Podcast
Questions and Answers
Which artery is associated with the lower thoracic or upper lumbar region?
Which artery is associated with the lower thoracic or upper lumbar region?
At which junction is the basilar artery formed?
At which junction is the basilar artery formed?
Which artery directly communicates with the internal carotid artery (ICA)?
Which artery directly communicates with the internal carotid artery (ICA)?
Which set of arteries is NOT a branch of the basilar artery?
Which set of arteries is NOT a branch of the basilar artery?
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What is the role of the AICA in cerebral circulation?
What is the role of the AICA in cerebral circulation?
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What is the first anatomical part of the internal carotid artery as it travels through the carotid canal?
What is the first anatomical part of the internal carotid artery as it travels through the carotid canal?
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Which part of the internal carotid artery passes through the cavernous sinus?
Which part of the internal carotid artery passes through the cavernous sinus?
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At which point does the cerebral part of the internal carotid artery join the circle of Willis?
At which point does the cerebral part of the internal carotid artery join the circle of Willis?
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What is the significance of the carotid angiogram shown in the content?
What is the significance of the carotid angiogram shown in the content?
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What anatomical feature does the internal carotid artery enter at the beginning of its course?
What anatomical feature does the internal carotid artery enter at the beginning of its course?
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What is the primary function of the anterior choroidal artery?
What is the primary function of the anterior choroidal artery?
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Which artery is responsible for connecting the anterior cerebral arteries?
Which artery is responsible for connecting the anterior cerebral arteries?
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Which of the following branches is NOT part of the internal carotid artery?
Which of the following branches is NOT part of the internal carotid artery?
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What structures are primarily supplied by the middle cerebral artery?
What structures are primarily supplied by the middle cerebral artery?
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Which artery enters through the optic canal to supply the eye?
Which artery enters through the optic canal to supply the eye?
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Which area is NOT supplied by the anterior cerebral artery?
Which area is NOT supplied by the anterior cerebral artery?
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What is the primary function of the middle cerebral artery?
What is the primary function of the middle cerebral artery?
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Which artery is considered the largest among the three cerebral arteries?
Which artery is considered the largest among the three cerebral arteries?
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Which of the following brain regions does the posterior cerebral artery supply?
Which of the following brain regions does the posterior cerebral artery supply?
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What is the role of the medial striate arteries in relation to the anterior cerebral artery?
What is the role of the medial striate arteries in relation to the anterior cerebral artery?
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Which arteries primarily supply the forebrain, excluding the occipital lobe?
Which arteries primarily supply the forebrain, excluding the occipital lobe?
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What is the significance of the Circle of Willis?
What is the significance of the Circle of Willis?
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From where do the vertebral arteries originate?
From where do the vertebral arteries originate?
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Which area is NOT supplied by the vertebro-basilar arteries?
Which area is NOT supplied by the vertebro-basilar arteries?
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What is a primary characteristic of the anterior spinal arteries?
What is a primary characteristic of the anterior spinal arteries?
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What does 'ischaemic stroke' primarily result from?
What does 'ischaemic stroke' primarily result from?
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Which of the following arteries is responsible for supplying blood to the posterior aspect of the cerebellum?
Which of the following arteries is responsible for supplying blood to the posterior aspect of the cerebellum?
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Which statement accurately describes the roles of radicular arteries?
Which statement accurately describes the roles of radicular arteries?
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What is the primary cause of a stroke?
What is the primary cause of a stroke?
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Which of the following symptoms is associated with PICA syndrome?
Which of the following symptoms is associated with PICA syndrome?
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How do symptoms differ between ischaemic and haemorrhagic strokes?
How do symptoms differ between ischaemic and haemorrhagic strokes?
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What type of stroke is characterized by a clot forming in cerebral arteries?
What type of stroke is characterized by a clot forming in cerebral arteries?
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Which artery is primarily responsible for supplying the medial portion of the medulla?
Which artery is primarily responsible for supplying the medial portion of the medulla?
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What is a common symptom associated with middle cerebral artery stroke?
What is a common symptom associated with middle cerebral artery stroke?
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What defines the symptoms of medial medullary syndrome?
What defines the symptoms of medial medullary syndrome?
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Which symptom is characteristic of a cerebellar stroke?
