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- 1. Posterior Spinal Artery
- occlusions: loss of T/P/P
- 2. Anterior Spinal Artery
- occlusions: B/L loss of P/T & paralysis NO changes T/P/P
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What are the 2 systems that supply the brain?
- Internal Carotid Arterial System
- Vertebral/Basilar Arterial System
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- 1. Anterior Communicating Artery
- 2. Anterior Cerebral Artery
- 3. Internal Carotid Artery
- 4. Posterior Communicating Artery
- 5. Posterior Cerebral Artery
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- 1. Posterior Cerebral A.
- 2. Paramedian branches(basilar)
- 3. Circumferential branches(basilar)
- 4. Superior Cerebellar A.
- 5. Anterior Inferior Cerebellar A.
- 6. Posterior Inferior Cerebellar A.
- 7. Lateral branches (vertebral)
- 8. Paramedian branches & Ant. Spinal A. (vertebral)
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Systems supplying the Brain?
- Internal Carotid
- Vertebral/Basilar
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Internal Carotid Branches?
- Ophthalmic A.: eyeball & orbital structures
- Ant. Choroidal A.: choroid plexus, thalamus & hippocampus
- Post. Communicating A.: connects to Post. Cerebral A.
- Middle Cerebral A.: lateral cerebral hemisphere & insula
- Ant. Cerebral A.: medial aspect of frontal & parietal lobes
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Middle Cerebral Artery
Where is it?
What does it supply?
Occlusions?
- Lateral Sulcus
- Lateral Cerebral Hemisphere (most of motor & somatosensory gyri) & Insula
- restricted C/L motor & somatosensory deficit
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Anterior Cerebral Artery
Where is it?
What does it supply?
Occlusions?
- Longitudinal Fissure
- Medial aspect of frontal & parietal lobes
- C/L motor & somatosensory deficit of the lower limb
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Vertebral Artery Branches?
- Ant. Spinal: anterior medial fissure
- Post. Spinal: postero-lateral sulcus
- Post. Inf. Cerebellar A.: inferior cerebellar, lateral medulla choroid plexus & 4th ventricle
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Inferior Alternating Syndrome
- lesion in the ant. spinal a. in the medulla
- Affects:
- Corticospinal tract (C/L voluntary motor)
- Medial Lemniscus (C/L touch)
- Hypoglossal N. (I/L voluntary motor of tongue)
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Lateral Medullary Syndrome?
- Wallenberg's Syndrome
- lesion of PICA
- Affects:
- Inf. Cerebellar peduncle (ataxia)
- Spinothalamic Tract (C/L pain)
- Sympathetic Fibers (Horner's)
- NA (hoarseness)
- NS (loss of taste & cardiorespiratory)
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Basilar Artery Branches?
- AICA: ant, inf, cerebellum & parts of pons
- --> labrynthe a.: inner ear (x vertigo/deafness)
- Sup. Cerebellar A.: sup cerebellum (x ataxia)
- Posterior Cerebral A.: medial, inf occipital & temporal lobes
- Long Circumferrential Branches
- Paremdian Pontine A.
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Superior Alternating Syndrome
- Weber's Syndrome
- occlusion of Posterio Cerebral A. (PCA)
- U/L damage to ventral midbrain
- I/L occulomotor n. palsy
- C/L hemiplegia
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Compostion of BBB
- endothelial cells
- tight junctions of capillaries
- supporting cells - astrocytes
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Importance of BBB?
- functions in preventing/slowing the passage of substances
- a benefit and hindrance (pharm)
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Complete breakdown of BBB
Brain tumors
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Subtle barrier impairment w/o end organ damage
- Disease states:
- MS
- Alzheimer's
- HIV
- Stroke
- Diabetes
- Eating/weight disorders
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Disturbances in Vascular Supply:
Stroke
thrombus or embolism
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Disturbances in Vascular Supply:
TIA-Transient Ischemic Attack
minute particles
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Disturbances in Vascular Supply:
Anneurysm
arterial wall swelling that can rupture
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Disturbances in Vascular Supply:
Watershed
dual blood supply
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