Very detail Explaination of blood supply

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2. ARTERIAL SUPPLY OF THE BRAIN.

3. BLOOD SUPPLY:
BRAIN
HIGH METABOLIC DEMANDS FOR OXYGEN & GLUCOSE.
HYPOXIA AND HYPOGLYCAEMIA.
CONCIOUSNESS LOST -10 SEC OF CESSATION OF BLOOD.
BRAIN DAMAGE -4 -10MINS.
2% OF THE BODY WEIGHT
20% OF THE TOTAL CARDIAC OUTPUT
20% OF THE TOTAL O2 USED BY THE BODY.
EMBOLISM,THROMBOSIS AND HAEMORRHAGE
ARE MOST COMMON CAUSE OF DEATH.
CAROTID SYSTEM
VERTEBRAL SYSTEM.

4. MODE OF BLOOD SUPPLY TO THE BRAIN
 ANTERIOR CIRCULATION
 POSTERIOR CIRCULATION

5. BLOOD SUPPLY:
BRAIN Branches of the cranial part of the
vertebral artery:
• Anterior spinal artery
• Posterior spinal artery
• Posterior inferior cerebellar artery
• Meningeal branches
• Medullary arteries

6. BLOOD SUPPLY:
BRAIN
po
st
posterior
Branches of basilar artery
• Pontine branches
• Anterior inferior cerebellar artery
• Labyrinthine artery
• Superior cerebellar artery
• Posterior cerebral artery-temporal branches

7. BLOOD SUPPLY:
BRAIN
Branches of the cerebral part of
the internal carotid artery:
• Ophthalmic artery
• Posterior communicating artery
• Anterior choroidal artery
• Anterior cerebral artery
• Middle cerebral artery

8. BLOOD SUPPLY:
BRAIN CIRCLE OF WILLIS:
Anteriorly: by the anterior communicating and the anterior cerebral arteries.
Posteriorly: by the basilar artery dividing into two posterior cerebral arteries.
Laterally: on each side, by the posterior communicating artery connecting the
internal carotid artery with the posterior cerebral artery.

9. BLOOD SUPPLY:
BRAIN CEREBRUM:

10. BLOOD SUPPLY:
BRAIN CEREBRUM:

11. BLOOD SUPPLY:
BRAIN CEREBRUM:
CEREBRAL ARTERIES
CORTICAL CENTRAL CHOROIDAL
OUTER PORTION OF
THE CEREBRUM
CENTRALLY LOCATED
PARTS OF CEREBRUM
PROJECT INTO THE
VENTRICLES
1.SHORT
2.LONG.
1.ANT-MED GROUP
2.ANT-LAT GROUP
3.POST-MED GROUP
4.POST-LAT GROUP.
1.ANT CHOROIDAL.A
2.POST CHOROIDAL.A

12. The arterial supply of the deep cerebral structures by
Middle and anterior cerebral arteries.

13. BLOOD SUPPLY:
BRAIN
CEREBRUM:
CEREBELLUM:
MIDBRAIN:
PONS:
MEDULLA :
ANT,MID AND POST CEREBRAL ARTERIES.
SUP,ANT-INF AND POST-INF CEREBELLAR ARTERIES.
POST CEREBRAL,SUP CEREBELLAR AND BASILAR ARTERIES.
ANT-INF,SUP CEREBELLAR AND BASILAR ARTERIES.
VERTEBRAL AND POST-INF CEREBELLAR ARTERIES.

14. Clinical Correlation
The occlusion of anterior cerebral artery
 Contralateral hemiparesis and hemianaesthesia involving
mainly the leg and foot
 Inability to identify the objects correctly
 Apathy and personality changes
The occlusion of middle cerebral artery
 Contralateral hemiplegia and hemianaesthesia
 Aphasia
 Contralateral homonymous hemianopia
The occlusion of posterior cerebral artery
 Contralateral homonymous hemianopia

15. • The cerebral angiography
It is a radiological technique to visualize the vessels of the brain.
A radiopaque solution is injected into one of the major arteries
supplying the brain, and serial radiographs of skull are taken at
approximately 1 second intervals.
 The injection into the common carotid artery or the internal carotid
artery (carotid angiogram) shows the distribution of middle and
anterior cerebral arteries;
 whereas the injection into the vertebral artery permits the
visualization of vertebral, basilar and posterior cerebral arteries
together with their branches.
 The cerebral angiography is valuable in identifying vascular
malformations and aneu-rysms.
 It is also provides useful information about occlusive vascular disease
and space-occupying lesions.

