Importance of vascular territories?

[majahops]

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For whatever reason, retaining the anatomical distribution of the cerebral arteries (let alone the clinical manifestations resulting from lesions to each) has been an insurmountable task for me to this point. Now that I'm studying for Step 1, I'm trying to decide whether I should spend the many, many hours it would take me to memorize these things or just glance over it quickly, try to appreciate the circle of Willis and the general results of lesions to the ACA, MCA, PCA and then move on.

Any ideas? Has anybody else found this particular task especially challenging? If so, have you overcome it, and how?

Thanks so much in advance!

 

[unsung]

For whatever reason, retaining the anatomical distribution of the cerebral arteries (let alone the clinical manifestations resulting from lesions to each) has been an insurmountable task for me to this point. Now that I'm studying for Step 1, I'm trying to decide whether I should spend the many, many hours it would take me to memorize these things or just glance over it quickly, try to appreciate the circle of Willis and the general results of lesions to the ACA, MCA, PCA and then move on.

Any ideas? Has anybody else found this particular task especially challenging? If so, have you overcome it, and how?

Thanks so much in advance!

Try and picture each area that's getting supplied.

For ex, for middle cerebral artery, it helps me to just picture the homunculus-- the legs are dangling over the medial surface of the brain. Therefore, problem with the anterior cerebral artery (supplying medial surface) results in leg or foot deficits.

http://en.wikipedia.org/wiki/File:Sensory_Homunculus.png

For PICA, picture a cross section of the medulla:

http://4.bp.blogspot.com/_th8h_a9bJP0/TCYTkLEr1fI/AAAAAAAAAEE/RwJBP42NdSE/s1600/fig09.jpg

There's a bunch of crap there, but don't have to memorize it all. Remember the big thing's the inferior cerebral peduncle (--> ipsilateral ataxia). The lateral spinothalamic tract carries pain & temp fr body (--> contralateral loss of pain/temp). The trigeminal tract supplies ipsilat face (--> ipsilat loss of face pain/temp).

STT tract crosses at the anterior white commissure in the spine, below the medulla. Therefore, lesioning at the medulla gives a contralat defect.

Etc.

Is this what you're talking about ? Basically, remembering a picture is easier than memorizing each defect.

 

[RySerr21]

For whatever reason, retaining the anatomical distribution of the cerebral arteries (let alone the clinical manifestations resulting from lesions to each) has been an insurmountable task for me to this point. Now that I'm studying for Step 1, I'm trying to decide whether I should spend the many, many hours it would take me to memorize these things or just glance over it quickly, try to appreciate the circle of Willis and the general results of lesions to the ACA, MCA, PCA and then move on.

Any ideas? Has anybody else found this particular task especially challenging? If so, have you overcome it, and how?

Thanks so much in advance!

yes, i found it especially challenging. So much so that I just skipped that page in FA all together. The one thing I did learn was the pictures on the previous page, which has the general areas of the middle, anterior, and posterior arteries. I found this pretty helpful, and I had 1 or 2 questions taht I got simply by knowing that distribution. I got zero questions that required the detailed knowledge on the following page that has all the syndromes of different artery blocks. Definitely not high yield - at most you may get one or two quesitons, but more likely you will just get one that requires the konwldge i described previously.

 

[ArcGurren]

I think if you learn your neuroanatomy and vascular territories it will make it all that much easier for you on the real deal. There's a great chart in FA and it makes a lot of logical sense to think out what an occlusion of X artery would cause ischemia to.

I didn't have a lot of neuro questions but of the ones I did have, 2 of them were arterial territory questions (one was an easy MCA question with aphasia, etc)