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Blood Supply to the Nervous System. Objectives. 1. Describe the importance of blood circulation to the brain. 2. List major arteries that transport blood to the cerebrum. 3. Describe region supplied by each major artery.

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Blood supply to the nervous system l.jpg

Blood Supplyto the Nervous System


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Objectives

  • 1. Describe the importance of blood circulation to the brain.

  • 2. List major arteries that transport blood to the cerebrum.

  • 3. Describe region supplied by each major artery.

  • 4. Discuss general blood supply for brainstem, cerebellum, and spinal cord.

  • 5. List common points of anastomoses in the vascular system.


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Objectives

  • 6. Explain significance of potential collateral circulation.

  • 7. Describe venous-sinus system.

  • 8. Discuss mechanism of cerebrovascular accidents.

  • 9. Discuss common cerebrovascular accidents.

  • 10. Describe the mechanism regulating blood flow.

  • 11. Discuss the blood-brain barrier and its clinical significance.


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Blood Supply

  • Function:

  • Total Dependence of Nerve Cells


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Oxygen Deprivation Within the Brain

  • Without Adequate Blood Supply

    • Irreversible Damage

    • Site of Lesion


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Metabolic Needs of the Brain

  • Brain’s Metabolic Needs

  • Blood Flow to the Brain



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Vascular Network

  • Blood Circulation to the Brain


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Vascular Network

  • Large Arteries

  • Small arteries

  • Arterioles with small diameters

  • Capillaries


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Cerebral Arteries: Lateral Brain and Cerebellar Surface

  • Bhatnagar & Andy, 1995, Figure 17.4


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Cerebral Arteries: Midsagittal Brain Surface

  • Bhatnagar & Andy, 1995, Figure 17.3


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Vascular Network

  • Veins

  • Venules


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Cerebral Venous Sinuses

  • Bhatnagar & Andy, 1995, Figure 17.7


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Cerebral Veins: Lateral Surface

  • Bhatnagar & Andy, 1995, Figure 17.8A


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Cerebral Veins: Midsagittal Surface

  • Bhatnagar & Andy, 1995, Figure 17.8B


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Cerebrovascular Supply

  • Two Arterial Systems:


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Cerebral Arteries

  • Love & Webb, 1996, Figure 3-7


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Cerebrovascular Supply: Carotid and Vertebral Basilar Systems

  • Bhatnagar & Andy, 1995, Figure 17.1A


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Cerebrovascular Supply: Circle of Willis Systems

  • Bhatnagar & Andy, 1995, Figure 17.1B


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Cerebrovascular Supply: Cerebral Arterial Structure at Base of Brain

  • Bhatnagar & Andy, 1995, Figure 17.2



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Cerebral Arteries of Brain

  • Love & Webb, 1996, Figure 3-7


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Cerebrovascular Supply: Carotid and Vertebral Basilar Systems

  • Bhatnagar & Andy, 1995, Figure 17.1A


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Carotid System Systems

  • External Carotid Artery and its Branches

  • Internal Carotid Artery and its Branches


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Cerebral Arteries Systems

  • Love & Webb, 1996, Figure 3-7


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Carotid System Systems

  • Internal Carotid


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Cerebrovascular Supply: Carotid and Vertebral Basilar Systems

  • Bhatnagar & Andy, 1995, Figure 17.1A


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Vertebral Basilar System Systems

  • Two Vertebral Arteries


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Cerebral Arteries Systems

  • Love & Webb, 1996, Figure 3-7


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Cerebrovascular Supply: Carotid and Vertebral Basilar Systems

  • Bhatnagar & Andy, 1995, Figure 17.1A


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Cerebrovascular Supply: Circle of Willis Systems

  • Bhatnagar & Andy, 1995, Figure 17.1B


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Cerebrovascular Supply: Cerebral Arterial Structure at Base of Brain

  • Bhatnagar & Andy, 1995, Figure 17.2


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Vertebral Basilar System of Brain

  • Branches


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Cerebrovascular Supply: Circle of Willis of Brain

  • Bhatnagar & Andy, 1995, Figure 17.1B


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Cerebrovascular Supply: Cerebral Arterial Structure at Base of Brain

  • Bhatnagar & Andy, 1995, Figure 17.2


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Vertebral Basilar System of Brain

  • Posterior Spinal Artery

    • Function:

    • Circulatory Disorders


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Vertebral Basilar System of Brain

  • Anterior Spinal Artery

    • Pathway:

    • Function:

    • Circulatory Disorders


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Corticobulbar of BrainTract

  • Bhatnagar & Andy, 1995, Figure 14.3A


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Corticospinal of BrainTract

  • Bhatnagar & Andy, 1995, Figure 14.3B


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Vertebral Basilar System of Brain

