Vertebral Artery: Difference between revisions

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'''Original Editor '''- [[User:Rachael Lowe|Rachael Lowe]]  
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== [[Image:532px-Vertebral artery 3D AP.jpg|thumb|right]]Description  ==
== [[Image:532px-Vertebral artery 3D AP.jpg|thumb|right]]Description  ==
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The vertebral artery is a major artery in the neck<ref name="aaa">http://home.comcast.net/~wnor/lesson5.htm</ref>. It branches from the subclavian artery, where it arises from the posterosuperior portion of the subclavian artery.  
The vertebral artery is a major artery in the neck<ref name="aaa">http://home.comcast.net/~wnor/lesson5.htm</ref>. It branches from the subclavian artery, where it arises from the posterosuperior portion of the subclavian artery.  


== Path ==
== Course ==


It ascends though the foramina of the transverse processes of the cervical vertebrae, usually starting at C6 but entering as high as C4<ref name="Magee">Magee, D. Orthopaedic Physical Assessment.  Elsevier.</ref>. It winds behind the superior articular process of the atlas. It enters the cranium through the foramen magnum where it unites with the opposite vertebral artery to form the basilar artery (at the lower border of the pons)<ref name="bbb">http://education.yahoo.com/reference/gray/subjects/subject/148</ref>.  
It ascends though the foramina of the transverse processes of the [[Cervical Vertebrae|cervical vertebrae,]] usually starting at C6 but entering as high as C4<ref name="Magee">Magee, D. Orthopaedic Physical Assessment.  Elsevier.</ref>. It winds behind the superior articular process of the [[atlas]]. It enters the [[Skull|cranium]] through the foramen magnum where it unites with the opposite vertebral artery to form the basilar artery (at the lower border of the pons (part of the [[brainstem]]))<ref name="bbb">http://education.yahoo.com/reference/gray/subjects/subject/148</ref>.  


== <br>Divisions  ==
== <br>Divisions  ==
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The vertebral artery can be divided into four divisions:  
The vertebral artery can be divided into four divisions:  


#The first division runs posterocranial between the longus colli and the scalenus anterior.<ref name="bbb" /> The first division is also called the ‘pre-foraminal division’.<ref name="aaa" />  
#The first division runs posterocranial between the [[Longus Colli|longus colli]] and the [[Scalene|scalenus anterior]].<ref name="bbb" /> The first division is also called the ‘pre-foraminal division’.<ref name="aaa" />  
#The second division runs cranial through the foramina in the cervical transverse processes of the cervical vertebrae C2.<ref name="bbb" /> The second division is also called the foraminal division<ref name="aaa" />.  
#The second division runs cranial through the foramina in the cervical transverse processes of the cervical vertebrae C2.<ref name="bbb" /> The second division is also called the foraminal division<ref name="aaa" />.  
#The third division is defined as the part that rises from C2. It rises from the latter foramen on the medial side of the rectus capitis lateralis, and curves behind the superior articular process of the atlas. Then, it lies in the  
#The third division is defined as the part that rises from [[Axis|C2]]. It rises from the latter foramen on the medial side of the [[Rectus Capitis Lateralis|rectus capitis lateralis]], and curves behind the superior articular process of the atlas. Then, it lies in the  
#groove on the upper surface of the posterior arch of the atlas, and enters the vertebral canal by passing beneath the posterior atlantoöccipital membrane<ref name="bbb" />.  
#groove on the upper surface of the posterior arch of the atlas, and enters the vertebral canal by passing beneath the posterior atlantoöccipital membrane<ref name="bbb" />.  
#The fourth part pierces the dura mater and inclines medial to the front of the medulla oblongata.<ref name="bbb" />
#The fourth part pierces the dura mater and inclines medial to the front of the medulla oblongata.<ref name="bbb" />
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== Supply  ==
== Supply  ==


It supplies 20% of blood to the brain (mainly hindbrain) along with the internal carotid artery (80%).  
It supplies 20% of blood to the [[Brain Anatomy|brain]] (mainly hindbrain) along with the [[Internal Carotid Artery|internal carotid artery]] (80%).  


== Clinical Relevance  ==
== Clinical Relevance  ==


It lies close to the vertebral bodies and facet joints where it may be compressed by osteophyte formation or injury to the facet joint.  
It lies close to the vertebral bodies and facet joints where it may be compressed by [[osteophyte]] formation or injury to the [[Facet Joints|facet joint.]]


