2: Blood Supply & Lymphatics of H & N Flashcards
What is the main blood supply to the Head & Neck?
Common Carotid Artery:
- Internal CA: Brain (w. vertebral artery)
- External CA: Face, scalp, skull
What is the blood supply of the face and scalp?
ECA
Except 2 small ICA branches: supratrochlear + supraorbital
What is the blood supply of the scalp?
ECA → Maxillary Artery → Middle Meningeal Artery
What do the veins of the H & N follow?
The arteries of the H & N
Follow them anteriorly
What is the superficial drainage of the H & N?
Into EJV
What is the deep drainage of the H & N?
Into IJV
What is a potential route of infection through veins in face?
Face + Scalp veins drain → cavernous sinus drains → pterygoid plexus inside skull
What are the 8 branches of the External Carotid Artery?
- Superior Thyroid
- Ascending Pharyngeal
- Lingual
4. Facial
- Occipital
- Posterior Auricular
7. Maxillary
8. Superficial Temporal
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What are the 6 Cervical triangles of the neck?
- Submandibular
- Submental
- Carotid
- Occipital
- Muscular
- Supraclavicular
What are the borders of the Submandibular triangle of the neck?
Superior: Mandible
Posterior: Posterior belly of Digastric Muscle
Anterior: Anterior belly of Digastric Muscle
What are the borders of the Submental triangle of the neck?
Inferior: Hyoid Bone
Medial: Midline of neck
Lateral: Anterior belly of Digastric muscle
What are the borders of the Carotid triangle of the neck?
Superior: Posterior belly of Digastric muscle
Lateral: SCM
Inferior: Omohyoid
What are the borders of the Occipital triangle of the neck?
Anterior: SCM
Posterior: Trapezius
Inferior: Omohyoid
What are the borders of the Muscular triangle of the neck?
Superior: Hyoid
Medial: Midline of neck
Supero-lateral: Omohyoid
Infero-lateral: SCM
What are the borders of the Supraclavicular triangle of the neck?
Superior: Omohyoid
Inferior: Clavicle
Anterior: SCM
What are the contents of the Carotid Triangle? (3 things)
- Common carotid artery
- IJV
- Hypoglossal + Vagus Nerves
What are the contents of the Submandibular Triangle? (3 things)
- Submandibular gland (salivary)
- Lymph nodes
- Facial artery + vein
What are the contents of the Muscular Triangle? (3 things)
- Infrahyoid muscles
- Pharnyx
- Thyroid + Parathyroid glands
What must a lymphatic drainage of a tissue pass through?
At least ONE lymph node
Where does lymph move from and to?
Cellular environment → R / L subclavian vein @ thoracic duct
What are lymph nodes? (2 points)
- Interruptions within lymphatic vessels
- Act as filters
What are some important groups of nodes? (3 things)
- Axillary
* Important in breast cancer - Para-aortic
- Drain into abdomen
- Important in intestinal fat absorption
- Imporant in gut pathogen management
- Cervical chains
* Important for H & N
What are H & N lymph nodes classified into? (2 things)
- Regional Nodes
* Drain specific regions of H & N - Terminal Nodes
* Drain entirity of of H & N
Regional drain → Terminal
What are the Regional Lymph nodes of the H & N? (6 things)
- Submental
- Submandibular
- Pre-auricular
- Posterior Auricular
- Occipital
- Superficial cervical
What are the Terminal Lymph nodes of the H & N? (3 things)
- Jugulo-digastric
- Deep cervical chain
- Jugulo-omohyoid
When do lypmh nodes swell? (2 things)
- Normal immune response to pathogen
- Cancer
How do lymph nodes swell in cancer? (2 steps)
- Metastatic cells get lodged in node
- Cells proliferate → enter blood + block lymph flow
What are 2 clinically important lymph nodes?
- Virchow’s Node
- @ L supraclavic fossa
- Swells in gastric cancer
- Jugulo-digastric
- Drains tonsils
- Swell in tonsilitis