Which symptom is characteristic of a cerebellar stroke?
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What is the correct anatomical location of the Artery of Adamkiewicz?
What is the correct anatomical location of the Artery of Adamkiewicz?
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Which combination of arteries is directly formed at the ponto-medullary junction?
Which combination of arteries is directly formed at the ponto-medullary junction?
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Which pair of arteries communicates with the internal carotid artery (ICA)?
Which pair of arteries communicates with the internal carotid artery (ICA)?
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What is NOT a direct branch of the basilar artery?
What is NOT a direct branch of the basilar artery?
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Which artery is primarily responsible for supplying the choroid plexus and parts of the optic system?
Which artery is primarily responsible for supplying the choroid plexus and parts of the optic system?
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Which arteries are primarily responsible for supplying the cerebellum?
Which arteries are primarily responsible for supplying the cerebellum?
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Which of the following arteries connects the anterior cerebral arteries?
Which of the following arteries connects the anterior cerebral arteries?
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Which of the following arteries is part of the Circle of Willis?
Which of the following arteries is part of the Circle of Willis?
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What is the role of the posterior communicating artery within cerebral circulation?
What is the role of the posterior communicating artery within cerebral circulation?
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Which artery enters through the optic canal specifically to supply the eye?
Which artery enters through the optic canal specifically to supply the eye?
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What is the correct sequence of the internal carotid artery as it travels from the cervical part towards the circle of Willis?
What is the correct sequence of the internal carotid artery as it travels from the cervical part towards the circle of Willis?
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Which anatomical feature does the internal carotid artery traverse as its petrous part?
Which anatomical feature does the internal carotid artery traverse as its petrous part?
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In which part of the internal carotid artery does the cavernous sinus occur?
In which part of the internal carotid artery does the cavernous sinus occur?
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What is the last anatomical feature through which the internal carotid artery passes before joining the circle of Willis?
What is the last anatomical feature through which the internal carotid artery passes before joining the circle of Willis?
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What type of imaging technique is utilized to display the intracranial course of the internal carotid artery?
What type of imaging technique is utilized to display the intracranial course of the internal carotid artery?
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Which type of stroke is typically caused by a burst blood vessel in the brain?
Which type of stroke is typically caused by a burst blood vessel in the brain?
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The lenticulostriate arteries primarily supply which brain structures?
The lenticulostriate arteries primarily supply which brain structures?
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What is a significant complication that may arise from a Transient Ischaemic Attack (TIA)?
What is a significant complication that may arise from a Transient Ischaemic Attack (TIA)?
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Which limb of the internal capsule contains corticobulbar fibres?
Which limb of the internal capsule contains corticobulbar fibres?
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Which of the following describes a common symptom of an ischaemic stroke?
Which of the following describes a common symptom of an ischaemic stroke?
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What type of paralysis is associated with medial medullary syndrome?
What type of paralysis is associated with medial medullary syndrome?
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Which structure is primarily responsible for conveying tactile discrimination?
Which structure is primarily responsible for conveying tactile discrimination?
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In cases of subarachnoid hemorrhage, what is a common diagnostic procedure?
In cases of subarachnoid hemorrhage, what is a common diagnostic procedure?
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Which cranial sinew nucleus can be affected in medial medullary syndrome?
Which cranial sinew nucleus can be affected in medial medullary syndrome?
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How are cerebral veins primarily drained?
How are cerebral veins primarily drained?
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What is the primary mechanism behind ischaemic strokes?
What is the primary mechanism behind ischaemic strokes?
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Which symptom is most commonly associated with a stroke involving the anterior cerebral artery?
Which symptom is most commonly associated with a stroke involving the anterior cerebral artery?
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In what manner does the PICA syndrome present symptoms?
In what manner does the PICA syndrome present symptoms?
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What are the classic symptoms of medial medullary syndrome?
What are the classic symptoms of medial medullary syndrome?
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What distinguishes the motor sensory loss pattern associated with middle cerebral artery strokes?
What distinguishes the motor sensory loss pattern associated with middle cerebral artery strokes?
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How are symptoms differentiated in vertebrobasilar strokes compared to other strokes?
How are symptoms differentiated in vertebrobasilar strokes compared to other strokes?
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Which condition primarily leads to the rupture of blood vessels resulting in haemorrhagic stroke?