In older individuals, artherosclerotic changes and other vascular risk facotrs (e.g. hypertension, high cholesterol, smoking, diabletes) may contribute to altered blood flow in the arteries.  
In older individuals, [[Arteriosclerosis|artherosclerotic]] changes and other vascular risk facotrs (e.g. [[hypertension]], [[Hypercholesterolemia|high cholesterol]], smoking, [[diabetes]]) may contribute to altered blood flow in the [[arteries]].  


The vertebral and carotid artieries are stressed primarily by rotation, extension and traction, but other movements may also stretch the artery. As little as 20% of rotation and extension have been shown to significantly decrease vertebral artery blood flow<ref name="Magee" />.&nbsp;  
The vertebral and carotid artieries are stressed primarily by rotation, extension and traction, but other movements may also stretch the artery. As little as 20% of rotation and extension have been shown to significantly decrease vertebral artery blood flow<ref name="Magee" />.&nbsp;  
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Symptoms, which may be delayed include:  
Symptoms, which may be delayed include:  


*vertigo  
*[[vertigo]]
*nausea  
*nausea  
*tinitus  
*tinitus  
*drop attacks  
*drop attacks  
*visual disturbances  
*visual disturbances  
*and in rare cases strok or death
*and in rare cases [[stroke]] or death
 
Read more here:
== Related Pages  ==
 
*[[Vertebral Artery Test]]  
*[[Vertebral Artery Test]]  
*[[Cervical Arterial Dysfunction]]
*[[Vascular Pathologies of the Neck]]


[[Category:Cervical_Anatomy]]
== References ==
[[Category:Cervical Spine - Anatomy]] [[Category:Arteries]]

Latest revision as of 08:36, 1 August 2023

532px-Vertebral artery 3D AP.jpg
Description
[edit | edit source]

The vertebral artery is a major artery in the neck[1]. It branches from the subclavian artery, where it arises from the posterosuperior portion of the subclavian artery.

Course[edit | edit source]

It ascends though the foramina of the transverse processes of the cervical vertebrae, usually starting at C6 but entering as high as C4[2]. It winds behind the superior articular process of the atlas. It enters the cranium through the foramen magnum where it unites with the opposite vertebral artery to form the basilar artery (at the lower border of the pons (part of the brainstem))[3].


Divisions
[edit | edit source]

The vertebral artery can be divided into four divisions:

  1. The first division runs posterocranial between the longus colli and the scalenus anterior.[3] The first division is also called the ‘pre-foraminal division’.[1]
  2. The second division runs cranial through the foramina in the cervical transverse processes of the cervical vertebrae C2.[3] The second division is also called the foraminal division[1].
  3. The third division is defined as the part that rises from C2. It rises from the latter foramen on the medial side of the rectus capitis lateralis, and curves behind the superior articular process of the atlas. Then, it lies in the
  4. groove on the upper surface of the posterior arch of the atlas, and enters the vertebral canal by passing beneath the posterior atlantoöccipital membrane[3].
  5. The fourth part pierces the dura mater and inclines medial to the front of the medulla oblongata.[3]

Supply[edit | edit source]

It supplies 20% of blood to the brain (mainly hindbrain) along with the internal carotid artery (80%).

Clinical Relevance[edit | edit source]

It lies close to the vertebral bodies and facet joints where it may be compressed by osteophyte formation or injury to the facet joint.

In older individuals, artherosclerotic changes and other vascular risk facotrs (e.g. hypertension, high cholesterol, smoking, diabetes) may contribute to altered blood flow in the arteries.

The vertebral and carotid artieries are stressed primarily by rotation, extension and traction, but other movements may also stretch the artery. As little as 20% of rotation and extension have been shown to significantly decrease vertebral artery blood flow[2]

The greatest stresses are placed on the verterbal arteries in 4 places:

  1. on entry to the C6 transverse process
  2. within the bony canals of the vertebral transverse processes
  3. between C1 and C2
  4. between C1 and entry of the arteries into the skull.

The most common mechanism for non-penetrating injury to the vertebral artery is extension with or without side flexion or rotation[2].

Symptoms, which may be delayed include:

  • vertigo
  • nausea
  • tinitus
  • drop attacks
  • visual disturbances
  • and in rare cases stroke or death

Read more here:

References[edit | edit source]