REVIT OF BLOOD SUPPLY OF
BRAIN
CRANIAL NERVES , SPINALCORD
DR. MARIA MOHIUDDIN
Arterial supply
• Blood supply to the brain,
• derived from:
• Internal carotid.
• vertebral arteries.
Internal Carotid artery
• Each internal carotid artery enters the cranial cavity through the
carotid canal in the petrous part of the temporal bone.
• internal carotid arteries course anteriorly through the cavernous
sinuses.
• terminal branches of the internal carotid arteries are the anterior and
middle cerebral arteries.
• Clinically, the internal carotid arteries and their branches are often
referred to as the anterior circulation of the brain.
Vertebral arteries
• vertebral arteries begin in the
root of the neck (the
prevertebral parts of the
vertebral arteries) as first branch
of subclavian artery.
Basilar artery
• basilar artery, because of its
close relationship to the cranial
base, ascends the clivus.
• ends by dividing into the two
posterior cerebral arteries.
Cerebral Arteries
• Anterior cerebral artery supply most of the medial and superior
surfaces of the brain and the frontal pole.
• Middle cerebral artery supply the lateral surface of the brain and the
temporal pole.
• Posterior cerebral artery supply the inferior surface of the brain and
the occipital pole.
Circle of Wilis
• The arterial circle is formed sequentially in an anterior to posterior
direction by the:
• • Anterior communicating artery.
• • Anterior cerebral arteries.
• • Internal carotid arteries.
• • Posterior communicating arteries.
• • Posterior cerebral arteries.
Venous drainage
• from the brain occurs via:
• cerebral and cerebellar veins that drain to the adjacent dural venous
sinuses.
• thin-walled, valveless veins draining the brain pierce the arachnoid
and meningeal layers of dura to end in the nearest dural venous
sinuses.
• Superior cerebral veins on the superolateral surface of the brain drain
into the superior sagittal sinus.
• Inferior and superficial middle cerebral veins.
• Great cerebral vein (of Galen) inferior sagittal sinus to form the
straight sinus.
CRANIAL NERVES (REVISIT)
CN-I TO CN-XII
• Olfactory nerve (CN-1) • Facial (CN-VII)
• Optic Nerve (CN-II) • Vestibulocochlear (CN-VIII)
• Oculomotor Nerve(CN-III) • Glossopharyngeal (CN-IX)
• Troclear Nerve (CN-IV) • Vagus (CN-X)
• Trigeminal Nerve(CN-V) • Accessory (CN-XI)
• Abducent Nerve (CN-VI) • Hypoglossal (CN-XII)
• extrinsic muscles of the eye:
• Levator palpebrae superioris,
superior rectus, medial rectus,
inferior rectus, and inferior oblique.
• Intrinsic muscles of the eye:
• parasympathetic nerve fibers to the
following intrinsic muscles: the
constrictor pupillae of the iris and
ciliary muscles
• Trochlear nerve (CN-IV)
• Supplies superior oblique
• Abducent nerve (CN-VI)
• Supplies lateral rectus
Trigeminal Nerve (CN-V)
• Mixed nerve.
• Major general sensory nerve of
the head (general somatic
afferent (GSA)
• Muscles that move the lower jaw
(branchial efferent fibers)nerve
of first pharyngeal arch.
FACIAL NERVE (CN- VII)
• Mixed nerve
• Sensory nucleus
• Motor nucleus
• Parasympathatic
nuclei
A. Superior salivatory
nucleus
B. Lacrimatory nucleus
Supra Nuclear lesion & Bell’s Palsy
VESTIBULOCOCHLEAR NERVE, CN. VIII
GLOSSOPHARHNGEAL NERVE CN. IX
• Mixed nerve
• Emerges from anterior surface of the medulla.
• leaves the skull by passing through jugular foramen.
VAGUS NERVE
• Mixed Nerve
• Main motor nucleus
Nucleus ambiguus
• Main sensory nucleus
Nucleus tractus solitarius
• Parasympathetic nucleus
Dorsal nucleus of vagus
nerve
ACCEASSORY CRAINIAL NERVE XI
• Two roots (cranial and spinal roots)
• Cranial root (part) is formed from the axons of nerve cells of the
nucleus ambiguous.
• Spinal root (part) supplies sternocleidomastoid and trapezius
muscles, two large muscles in the neck.
HYPOGLOSSAL NERVE CN.XII
• Hypoglossal nerve is a
motor nerve.
• nucleus is situated in the
medulla beneath the
floor of the lower part of
the fourth ventricle.
SPINAL CORD
• Roughly cylindrical in shape
• Starts=at the foramen magnum in the skull, where it is continuous with
the medulla oblongata of the brain.
• Terminates=adult at the level of the lower border of the first lumbar
vertebra.
• children, ends at the upper border of the third lumbar vertebra
L2-L5, S1-S5, Co
Internal features
Nerve Cell Groups in the Posterior Gray
Columns
• Substantia gelatinosa group is situated at the apex of the posterior gray
column
• afferent fibers: pain, temperature, and touch from the posterior root.
• Nucleus proprius: senses of position and movement (proprioception),
two-point discrimination, and vibration.
• throughout the length of the spinal cord
• Nucleus dorsalis (Clarke's column) base of the posterior gray column.
• Receives proprioceptive endings (neuromuscular spindles and tendon
spindles.
• Visceral afferent nucleus is a group of nerve cells of medium size
situated lateral to the nucleus dorsalis.
• Associated with receiving visceral afferent information
Nerve cells lateral horn
• Small and give rise to
preganglionic sympathetic fibers.
• First thoracic to the second or
third lumbar segment of the
spinal cord.
• Gray commissure and central
canal.
THANK YOU
