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What is the effect if the Posterior spinal arteries are occluded
Loss of proprioception, pressure, and vibration
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What is the effect of an occlusion of the Anterior Spinal Artery at the level of the spinal cord
- Bilateral loss of pain and temperature
- Bilateral paralysis
- No changes in touch, proprioception, pressure, or vibration sense
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What arteries come off the Internal Carotid artery
- Opthalmic artery
- Anterior choroidal artery
- Posterior communicating artery
- Middle cerebral artery (MCA)
- Anterior cerebral artery (ACA)
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What does the opthalmic artery supply blood to
- Eyeball
- Orbital structures
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What does the anterior choroidal artery supply
- Optic tract
- Choroid plexus (some)
- Cerebral Peduncle
- Internal capsule
- Thalamus
- Hippocampus
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Where does the posterior communicating artery feed
It communicates from the Posterior cerebral (PCA) to the Carotid Artery
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Where does the Middle cerebral artery travel
Into the lateral sulcus supplying the insula and most of the lateral surface of the cerebral hemisphere
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If there is an occlusion of the middle cerebral artery what would be the neural deficits
- Restricted contralateral motor and somatosensory deficits (face and arm)
- If the left hemisphere is invloved, language deficits may be apparent
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Where does the anterior cerebral artery travel
It courses along the longitudinal fissure to supply the medial aspect of the frontal and parietal lobes
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If there is an occlusion of the anterior cerebral artery, it has what effects
Contralateral motor and somatosensory deficits restricted to the lower limb
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What are the two different systems that supply the brain with blood
- Internal Carotid Arterial system
- Vertebral/Basilar Arterial system
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What arteries branch from the Vertebral-Basilar system
- Posterior cerebral artery
- Superior cerebellar artery
- Anterior inferior cerebral artery (AICA)
- Posterior inferior cerebellar artery (PICA)
- Posterior spinal artery
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What does the posterior spinal artery branch from
Posterior inferior cerebellar artery (PICA)
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Medial Medullary syndrome
- Occlusion of the branches of the anterior spinal artery at the level of the medulla on one side
- Effecting the corticospinal tract, medial lemniscus, and hypoglossal nucleus
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What are the specific deficits caused by Medial Medullary Syndrome
- Corticospinal (Contralateral hemiparesis of the lower limbs)
- Medial Lemniscus (decreased contralateral proprioception, touch, and pressure)
- Ipsilateral paralysis of hypoglossal nerve (movement of tongue)
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What are the affects of an total occlusion of the Anterior spinal artery at the level of the medulla
- Medial Medullary Syndrome
- Corticospinal tract (Bilateral voluntary motor)
- Medial lemniscus (Bilateral touch and pressure)
- Hypoglossal Nucleus (Ipsilateral voluntary motor to the tongue)
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What would be the neural effects of an occlusion of the anterior spinal artery at the level of the spinal cord
- Bilateral loss of pain and temperature
- Bilateral paralysis
- No changes in touch, proprioception, pressure, or vibration sense
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What does the Posterior Inferior Cerebellar Artery (PICA) feed
Much of the inferior surface of the cerebellar hemispheres, the lateral medulla, and choroid plexus of the 4th ventricle
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Wallenbergs syndrome is damage to what
Occlusion of Posterior inferior cerebellar artery (PICA) on one side
It is also known as lateral medullary syndrome
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What functions does a Wallenberg syndrome (Lateral Medullary Syndrome) effect
- Contralateral Loss of Pain and temp (Spinothalamic)
- Ipsilateral Horners (Sympathetic fibers)
- Loss of taste (Nucleus solitarius)
- Double vision
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Lateral Medullary Syndrome (Wallenberg's) effects what regions
- Inferior Cerebellar peduncle
- Spinothalamic tract
- Sympathetic fibers
- Nucleus Ambiguus
- Nucleus Solitarius
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What are the important branches of the Basilar artery from cranial to caudal
- Posterior cerebral artery
- Superior cerebellar artery
- Anterior Inferior cerebellar artery (AICA)
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What does the Anterior inferior cerebellar artery (AICA) feed
Supplies the anterior portions of the inferior surface of the cerebellum (flocculus) and parts of the Pons
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What would an occlusion of the Anterior Inferior cerebellar artery (AICA) effect
- Middle cerebellar peduncle
- Vestibular nuclei
- Spinal V nucleus and tract
- Spinothalamic tract
- Descending sympathetic fibers
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What would be the physical signs of a Anterior Inferior Cerebellar Artery (AICA) occlusion
- Ipsilateral facial paralysis
- Ipsilateral facial pain and temp loss (V Nucleus)
- Ipsilateral Dystaxia (Middle cerebral peduncle)
- Nystagmus (Vestibular nuclei)
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What do the Superior Cerebellar arteries feed
Superior surface of the cerebellum and most of the caudal midbrain and rostral pons
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An occlusion of the Superior Cerebellar artery would effect what structures
Superior cerebellar peduncle and cerebellum
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What do the Posterior Cerebral arteries feed
- Medial and inferior surfaces of the occipital and temporal lobes
- Part of the rostral midbrain and caudal diencephalon
- Choroid plexus of the 3rd and lateral ventricles
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What nuclei are damaged in Superior alternating Syndrome (Webers Syndrome)
- Cerebral Peduncle
- Substantia Nigra
- Red Nucleus
- Oculomotor Nucleus
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Superior Alternating (Weber's) Syndrome
- Unilateral damage to the ventral region of the midbrain caused by the occlusion of the posterior cerebral/basilar arteries
- Results in superior alternating hemiplegia (ipsilateral oculomotor nerve palsy and contralateral hemiplegia)
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How do the eyes present in Webers Syndrome
- Down and out
- The eye will dilate and eyelid will droop
- Loss of all eye movements but the lateral rectus and superior oblique (CN III)
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What is the difference between Benedkts syndrome and Webers
Benedikts includes damage to the tegmental region of the midbrain in addition to the ventral, thus ataxia is seen along with the contralateral hemiplegia, and oculomotor palsy
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What arteries are considered to be a part of the circle of Willis
- Posterior Communicating
- Internal Carotid
- Anterior Cerebral
- Anterior Communicating
- Posterior Cerebral Artery
- Middle Cerebral Artery
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Transient Ischemic attack
Temporarily attack caused by minute particles that occlude arteries and are then degraded
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What is damaged in Superior Alternating (Webers) Syndrome
- Unilateral damage to:
- Cerebral peduncle (carrying corticobulbar and corticospinal tracts)
- Substantia Nigra
- Red nucleus
- Occulomotor nerve
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