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