial medullary syndrome

  • CN XII ipsilateral palsy

    • same side of lesion will have tongue palsy

  • Cortico Spinal Tract

    • contralateral hemiplegia → loss of control of voluntary motor movement on opposite side

  • Medial Lemniscus → contralateral loss of touch pressure and proprioception

What would a lesion to posterior spinal artery lead to?

• supplies the posterior spinal cord

• CVA would result in issues of proprioception and vibration below the lesion

• Can result in a positive romberg sign

  • they dont have adequate balance

What would a lesion to PICA lead to?

• PICA supplies the cerebellum

• CVA here can cause ataxia

• cerebellum gives feedback to our cortex to know if movement are correct

  • stroke prevents cerebellum from giving that feedback

• Ataxia looks like someone is drunk → stumbling, slurring of speech → lack of coordination

  • balance and coordination problems

• CN X Palsy can also occur

  • results in dysphagia (swallowing disorder)

  • negative gag reflex

• Horners Syndrome

  • sympathetic fibers of the eye are not working as they should

  • pupil constriction, no sweating (no body temp regulation), ptosis (drooping of eyelid)

What would a lesion to AICA lead to?

• lateral pontine syndrome

  • issue with the lateral pons

  • impacts CN VII → cranial nerve VII palsy (paralysis of facial muscles)

  • vertigo and dizziness → bc the AICA is still close to the cerebellum so if there is involvement and an infarct that impacts the cerebellum and its connection to some of the CNs, you can see symptoms like this

  • ataxia

  • deafness bc of cerebellar and vestibular involvement

What would a stroke to the basilar artery lead to?

• CVA can result in locked in syndrome

  • quadriplegia (all four limbs paralyzed)

  • preserved vertical eye movement (can look up)

  • these people are alert and conscious → know what they want to do but cant do it

  • aware of what is going on around them but can not talk or move

• basilar artery is the connection between anterior and posterior systems

What would a stroke to the labyrinthine artery lead to?

• supplies inner ear → vestibular system

• CVA would result in a hearing deficit, vertigo, tinitus

What would a stroke to the pontine arteries lead to?

• affects the pons and the CNs associated with the pons

• a pontine stroke can result in dyspahgia

What would a stroke to the superior cerebellar artery lead to?

• supplies the superior portion of the cerebellum and midbrain

• CVA can result in ataxia, dysarthria

• cerebellar cognitive affective syndrome (person appears like they have a cognitive deficit bc they are not receiving feedback from cerebellum → damage impacting feedback to frontal lobe)

• double vision → CNs impacts in this artery

• difficulty regulating breathing and heart rate

What would a stroke to the posterior cerebral artery lead to?

• supplies the occipital lobe

• results in the loss of temporal and nasal field

What would a stroke to the lenticulostriate arteries lead to?

• tiny branches that come off middle cerebral artery

• responsible for sending blood supply to basal ganglia and internal capsule

• problems here result in motor initiation difficulty

What does the posterior communicating artery do?

• connects the anterior and posterior systems

  
  

What would a stroke to the anterior choroidal artery lead to?

• feed blood to limbic system and choroid plexus

• CVA can result in CSF not being produced in the way it should be

What would a stroke to the ophthalmic artery lead to?

• vision and eye movement

• CVA results in problems with vision and eye movement

What would a stroke to the middle cerebral artery lead to?

• most important for speech therapy and aphasia!!!!

• there are a couple divisions of the MCA

  • Ophthalmic, choroidal, lenticulostriate

• supplies the lateral surface of the frontal and parietal lobes

  • impacts sensory and motor of face, hand, and arm

• supplies parts of the temporal love

  • includes wernickes

• Supplies some of the basal ganglia

  • bc of the lenticulostriate arteries → motor control

• CVA → aphasias, contralateral motor and sensory of face, arm, and hand

  • lesion to the artery in right hemisphere can lead to neglect

    • very common → do not recognize left side of visual field → perception is off → might only wheel one wheel, only eat one side of their plate, only clothe one side → do not pay attention to left side

    
    

What would a stroke to the anterior cerebral artery lead to?

• the medial and superior parts of the frontal and parietal lobes

• CVA leads to motor and sensory deficits on contralateral lower extremities

• Urinary Incontinance → area in the median frontal lobe that is responsible for control of bladder → if impacted it can result in this

• Cognitive and Personality Changes → apathy, lack of initiative, changes in personality, probs with executive function

• If bilateral ACA stroke, alien hand syndrome may occur → no voluntary control of hand movement

• Produce Aconnetic Mutism

  • lack the initiative to talk → can talk but no initiative to do so

What would a stroke to the anterior communicating artery lead to?

• Berry Aneurysms → caused by chronic hypertension

  • happen 40% of the time in this artery → MCA makes up 34%

  • can also be caused by connective tissue disorders → break down vessel walls and cause them to balloon out into aneurysms

What artery is labeled A?

Anterior Communicating Artery

What artery is labeled B?

Middle Cerebral Artery

What artery is labeled C?

Anterior Choroidal Artery

What artery is labeled D?

Posterior Cerebral Artery

What artery is labeled E?

Basilar Artery

What artery is labeled F?

Labyrinthine Artery

What artery is labeled G?

Anterior Inferior Cerebellar Artery (AICA)

What artery is labeled H?

Posterior Inferior Cerebellar Artery (PICA)

What artery is labeled I?

Posterior Spinal Artery

What artery is labeled J?

Vertebral Arteries

What artery is labeled K?

Anterior Spinal Artery

What artery is labeled L?

Pontine Arteries

What artery is labeled M?

Superior Cerebellar Arteries

What artery is labeled N?

Posterior Communicating Arteries

What artery is labeled O?

Lenticulo-striate arteries

What artery is labeled P?

Ophthalmic Artery

What artery is labeled Q?

Anterior Cerebral Artery