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BS III, Module II > 3. Blood Supply of H/N, Pt. 1 > Flashcards

3. Blood Supply of H/N, Pt. 1 Flashcards

1
Q

Recall that the ____ and ____
ascend into the root
of the neck bilaterally

A

common carotid

subclavian

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2
Q

Recall too that the
VERTEBRAL ARTERIES
are the first branches to arise from the ____ arteries

A

subclavian

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3
Q

Each artery ascends and enters a transverse foramen of the ____ vertebra

Ascent continues thru the transverse foramina of ____

____ and ____ branches arise as the vessels ascend the cervical spine

  • Each artery turns medially and passes superior to the posterior arch of the ____
  • After piercing the posterior atlanto- occipital membrane and dura, the artery enters the skull thru the ____
A 
C6
C6-C1
muscular
spinal
atlas
foramen magnum
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4
Q

At the level of the junction between pons and medulla, the two vertebral arteries form the ____ ascending the ____

Both vessels contribute to formation of a single ____ artery

After piercing the dura, a ____ artery arises from each vertebral

A

basilar artery
clivus
anterior spinal
posterior spinal

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5
Q

Cerebellar
arteries arise
from the ____ system…

…which terminates in the
____ arteries

A

vertebro-basilar

posterior cerebral

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6
Q 
Recall that the
RIGHT COMMON CAROTID
usually arises from the \_\_\_\_
while the
LEFT COMMON CAROTID usually arises from the \_\_\_\_
A

braciocephalic

aortic arch

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7
Q

Each common carotid normally bifurcates into INTERNAL and EXTERNAL branches at the ____ intervertebral level
…in the plane of the superior border
of the ____

A

C3-C4

thyroid cartilage

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8
Q

Within the
____ lies the bifurcation of the common carotid a.

Within the triangle, the carotid pulse
may be taken carefully along the along
____ just anterior to ____

A

carotid triangle
carotid line
SCM

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9
Q

____

are located in the vicinity of the carotid bifurcation

A

visceral sensory receptors

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10
Q

Carotid visceral sensory receptors
• Carotid sinus, subsuming the dilated distal end of the ____ and the proximal portion of the
____, contains pressure receptors, sensitive to stretching of the wall of the sinus
• These ____ convey inputs to the CNS via afferent branches of the ____ nerve
• Impulses are conveyed to
the ____ to
control blood pressure by altering heart rate and cardiac output

Carotid body (2-5mm in diameter) lies just above the bifurcation of the ____ artery, between the two branches.
• ____ respond to low levels of oxygen, and high levels of carbon dioxide, i.e., lowered blood pH.
• Visceral afferent branches of the ____ nerve convey the data to the ____

A 
common carotid
internal carotid
baroreceptors
glossopharyngeal
medulla oblongata

common carotid
chemoreceptors
glossopharyngeal

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11
Q

Excessive stimulation
of the baroreceptors
may cause ____

Carotid body - ____
Carotid sinus - ____
— bilateral stimulation continued after (Syncope) is dangerous because it might tell the brain (after continuous baroreceptor stimulation) to stop the ____ completely. i.e. Police performing Vascular Neck restraint/ Choke hold

A

syncope (faint)
chemoreceptors
baroreceptors
heart

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12
Q

Several small clusters of both chemoreceptors and baroreceptors
are also located along the ____

____ convey the command to the heart to slow down and decrease cardiac output

A 
aortic arch
vagal efferents (CN X)
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13
Q

Atherosclerotic plaque accumulation leads to ____ and may contribute to formation of ____. Atheromas not only block blood flow to the brain; clots may also break away and ascend to the brain, leading to cerebral artery occlusion and debilitating ____ which may cause paralysis, brain damage or death.

So a Procedure called ____ is usually no longer recommended(with patients with high heart rates) because you might dislodge some of plaque and might travel up to brain - problematic - ischemic stroke.

Carotid endarterectomy
Surgery for removal of ____ blocking the carotid arteries
can you think of a good reason why this surgery is potentially dangerous?
by detaching and mobilizing the plaque, plaque goes up and leads to ischemic stoke.