16. VENOUS DRAINAGE OF THE BRAIN.

17. BLOOD SUPPLY:
BRAIN
DRAINS INTO DURAL VENOUS SINUSES.
FINALLY INTO THE INERNAL JUGULAR VEINS.
TRAVERSE THE SUBARCHNOID SPACE,
PIERCES ARCHNOID MATER,
MENINGEAL LAYER OF DURA MATER.
DOES NOT FOLLOW ARTERIAL PATTERN.
THIN WALLED DUE TO ABSENCE OF MUSCULAR TISSUE IN THEIR WALLS.
POSSESES NO VALVES.
RUNS IN SUBARACHNOID SPACE.
 ENTER OBLIQUELY INTO THE DURAL VENOUS SINUSES.

18. BRAIN
SUPERFICIAL VEINS:
1. SUPERIOR CEREBRAL
2. MIDDLE CEREBRAL
3. INFERIOR CEREBRAL.
BLOOD SUPPLY:
OTHER VEINS:
1. ANTERIOR CEREBRAL
2. BASAL
3. INTERNAL CEREBRAL
4. GREAT CEREBRAL.

19. ANTERIOR CEREBRAL VEIN
It accompanies the anterior cerebral artery around the corpus
callosum and drains the parts of medial surface which cannot be
drained into the superior and inferior sagittal sinuses
The anterior cerebral vein is the only large vein of the brain which has
a similar name and course as its companion artery (anterior cerebral
artery).

20. THE BASAL VEIN.
Tributaries
1. Anterior Cerebral
2. Deep Middle Cerebral
3. Striate Veins
Basal vein receives the tributaries
from:
• Cerebral peduncle
• Uncus and parahippocampus
• Structures of interpeduncular
fossa
• Optic tract and olfactory trigone
• Inferior horn of the lateral
ventricle.

21. THE INTERNAL CEREBRAL VEINS AND THE GREAT CEREBRAL VEIN OF GALEN.
Internal cerebral vein is formed at
the interven-tricular foramen (of
Monro) by the union of three
veins:
1. Thalamostriate,
2. Septal And
3. Choroidal.
Between the two layers of tela
choroidea of third ventricle and
unite together beneath the
splenium of corpus callosum to
form the great cerebral vein (of
Galen) which empties into the
straight sinus.

22. • Capillary endothelial cells
• A basement membrane
• The foot processes of the astrocytes that adhere to the outer surface of the
capillary wall.
BLOOD- BRAIN BARRIER?
This barrier protects the brain and spinal cord from potentially
harmful substances (toxic drugs and other exogenous materials)
while allowing the gases and nutrients to enter the nervous tissue.

23. BLOOD- CSF BARRIER?
• The endothelial cells
• The basement membrane of the capillary endothelial cells.
• The basement membrane of the choroidal epithelial cells.
• The tight junctions between the choroidal epithelial cells.
• The scattered pale cells with their flattened processes between the two basement
membranes.
It allows the free passage of water, gases and lipid soluble substances from the
blood to the CSF, but prevents the entry of macromolecules such as proteins and
most hexoses other than glucose.

25. The Spinal Cord : Arterial Supply
1. Anterior spinal artery.
2. Two posterior spinal arteries.
3. Segmental arteries.
 Deep Cervical,
 Ascending Cervical,
 Posterior Intercostal,
 Lumbar and
 Lateral Sacral Arteries.

26. The Spinal Cord : Arterial Supply
These arteries are reinforced by the segmental arteries to form 5 longitudinal arterial
trunks.These arterial trunks communicate around the cord forming a pial plexus, the
arterial vaso corona/arteriae coronae. The arteriae coronae give peripheral
branches which supply the superficial regions of the cord.
The anterior spinal artery supplies the anterior two-third of the cord,
while two posterior spinal arteries together supply the posterior one-third of the cord.

27. • Anterior spinal artery syndrome:
It occurs due to occlusion (thrombosis or compression of the anterior spinal artery).
Each segmental artery divides into anterior and posterior branch which enter the
vertebral canal along the anterior and posterior nerve roots of corresponding spinal
nerve; hence termed anterior and posterior radicular arteries respectively. Many of these
radicular arteries are small and end by supplying the spinal nerve roots.
Since the anterior spinal artery supplies anterior two-third of the cord, the occlusion of
this artery will therefore result in:
(a) motor symptoms, due to involvement of corticospinal tracts and anterior grey
columns, and
(b) bilateral loss of pain and temperature sensation due to ischaemia of spinothalamic
tracts.

28. These longitudinal venous channels communicate with the internal vertebral venous
plexus and drained by veins which leave through the intervertebral foramina to empty into
the vertebral,posterior intercostal, lumbar and lateral sacral veins.
The internal vertebral venous plexus communicates above with the basilar venous plexus.
Venous drainage of the spinal cord.

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