Lecture a -

Anatomical Blood Supply the

to
Brain
20231021 15th M

The Cerebral Arteries Internal carotid and Vertebral Arteries

Interface with the anastomotic Circle of Willis.

The Internal Carotid

Artery
-

Right
Common Carotidarises from the brachiocephalic trunk, andthe leftfrom the
portic arch.
- At
thyroid cartilage level, the common carotids bifurcate, yielding external and
internal carotidarteries
- The internal carotiol arteries ascend this the
deep neck, the carotid canals of the

petrous bones andthe cavernous sinus.

-
The internal carotidemits the ophthalmic and
posterior communicating arteries
middle cerebral arteries.
and
they divide, ending as the anterior and

The Vertebral Artery

· Are the firstbranches of the subclavian
artery

Seet
Ascend
·
through the transverse foraming (of the upper 6 (V) andenter the skull thro
the foramen
magnum.
·
fruitthe
posterior inferior cerebellar arteries (PICA) which usuallyemit the posterior
spinal arteries.
· The vertebral arteries then emitthe anterior
spinal arterybefore unifying to form the
basilar artery.
The Basilar Artery - Gives to anterior inferior cerebral artery (AICA).
rise

-
The
superior cerebellar arteries arise from the basilar artery,justbefore its bifurcation
into the two cerebral arteries near the caudal midbrain.
posterior

anterior The Arterial Circle of Willis

cerebral A
Isformedbypygroup of arteries perforating the
Cerebral whose
Midolle

Internal carotiol)

Posterior communicating &Posterior communicating)

superior cerebral Ibasilar artery)
anterior [vertebral atery)
inferior (A

Posterior
inferior CA
 The Anterior and Middle Cerebral Arteries
Are terminal divisions ICA, also

!"or
-
of emits
the PCA to anastmose with the vertebral

rb"cating arterial circulation.

The Anterior cerebral

-

artery
runs
medially

ineternalcarotan
anterior to the optic chiasm tothe

longitudinal cerebral fissure to supply the

frontal lobes.
en

⑲Posterior
cereal e
The ACAjoins the anterior cerebral arteriesse
-

Major branches of the ACA

pass to
the
medial of the frontal and
parietal
aspect
lobes and corpus callosum.
of Willis
The Circle -

Easy Memory
The Middle CAextend laterally, off
giving
-

branches of lateral aspect of frontal,

The Posterior Cerebral Arteries temporal and lobes.
parietal
-
Are terminal branches of the basilar artery.
-
Receive PCA.
the
-

Supplymedial temporal, occipital and

parietal sutures.

The Ventricular
System
9) Prosencephalon -

telencephalon and diencephalon (and ventricle)

b) Mesencephalon -
cerebral aqueduct
c) Rhombencephalon metencephalon
-
and myelencephalon 14th ventridel

the caudal myencephalon and myelon (spinal

corol) contain central canal.
the interconnectedventricles are lined with epenoyma filled with CSF(secreted by choroid plexus)
The left andright lateral ventricles communicated with grd ventricle via intraventricular foramina of
Monro
zrol-4th communicate via cerebral
aqueduct
4th central canal of medulla, which is continuous with central canal of
->

spinal corol
the spinal cord ends as terminal ventricle in conus medullaris -
the Lateral Ventricles -

Anterior (frontall, body (corpus), Posterior (occipital), Inferior (temporall

third Ventricle thin, occupies the midline between the diencephalic hemisphere.
Roofformed by choroid plexus and the bodyofthe fornix.
Fourth Ventricle Is rhomboid overlying pons androstral medulla.
a
carity
Connected to go ventricle by Mesencephalic cerebral aqueduct
Communicates with subarachnoid space via the two foramina of Luschka and foraming of

Megendie
ChoroidPlexus Occupies
· all Ventricles
·
Is a rich network of blood vessels of the pia matter thatprojects each
into ventricle to form a

semipermeable filter between arterial blood andthe CSF.

