Vascular supply + Venous drainage of the brain

Vascular supply + Venous drainage of the brain

By Mameh Bockarie

Multiple Select

What are the principal arterial supplies to the brain?

• Internal Carotid Arteries

• Vertebral Arteries

• External Carotid Arteries

• Internal Jugular Vein

Multiple Choice

What do the Internal Carotid Arteries supply in the brain?

• Areas of the forebrain

• Brainstem, Cerebellum and occipital lobe

• Areas of the Midbrain

• Brainstem, Cerebellum, Occipital lobe, Parts of the thalamus

Multiple Choice

What do the Vertebral Arteries Supply?

• Areas of the Forebrain

• Areas of the Midbrain

• Brainstem, Cerebellum, Occipital lobe and parts of the thalamus

• Brainstem, Cerebellum and Occipital lobe

Multiple Choice

Pathway of blood internal carotid artery pathway:

1. Passes through canal at the base of skull to sinus

2. Forms a loop in the sinus

3.Reaches the brain

• True

• False

Multiple Select

What does the Internal Carotid artery branch into?

• Opthalamic Artery

• Middle anterior cerebral artery

• Superior anterior cerebral artery

• Anterior choroidal artery

• Internal auditory arteries

Multiple Choice

What artery forms from the two anterior cerebral arteries coming together in the mid plane?

• Posterior Communicating artery

• Anterior Communicating Artery

• Anterior Choroidal Artery

Multiple Select

What is the role of the anterior choroidal artery?

• Connects to the posterior communicating artery

• Carries blood to the choroid plexus

• Connects to the anterior communicating artery

• Carries blood to the pterygoid plexus

Multiple Choice

What artery is a single continuation of the vertebral arteries in the midplane?

• Basilar Artery

• Posteror Cerebral artery

• Penetrating arteries

Multiple Select

What arteries branch off the basilar artery?

• Posterior Cerebral Artery

• Posterior and inferior anterior cerebellar artery

• Superior cerebellar artery

• Pontine and internal auditory artery

• Penetrating arteries

• Arise from the subclavian arteries

• Supplies​: Brainstem, cerebellum, occipital lobe and parts of the thalamus

Vertebral arteries

• Branch off common carotids

• Supply areas of the forebrain that vertebral don't ​

Internal Carotid Arteries

Principle Arteries

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Carotid Territory

The internal carotid artery (on each side): ​

1. Passes through carotid canal of skull to the cavernous sinus

2. Curves forward within sinus, then up and backwards through the dura, forming a loop called the carotid siphon

3. Reaches the brain

4. Branches into these arteries: ophthalmic artery, large middle and smaller anterior cerebral arteries, and the anterior choroidal artery

• ​The anterior cerebral arteries meet in mid plane to form the anterior communicating artery. This form an anastomosis between the left and right hemispheres

• ​The anterior choroidal artery connects to the posterior communicating artery and carries blood to the choroid plexus (blood vessels in the Pia mater that produces cerebrospinal fluid) of the lateral hemispheres of the brain

• Carotids connect to ​posterior cerebral arteries via the posterior communicating arteries

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Vertebral Territory

• Vertebral arteries pass through the ​foramen magnum in the base of the skull and forms a single major midline structure, called the Basilar artery

• Basilar artery terminates in the interperduncular cistern and bifurcates into left and right posterior cerebral arteries ​

• ​The Basilar artery branch into these arteries: posterior and anterior inferior cerebellar arteries, the superior cerebellar arteries, pontine and internal auditory arteries, and penetrating arteries which supply vital centres in the brainstem​

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Multiple Choice

What is the circle of willis?

• A hexagon of vessels that give rise to the major cerebral arteries

• A circle of vessels that give rise to the major cerebral arteries

• A hexagon of vessels that give rise to the major cerebellar arteries

• A circle of vessels that give rise to the major cerebellar arteries

Multiple Choice

Where do these cerebral arteries run?

• Subarachnoid space

• Subdural Space

• ​Largely ventral to the brain

• Runs in the subarachnoid space before entering the regions of the brain

Characteristics of cerebral arteries

• A hexagon of vessels that gives rise to all major cerebral arteries​

• Supplied by paired internal carotid arteries and ​the basilar artery

• Consists of two parallel posterior communicating arteries and an anterior communicating artery

​Circle of Willis

Cerebral arteries

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Multiple Select

What does the anterior cerebral artery supply

• Frontal lobe

• Medial aspect of the cerebral hemisphere

• Deep structures of the brain

• Lateral aspect of the cerebral hemisphere

Multiple Select

What does the middle cerebral artery supply?