Which condition primarily leads to the rupture of blood vessels resulting in haemorrhagic stroke?
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Which area of the brain is primarily affected by ischaemia during a thrombosis?
Which area of the brain is primarily affected by ischaemia during a thrombosis?
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Study Notes
Brain Blood Vessels and Intracerebral Bleeds
- Class: Year 2, Semester 1
- Course: Medicine
- Lecturer: Dr. Vijayalakshmi S B
- Date: 06/11/2024
Learning Outcomes
- Describe the blood supply to the brain and spinal cord
- Identify the areas supplied by individual arteries
- Describe the Circle of Willis
- Define "stroke" and differentiate between ischaemic and haemorrhagic strokes
- Explain the effect of focal lesions caused by strokes in major cortical functional areas
Blood Supply to the Brain
- Anterior system: Internal carotid arteries supply most of the forebrain, except the occipital lobe
- Posterior system: Vertebro-basilar arteries supply the spinal cord, brainstem, cerebellum, and occipital lobes
- Connection: The two systems are connected via the Circle of Willis
Blood Supply
- Internal carotid arteries
- Vertebral arteries
Vertebrobasilar System
- Origin: Subclavian artery
- Path: Ascend in transverse foramina
- Foramen magnum: Enter the foramen magnum
- Branches: Poster o-inferior cerebellar artery (PICA), posterior and anterior spinal arteries
- Basilar artery: The two vertebral arteries merge to form the basilar artery
Vertebral Arteries and Spinal Cord
- Anterior spinal arteries: Unite to form a single anterior spinal artery
- Posterior spinal arteries: Travel vertically
- Segmental arteries: Supplement spinal arteries, entering intervertebral foramina
- Artery of Adamkiewicz: Supplies the lower thoracic or upper lumbar spinal cord
Branches of the Basilar Artery
- Ponto-medullary junction: Forms the basilar artery
- AICA (Anterior Inferior Cerebellar Arteries): Branches of the basilar artery
- Labyrinthine arteries:
- Pontine arteries:
- Superior cerebellar arteries:
- Posterior cerebral arteries:
- Terminal branches: Communicate to ICA via posterior communicating arteries
Pontomedullary Junction
- Location: The junction between the pons and the medulla oblongata
- Displayed on the diagrams provided showing the locations of various arteries
Internal Carotid Artery
- Origin: The brachiocephalic trunk
- Course: Travels through the carotid canal as the petrous part of the ICA
- Foramen lacerum: Opens into the top part of the foramen lacerum
- Cavernous sinus: Passes through the cavernous sinus (cavernous part)
- Circle of Willis: The cerebral part of the ICA joins the Circle of Willis
The Carotid Siphon: Angiogram
-
Stages:
- Cervical part of ICA enters the carotid foramen/canal
- Passes through the carotid canal as the petrous part of ICA
- Opens into top part of foramen lacerum and travels through the cavernous sinus
- Cerebral part of ICA joins the Circle of Willis
Branches of the Internal Carotid Artery
- Ophthalmic artery: Through the optic canal to the eye
- Anterior choroidal artery: To choroid plexus; supplies optic chiasma, optic tract, lateral geniculate body, and retrolentiform part of the internal capsule
- Posterior communicating artery:
- Terminal branches: Anterior cerebral (joined by the anterior communicating arteries), Middle cerebral
Anterior cerebral artery
- Supply: Orbital surface of frontal lobe, medial aspect of hemisphere (except occipital lobe), upper border of frontal & parietal lobes; lower limb; perineum; micturition & defecation
- Arteries: Medial striate arteries to basal ganglia & supply anterior limb & genu of internal capsule
Middle cerebral artery
- Supply: Lateral fissure, lateral aspect of hemisphere (except anterior cerebral strip & occipital lobe) ; thorax; upper limb; head & neck; speech & auditory
- Branches: Medial striate arteries to basal ganglia, supply anterior temporal lobe, speech (Broca's & Wernicke's) & auditory areas, lateral striatal or lenticulostriate arteries
Posterior cerebral artery
- Supply: Occipital lobe, Infero-medial temporal lobe
- Origin: Terminal branch of the basilar artery
- May receive blood supply via posterior communicating artery (especially in the embryo)
Blood supply of the central cerebral areas
- Areas: Basal ganglia, internal capsule
- Arteries: Anterior choroidal & striate arteries
Internal Capsule
- Anterior limb: Frontopontine fibers, thalamus to prefrontal fibers
- Genu: Corticobulbar fibers
- Posterior limb: Corticospinal & sensory fibers, corticobulbar fibers
- Retrolentiform: Fibers passing to auditory and visual cortex
Striate arteries
- Types: Lenticulostriate, thalamostriate, long central artery
- Medial striate arteries: Originate from anterior cerebral artery; supply internal capsule, anterior limb & genu, nearby basal ganglia, head of caudate, medial globus pallidus, anterior hypothalamus.