  • Posterior Inferior Cerebellar Artery

    • Function:


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Vertebral Basilar System of Brain

  • Anterior Inferior Cerebellar Arteries


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Vertebral Basilar System of Brain

  • Pontine Level


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Cerebrovascular Supply: Circle of Willis of Brain

  • Bhatnagar & Andy, 1995, Figure 17.1B


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Vertebral Basilar System of Brain

  • Internal Auditory Artery

    • Function:


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Vertebral Basilar System of Brain

  • Superior Cerebellar Arteries

    • Pathway:

    • Function:

    • Circulatory Disorders:


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Circle of Willis of Brain

  • Shape:

  • Location:

  • Connections:


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Cerebrovascular Supply: Carotid and Vertebral Basilar Systems

  • Bhatnagar & Andy, 1995, Figure 17.1A


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Cerebrovascular Supply: Circle of Willis Systems

  • Bhatnagar & Andy, 1995, Figure 17.1B


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Cerebrovascular Supply: Cerebral Arterial Structure at Base of Brain

  • Bhatnagar & Andy, 1995, Figure 17.2


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Circle of Willis of Brain

  • Components:

    • Communicating Arteries

      • 1.

      • 2.

    • Proximal Portions of the Cortical Arteries

      • 1.

      • 2.

      • 3.


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Circle of Willis of Brain

  • Importance:

    • Anastomotic Point


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Circle of Willis of Brain

  • Two Types of Arteries:

    • 1. Cortical (Circumferential) Arteries

    • 2. Central (Penetrating) Arteries


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Cortical Arteries of Brain

  • 1. Anterior Cerebral Artery

    • Pathway:


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Cerebral Arteries: Midsagittal Brain Surface of Brain

  • Bhatnagar & Andy, 1995, Figure 17.3


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Cortical Arteries of Brain

  • 1. Anterior Cerebral Artery

    • Vascular Supply

      • Regions:


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Cerebral Arteries of the Lateral and Medial Surfaces of the Left Cerebral Hemisphere

  • Love & Webb, 1996, Figure 3-8


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Cortical Arteries Left Cerebral Hemisphere

  • 1. Anterior Cerebral Arteries

    • Vascular Supply

      • Interruption of Blood Circulation:

        • Motor Impairment:

        • Cognitive Impairments:

        • Additional Impairments:

          • Decreased spontaneity

          • Motor inaction

          • Impaired judgment

          • Limited concentration


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Cortical Arteries Left Cerebral Hemisphere

  • 2. Middle Cerebral Arteries

    • Pathway:


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Cerebral Arteries: Lateral Brain and Cerebellar Surface Left Cerebral Hemisphere

  • Bhatnagar & Andy, 1995, Figure 17.4


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Cortical Arteries Left Cerebral Hemisphere

  • 2. Middle Cerebral Artery

    • Vascular Supply

      • Important Areas


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Cerebral Arteries of the Lateral and Medial Surfaces of the Left Cerebral Hemisphere

  • Love & Webb, 1996, Figure 3-8


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Cortical Arteries Left Cerebral Hemisphere

  • 2. Middle Cerebral Arteries

    • Vascular Supply


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Cortical Arteries Left Cerebral Hemisphere

  • 2. Middle Cerebral Arteries

    • Interruption of Blood Supply

      • Motor Impairment:

      • Sensory Impairment:

      • Other Symptoms:

      • Subcortical damage:


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Cortical Arteries Left Cerebral Hemisphere

  • 3. Posterior Cerebral Artery

    • Pathway:


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Cortical Arteries Left Cerebral Hemisphere

  • 3. Posterior Cerebral Artery

    • Vascular Supply


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Cerebral Arteries of the Lateral and Medial Surfaces of the Left Cerebral Hemisphere

  • Love & Webb, 1996, Figure 3-8


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Cortical Arteries Left Cerebral Hemisphere

  • 3. Posterior Cerebral Artery

    • Interruption of Blood Supply

      • Visual Impairment:


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Central (Penetrating) Arteries Left Cerebral Hemisphere

  • Pathway:


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Central (Penetrating) Arteries Left Cerebral Hemisphere

  • Vascular Supply:

    • Supply the subcortical structures that include:

      • Thalamus

      • Hypothalamus

      • Caudate nucleus

      • Putamen

      • Globus pallidus

      • Basal ganglia

      • Internal capsule

      • Choroid plexus

      • Other structures


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Central (Penetrating) Arteries Left Cerebral Hemisphere

  • Interruption of Blood Supply:

    • Anteromedial Arteries

    • Medial Striate Arteries

    • Anterior Choroidal Artery

    • Posteromedial Arteries

    • Posterolateral Arteries


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Collateral Circulation Left Cerebral Hemisphere