• Frontal lobe

• Medial aspect of the cerebral hemisphere

• Deep structures of the brain

• Lateral aspect of the cerebral hemisphere

Multiple Select

What does the posterior cerebral artery supply

• Frontal lobe

• Occipital lobe

• Choroid plexuses

• Lateral aspect of the cerebral hemisphere

Cortical Supply

• ​Anterior Cerebral Artery: supply the anterior frontal lobe and the medial aspect of the cerebral hemisphere

• Middle Cerebral Artery: supply many deep structures of the brain and much of the lateral aspect of the cerebrum. The left middle cerebral artery supplies cortical areas essential for speech

• Posterior Cerebral Artery: supply mainly the occipital lobe and choroid plexuses of the third and lateral ventricles and lower surface of the temporal lobe​

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Multiple Choice

Where are Venous sinuses found?

• Between inner and outer layer of dura mater

• Between inner and outer layer of arachnoid mater

• Between inner and outer layer of Pia mater

• Between inner and outer layer of sub-dural mater

Multiple Select

Where do all venous sinuses ultimately drain into?

• Internal jugular vein

• Choroid Plexus

• Pterygoid Plexus

• External Jugular Vein

Multiple Select

Which of these are types of venous sinuses?

• Sagittal Sinus

• Cavernous Sinus

• Intramural Sinus

• Transverse sinus

• Lined with mesothelium

• Lies between the inner and outer layers of the dura mater (intramural sinuses)​

• All sinuses drain into internal jugular veins or pterygoid plexus

• Communicate with extra cranial veins via emissary veins​

​Venous sinuses

Venous drainage of the brain and coverings include: ​

• Veins of the brain

• Dural venous sinuses

• Meningeal veins of dura and diploid veins between the tables of the skull​

tYPES OF channels

Venous Drainage

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Venous sinuses

Most Important Venous sinuses:

• ​Superior Sagittal Sinus: between the cerebral flax and the inside of the skull cap

• Inferior Sagittal Sinus: in the free edge of the cerebral flax

• Straight Sinus: between cerebral flax and tentorium

• Transverse Sinuses​: between the tentorium and its attachment on the skull cap

• ​Sigmoid Sinuses: S-curved continuations of the transverse sinuses into jugular veins, forms lateral sinus

• Sphenoparietal Sinuses: Drains deep middle cerebral veins into ​Cavernous Sinuses

• Inferior Petrosal Sinuses: from the cavernous sinus to the jugular foramen

• Superior Petrosal Sinus: from the cavernous sinus to the beginning of the sigmoid sinus

• ​Cavernous Sinuses: receive drainage from many sources, including ophthalmic and facial veins

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Venous Sinuses

​Cavernous Sinuses

• Blood leaves the cavernous sinuses via the petrosal sinuses

• A number of important arteries and nerves run alongside these sinuses:

• Internal ​Carotid Artery

• Oculomotor, trochlear, abducens , ophthalmic division of trigeminal nerves, and the trigeminal ganglion

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Multiple Choice

What is the main vein that the interior of the cerebrum drains into?

• Great Cerebral Vein (of Galen)

• Great Cerebral Vein (of Rosenthal)

• Internal Jugular vein

• External jugular vein

Multiple Select

What veins drain into the great cerebral vein (of Galen)?

• Internal Cerebral Veins

• Basal Veins (of Rosenthal)

• Precentral Veins

• Veins of the brainstem

Multiple Choice

What is the main vein that the cortical veins drain into?

• Great Cerebral Vein (of Galen)

• Great Cerebral Vein (of Rosenthal)

• Internal Jugular vein

• External jugular vein

Multiple Select

What are the main cortical veins?

• Superior Cerebral Vein

• Anterior Cerebral Vein

• Inferior Cerebral Vein

• Posterior Cerebral vein

Internal Drainage

T​he interior of the cerebrum drains into a single midline great cerebral vein (of Galen)

Veins that empty into the great cerebral vein

• Internal Cerebral Veins: including septal, thalamostrate and choroidal veins

• Basal Veins (of Rosenthal)​: drain the base of the forebrain

• Precentral Vein​: from the cerebellum

• Veins of the brainstem ​

​Venous drainage from the base of the cerebrum also goes into the deep middle cerebral vein and then to the cavernous sinus

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Cortical Veins

Veins of Cerebral Cortex surfaces: divided into superior and inferior groups

All ultimately drain into the internal jugular vein

• Superior Cerebral Vein​: run upwards to superior sagittal sinus

• Inferior Cerebral Vein: end in superficial middle cerebral vein or transverse sinus​

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