CVP quiz 1 intracranial & extracranial anatomy

VERTEBRAL ARTERIES: (1) ____ branch off subclavian artery, (2) ___ is smaller than _____

1. 1st branch 2. Right vertebral artery smaller than left

3 Congenital Variations of COW.

1. Absence or hypoplasia of one or both communicating arteries 2. origin of the PCA from the ICA 3. Absence of proximal A1 segment of ACA

Circle of willis is composed of a hexagonal arrangement of arteries: (1) ______ (ACA), (2) ______ (MCA), (3) ______ (PCA), (4) Connecting arteries

1. Anterior Cerebral Artery 2. Middle Cerebral Artery 3. Posterior Cerebral Artery 4. Connecting arteries (Anterior Communicating artery - AComm, and Posterior Communicating artery - PComm)

the ICA is divided into 4 main segments: (1) Cervical Segment, (2) ________ Segment, (3) Cavernous Segment (aka the _____ Siphon_, (4) Supraclinoid segment

1. Cervical Segment 2. Petrous Segment 3. Cavernous Segment (aka the carotid siphon) 4. Supraclinoid segment

The CCA bifurcates at the level of the thyroid cartilage in the mid neck to form the : (1) ____ carotid artery (ICA) and (2) the ______ carotid artery (ECA)

1. Internal carotid artery 2. External carotid artery

SCA vertebral artery branch: (1) ___ vertebral is smaller than ____, (2) heads _________ through the cervical vertebral bodies of the spine

1. Right smaller than Left 2. heads superiorly

The ECA has 8 major branches: (1) S______ T______ (the "1st branch" of the ECA), (2) A______ p______, (3) L______, (4) O______

1. Superior thyroid 2. Ascending pharyngeal 3. Lingual 4. Occipital

Subclavian artery has 2 major branches near the base of the neck: (1) _____ artery, and (2) _____ trunk

1. Vertebral artery 2. thyrocervical trunk

The brain receives ___% of cardiac output

15%

The 3 branches of the aortic arch, from R to L: (2) the L _____ _____ artery, and (3) L _____ artery

2. Left Common Carotid Artery (Lt CCA) 3. Left Subclavian Artery (L SCA)

The brain consumes ___% of the body's oxygen supply

20%

The aortic arch has ____ branches

3

Flow to the cerebralvascular arterial system begins with the aorta, more specifically by the 3 _____ of the aortic ______

3 branches aortic arch

The ECA has 8 major branches: (5) T_____ F_____, (6) Posterior a________, (7) External and internal _______, (8) Superficial ________

5. Transverse Facial 6. Posterior Auricular (ear) 7. External and internal Maxillary (behind cheek bones) 8. Superficial temporal

the middle cerebral artery (MCA) carries ____-____% of the ICA flow

75-80%

How many congenital variations, and where?

9 congenital variations. Also has variations of the aortic arch.

The A_____ and P______ communicating arteries connect the halves of the COW (Circle of willis)

Anterior and Posterior Communicating arteries

Artery formed by the confluence of the right and left vertebral arteries

Basilar Artery

SCA on the arm is called ______ _____-

Brachial artery

The 3 branches of the aortic arch , from R to L: (1) Innominate/_______ artery branches into.....

Brachiocephalic artery branches into: the Right Common carotid artery (Rt CCA), and the right Subclavian Artery (Rt SCA)

The ____ of ____ is the most important element in intracranial collateral circulation. Common site for aneurysms.

Circle of Willis

Once the arch starts to head inferiorly, it becomes the __________ aorta

Descending

What vessel can be used as a collateral pathway in the event of ICA or other vessel occlusion

ECA

The ICA is ______ to the ECA 95% of the time

ICA is posterior

The root of the aorta arises from the L____ _____ outflow tract (LVOT) of the heart. (blood that leaves the left ventricle).

Left Ventricle outflow tract

after it's origination at the L____ _____ (aortic root), the _____ aorta arises a short distance from the ventricle, then goes to the _____ superiorly to form the aortic arch

Left ventricle ascending aorta to the arch

The _____ cerebral artery and the _______ cerebral artery bifurcate from the terminus of the ICA

Middle Cerebral Artery (MCA) Anterior Cerebral Artery (ACA)

Congenital Variations - Aortic Arch.

Most congenital variations of the aortic arch involve anolmalous origins of the common carotid and verterbral arteries.

The common carotid artery (CCA) is the main trunk that brings blood flow into the ______

NECK

Why one innominate artery?

Only found on right side because the heart's left-sided position in the chest.

the first branch of the ICA is the _________ artery.