- Lateral striate arteries: Originate from middle cerebral & anterior choroidal arteries; supply internal capsule, nearby basal ganglia, putamen.
- Central branches of posterior cerebral arteries: Supply thalamus and third ventricle, plus some from posterior communicating arteries
Venous Drainage of the Brain
- Drainage via veins that empty into dural sinuses
- Sinuses drain into right & left internal jugular veins
- Veins: Superficial (middle cerebral, superior anastomotic, inferior anastomotic), deep (great cerebral vein of Galen, basal vein of Rosenthal, internal cerebral veins)
Venous Drainage of Spinal Cord
- Veins drain to vertebral venous plexuses
- Veins collect in the epidural venous plexus
Stroke
- Sudden development of focal neurological deficits related to impaired cerebral blood flow
- Types: Ischemic, Haemorrhagic
- Causes: Spontaneous cerebrovascular accidents (CVA), cerebral thrombosis, cerebral hemorrhage, cerebral embolism, subarachnoid hemorrhage
- TIAs (Transient Ischemic Attacks): Neurologic symptoms due to ischemia (carotid or vertebrobasilar stenosis) lasting only a few minutes (but sometimes up to an hour); symptoms include staggering, dizziness, light-headedness, fainting, and paraesthesia. (TIAs are a risk factor for MI or ischaemic stroke)
FAST...
- FACE: Has their face fallen on one side? Can they smile?
- ARMS: Can they raise both arms and keep them there?
- SPEECH: Is their speech slurred?
- TIME: Time to call 999.
Stroke Symptoms (Cerebral Hemispheres)
-
Contralateral symptoms
- Anterior cerebral: contralateral hemiplegia and anaesthesia
- Middle cerebral: contralateral hemiplegia and anaesthesia & aphasia
- Posterior cerebral: contralateral hemianopia
- Vertebrobasilar: Mix of contralateral and ipsilateral symptoms
- Brainstem: Varies depending on the area affected
- Cerebellar hemispheres: Ipsilateral symptoms (loss of balance & coordination)
- Specific Syndromes: Medial medullary, Lateral medullary (PICA)
Middle cerebral artery
- Main supply to the internal capsule
- Contralateral motor/sensory loss, sparing of lower limb & perineum
- Speech deficit if the dominant hemisphere is involved.
PICA Syndrome (Lateral Medullary Syndrome)
- Location: Lateral medulla
- Causes/symptoms: Vertigo, nystagmus, tinnitus, sympathetic (descending) ipsilateral Horner's syndrome, ptosis, meiosis, anhydrosis, contralateral pain & temperature from the body, loss of taste, hoarseness/dysphagia (nucleus ambiguus IX, X, XI nerves)
Medial Medullary Syndrome
- Location: Medial part of the medulla
- Blood supply: Vertebral artery
- Symptoms: Contralateral hemiparesis, ipsilateral paralysis of the tongue, loss of sensations/position/movement/tactile discrimination
Subarachnoid Haemorrhage
- High density blood in the subarachnoid space
Video Links
- Provided are links to videos for further study (Anterior cerebral artery stroke, Middle cerebral artery stroke, Posterior cerebral artery stroke, Internal capsule stroke)
Practice Questions
- Questions are available. Use QR code to access the practice questions
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Description
This quiz tests your knowledge on the neuroanatomy of the arteries associated with the brain and upper spinal regions. You'll explore details regarding the internal carotid artery, basilar artery, and their branches, along with their significance in cerebral circulation. Perfect for students studying human anatomy or neuroanatomy.