  • Alternative Blood Supply:

  • Importance in Recovery:


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Cerebrovascular Supply: Carotid and Vertebral Basilar Systems

  • Bhatnagar & Andy, 1995, Figure 17.1A


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Cerebrovascular Supply: Circle of Willis Systems

  • Bhatnagar & Andy, 1995, Figure 17.1B


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Collateral Circulation Systems

  • Two Common Points of Collateral Circulation


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Vascular Pathologies Systems

  • Vascular Diseases of the Brain



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Vascular Pathologies: Occlusive Vascular Pathologies Systems

  • Ischemia

  • Transient Ischemic Attack (TIA)


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Vascular Pathologies: Occlusive Vascular Pathologies Systems

  • Treatment

  • Compensation for Atherosclerosis


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Cerebrovascular Disorders Systems

  • Bhatnagar & Andy, 1995, Figure 17.6A, B, C




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Vascular Pathologies: Hemorrhage Systems

  • Hemorrhagic Strokes


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Vascular Pathologies: Hemorrhage Systems

  • Three Major Types:

    • 1. Intercerebral Hemorrhages

    • 2. Subdural Hematoma

    • 3. Aneurysm



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Venous Sinus System Systems

  • Veins and Sinuses

    • Function:

    • Process:


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Venous Sinus System: Location of Prominent Dural Sinuses Systems

  • Bhatnagar & Andy, 1995, Figure 2.42


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Dural Sinuses Systems

  • Structure:

  • Function:

  • Major Dural Sinuses:

    • 1.

    • 2.

    • 3.

    • 4.


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Venous Sinus System Systems

  • Bhatnagar & Andy, 1995, Figure 17.7


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Cerebral Veins Systems

  • Function:

  • Two Types:

    • 1. Superficial Cerebral Veins

      • Three Large Superficial Veins

        • A.

        • B.

        • C.


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Cerebral Veins: Lateral Surface Systems

  • Bhatnagar & Andy, 1995, Figure 17.8.A


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Cerebral Veins Systems

  • Two Types:

    • 2. Deep Cerebral Veins

      • Function:


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Cerebral Veins: Medial Surface Systems

  • Bhatnagar & Andy, 1995, Figure 17.8.B


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Blood-Brain Barrier Systems

  • Important Clinical Concept


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Blood-Brain Barrier Systems

  • Selective Membrane Permeability

  • Cortical Pathologies


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Anastomose Systems

Aneurysm

Arteriosclerosis

Arteriovenous Malformations

Atherosclerosis

Blood-Brain Barrier

Carotid Vascular System

Cerebrovascular System

Circle of Willis

Coagulation

Collateral Circulation

Embolism

Hemorrhage

Ischemia

Metabolism

Paresthesia

Sinus

Thrombosis

Watershed Infarction

Define the Following Technical Terms:


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Review Questions Systems

  • 1. Describe the importance of oxygen to brain cells and how long the brain can sustain blood deprivation.

  • 2. Describe vascular circulation to the brainstem and cerebellum.

  • 3. Describe the difference between cortical (circumferential) and central (penetrating) arteries.

  • 4. Describe the distribution area covered by the anterior, middle, and posterior cerebral arteries.


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Review Questions Systems

  • 5. What important functional impairments follow interruptions with blood flow in each cortical artery?

  • 6. Discuss the importance and mechanism of collateral circulation.

  • 7. Describe common vascular pathologies.

  • 8. Describe the venous-sinus system.

  • 9. What is the blood-brain barrier and what are its clinical advantages?


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Blood Supply Systemsof the Nervous System

Graphics


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THINGS TO DO BEFORE LECTURE Systems

  • TERMS:

    • Perfusion

      • Act of pouring over or through, especially the passage of a fluid through the vessels of a specific organ

    • Location of Petrous Bone

    • Epicritic sensation

      • Cutaneous nerve fibers that serve the purpose of perceiving fine variations of touch or temperature

    • Watershed region

      • A ridge which directs drainage toward either side

    • Paresthesia

      • Morbid or perverted sensation

      • Abnormal sensation, as burning, prickling, formications, etc.

    • Hemianesthesia

      • Loss of feeling or sensation

      • Anesthesia affecting only one side of the body; called also unilateral anesthesia

    • Cranium

      • The skeleton of the head, variously construed as including all of the bones of the head, all of them except the mandible, or the eight bones which form the vault that lodges the brain

    • Neocortex

      • The newer, six-layered portion of the cortex cerebri showing stratification and organization characteristic of the most highly evolved type of cerebral tissue

    • Homonymous Hemianopia

      • Defective vision or blindness in half of the visual field of one or both eyes; Affecting the right halves or the left halves of the visual fields of the two eyes


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