Opthalmic artery. --> arises from the cavernous portion of the ICA, specifically the Genu

PCA wraps around the cerebral peduncles. Has 2 segments

P1 Segment, P2 segment

AComm connects the R & L halves of the COW by connecting the R & L ____'s

R&L ACA's

Main blood supply to the brain: (1) R & L ______, and (2) R&L ______

R&L Carotid arteries R&L Vertebral arteries

Innominate vein bifurcates to for the R _____ _____ artery, and the R ______ artery

Right common carotid artery Right subclavian artery

TRUE OR FALSE: Aortic arch and ascending aorta are often referred to similarly

TRUE

True or false: having one innominate artery allows for Rt SCA & Rt CCA to have more room after they branch instead of risking entanglement

TRUE

TRUE OR FALSE: The aortic root/valve has 3 semilunar cusps that prevent blood from flowing back into the LV after the heart relaxes in diastole

TRUE!

True or false: Communicating arteries normally do not have much blood flow, but if there is an occlusion the communicating arteries will take on more blood re-routing through the brain

TRUE!

TRUE OR FALSE: ICA does NOT give off any branches in the neck. Branches only come off intracranially.

True

True or false: the ICA plays an important role in intracranial vasculature and the Circle of Willis (COW)

True!

True or false: the MCA is much larger than the ACA

True!

When the descending aorta enters the abdomen through an opening in the diaphragm at T-12, it becomes the ______ aorta

abdominal aorta

Innominate artery, aka _________ artery, arises only on the ____ side

aka brachiocephalic (feed head "cephalic" and arm "brachio") arises on Right side only

ICA distributes blood to the ______ brain and the ____. (very common to see stenosis in ICA)

anterior brain the eyes

ACA gives rise to the _____ communicating artery

anterior communicating artery (AComm)

Because the heart is more left-sided, the Lt SCA & Lt CCA will branch directly off of the ______ _____

aortic arch

The Lt CCA is a direct branch of the _____ ____.

aortic arch

Subclavian arteries are primary means for arterial blood supply to the ______

arms

ACA and AComm picture

at top is AComm

Once the subclavian artery (SCA) reaches the axilla, it is called the ______ artery

axillary artery

Vertebral arteries unite at the base of the skull to form the _____ artery

basilar artery. (the basilar artery divides into vessels that supply the posterior aspect of the COW)

ICA is largely responsible for supplying blood flow to the _____ of _____ in the brain

circle of willis

the ICA terminates when it branches into the ACA and MCA in the ___ of _____

circle of willis

The subclavian arteries course under the _____

clavicle! (Sub below, clavian clavicle)

PComm connects the anterior and posterior halves of the COW by connecting the ____ to the _____

connecting the PCA's to the MCA's

ICA Segment #3: Cavernous. (a) Cavernous ICA consists of p_____ p_____ and the ____ portion

consists of parasellar portion and the Genu portion

The Middle Cerebral Artery (MCA) courses ___________ toward the temporal bone with a number of branches

courses laterally

These semilunar cusps ____ with systole to allow blood to be ejected into the ____ aorta --> the cusps are then _____ during diastole

cusps OPEN the ascending aorta then closed

From the arch, the aorta descends ______ along the back wall of the heart through the t_____ c_____ where it pierces the d_______

descends posteriorly thoracic cavity diaphragm

ICA Segment #4: Supraclinoid. (b) Supraclinoid portion has d____ segment

distal segment

abnormalities of aortic arch vessels will affect all vessels ______ as well

downstream

ACA has two segments: (1) from ____ to origin of the AComm, and (2) distal to the AComm

from ICA

The Rt CCA is a branch of the _______ artery

innominate (brachiocephalic) artery

Remember only have ONE Right-sided innominate artery, even though we have both a right and a left ________ vein

innominate vein

The Anterior Cerebral Artery (ACA) courses ______ toward the midbrain

medially

ACA in COW picture

one protrusion to the R is the PCA

In the ICA, the first intracranial branch is the _______ artery, which originates near the carotid siphon

opthalmic artery

Posterior Cerebral Arteries (PCA) perfuse the ________ hemispheres

posterior hemispheres

At the elbow, the SCA splits into the ____ artery (lateral side), and ____ artery (medial side)

radial artery ulnar artery

Basilar artery bifurcates into the Posterior Cerebral Arteries (PCA's) to supply the ________ aspect of the Circle of WIllis

supply the posterior (perfuses the posterior aspect of the brain)

SCA thyrocervical trunk branch gives off branches that supply the ______ and other neck structures

supply the thyroid

Vertebral arteries provide blood supply to the _________ and i______ cerebellum

supply to the medulla and inferior cerebellum

VERTEBRAL ARTERIES: (3) lie within the f_____ t______ of the cervical vertebrae. * These are the "shadows" we see the vertebrals course through on US

the foramina transversarium

ICA Segment #2: Petrous. Courses through the Petrous portion of the ____ bone. can NOT see with US

the temporal bone

True or false: the ICA travels into the base of the skull WITHOUT branching

true!

true or false: Internal Carotid Artery (ICA) is generally the larger of the two CCA branches

true!

The aortic arch branches provide arterial supply to the _____ _______ and c______ s_______

upper extremities cerebrovascular structures