· An epithelial layer of
epenoyma covers the plexus andlines the ventricles.

Cerebro -

spinal fluid ~
Clear, colourless, almost protein free filtrate -
of blood
-
functions:
support cushion the CNS
· and
againstinjury
·
serve function andremove metabolic
nutritive waste products.
·
ICP:65-200mm H20 Is-is mmHg)

Contents:
plexus, epenoyma, glia,pial and arachoid vessels.
·

produced in choroid
·

passive movement of water (wo.s mL/min)

·
clear, low in glucose, protein, kt, Catt and cells.
Nat, (1-
·
Mgat higher than in
and serum

·
Constantly formed (600 700mL/day)
-

·
Total volume -140 mL.

Circulation of CSF thru ventricular system

4)from lateral ventricle to end ventricle via interventricular foraming ofMonro
2) 3rd ventricle to cerebral aqueduct
3) Cerebral
aqueductto 4th ventricle
Small amount trickle between the 4th ventricle and the central canal.
4)

3) Exit 4th ventricle into subarachnoid space via foraming ofluschka andMagendie.
6) EV CSFfollows the subarachnoid space.
7) Return to venous system thru small membranous villi, the arachnoid granulation
llocated along the superior saggital sinus)
8) The arachnoidvillireact to pressure gradientbetween the subarachnoid space and
venous system to form one movement.
way values, ensuring one-way
Brain Sinuses and Veins

· Are epithelium-lined spaces channels between the two layers of

or dura of the brain, and

drainage of blood from the brain is mainlyintothese sinuses.

· Do have values;usually triangular
not

·Receive blood from:

9) the cerebral veins -
main source of blood
drainage
b)The short midline great cerebral vein (of Galent forms &
junction of the a internal
cerebral veins and drains into straight sinus.

c) The diploic vein between layers of cranial bone.

They anastmose freely with each other and also communicate with the meningeal veins

internally and the superficial veins externally.

-
The emissaryvein connect extracranial and intracranial veins.

have little
- Venous sinuses
tendencyto collapse as do most other veins because of
the fibrous consistency of the dura matter.

Unpaired Superior longitudinal saggital-begin as continuation of nasal

vein;recieve bloodfrom the
Dural Sinus cerebral, diploic and
emissary veins.

Inferior saggital -
recieve blood from veins medial surface of the brain.
on

StraightSinus-occupies area between the fallcerebri and tentorium cerebelli.

The
straight sinus is the posterior continuation the great or of Galen and joins the
of

superior saggital sinus to form the confluence of sinuses.

small Occipital Sinus-begin near foramen magnum and ascend in the attached margin
offall cerebellito end in the confluence of sinuses. It also
receives the inferior cerebellar veins.
Paired Dural Venous Sinuses
Transverse Sinus Receive bloodfrom the confluence of sinus anddrain into the internal jugular veins via
the
sigmoidsinuses.
Cavernous Sinus Located lateral to the body of sphenoid bone and the sella turcica and receive
blood from the superficial MCU and superior ophthalmic veins.
The internal carotiol artery and the abducens nerve this these sinuses.
pass
the oculomotor, trocklear, ophthalmic and maxillary nerves pass toward in
the lateral wall of the sinuses.
Communicate with pterygoid venous plexus by emissary veins and receive the

superior ophthalmic vein.

They communicate with each other via cavernous sinuses.

These sinuses are the largest
and most clinically important of the deep inter-

connecting sinuses and drain into the superior and inferior petrosal sinuses -

SigmidSinus Are a continuation of the transverse sinuses. Receive blood from the inferior
cerebrum, cerebellum and emissary veins.

Superior and Drain from cavernous sinus into the transverse sinuses and internal jugular veins,
inferior Petrosal respectively.
Spheroparietal sinus
Having received blood from the SMCA, extend along the crest of the lesser wing
of the and
sphenoidbone drain into cavernors sinuses.