A

carotid stenosis
aneurysms
ischemic strokes

carotid massage

atheroma

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14
Q

Four distinct parts of each Internal Carotid Artery may be identified

Four portions

  1. ____ portion
  2. ____ portion
  3. ____ portion
  4. ____ portion
A

cervical
petrous
cavernous
cerebral

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15
Q

The ____ portion
of the ICA ascends to the base of the skull within the fascial ____, anterior to the transverse processes of the upper cervical vertebrae
however sometimes the pathway to the carotid canal is not exactly ____! might vary in population. (due to ____, etc)

it has NO ____!

A

cervical
carotid sheath
direct
hypertension

branches

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16
Q 
The
PETROUS
PORTION
of the ICA
runs through the \_\_\_\_ of the \_\_\_\_ BONE
A

carotid canal

temporal

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17
Q

The PETROUS PORTION of the ICA has TWO branches
first, ____ artery (supplies the middle ear cavity or ____)

second, we have the artery of the ____ aka vidian artery, this will run from ICA toward to ____.

A

caroticotympanic
tympanic cavity

pterygoid canal
pterygopalatine fossa

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18
Q

The Vidian artery anastomoses with a branch of the ____ in the pterygopalatine fossa

A

maxillary artery

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19
Q

Upon exiting the carotid canal and petrous temporal, the ICA passes over the ____ and then travels anteriorly thru the ____

A

foramen lacerum

cavernous sinus

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20
Q

The CAVERNOUS PORTION
of the ICA

  1. ____ - to dura of the sinus
  2. ____ branch - trigeminal impression on petrous temporal
  3. ____ branch - supplies all these nerves running through
  4. Meningeal branch - supplies the dura of the ____
  5. ____ artery
  6. ____ branches
A 
cavernous sinus branch
trigeminal ganglion
neural
anterior cranial fossa
inferior hypophyseal
tentorial
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21
Q

Blood in the hypophyseal arteries enters capillaries contributing to the HYPOPHYSEAL PORTAL SYSTEM allowing fast hormonal communication between ____ and
____

A

hypothalamus

anterior pituitary

22
Q

Note again the proximity of the cavernous portion of the ICA to ____, ____ and ____ - aneurysm may produce ____

Cavernous portion
of the Internal carotid
in the ____

A

CN III
CN IV
CN VI
opthamoplegia

cavernous sinus

23
Q

Coronal section through the “CAROTID SIPHON”

we saw the ICA running through the cavernous sinus anteriorly, now it is going to turn backward we call this turn in the sagittal plane in the ICA as it leaves the cavernous sinus and continues upward and turns: ____

A

siphon

24
Q

A coronal section thru the ____, just posterior to the tips of the anterior clinoid processes will actually intersect each internal carotid artery ____

A

middle cranial fossa

internal carotid artery

25
Q

The ____ arises as the vessel pierces the dural roof of the cavernous sinus

A

cerebral (supraclinoid) portion

26
Q

The CEREBRAL PORTION
of the ICA

Muscular branches to ____ muscles

Anterior and Posterior Ethmoidal arteries
- supply the ____ and ____

____ artery

Posterior Ciliary arteries - supplies the ____ and ____

____ artery

A 
extraocular
ethmoid sinuses
nasal cavity
lacrimal
eyeball
sclera
central retinal
27
Q

Central Retinal Artery

Each branch is an examples of an ____ (= no peripheral anastomoses)

The artery sends four
branches thru the ____

A

end artery

optic disk

28
Q

These three branches of the OPHTHALMIC ARTERY supply the skin of the ____ as well as of the root and bridge of the ____…

These branches of the
OPHTHALMIC ARTERY…

supply the skin of the forehead as well as
the root and bridge of the nose….

… anastomose with branches of the ____ supplying the face and scalp

A

forehead
nose
external carotid

29
Q

The CEREBRAL PORTION
of the ICA

  1. OPHTHALMIC courses thru the ____
  2. SUPERIOR HYPOPHYSEAL to the ____ (demanding organ)
  3. ____ aka PCOM
A

optic canal
pituitary
posterior communicating

30
Q 
The POSTERIOR COMMUNICATING
ARTERY (PCOM)
plays an important role
in formation of the
“\_\_\_\_,” communicating between the \_\_\_\_ and \_\_\_\_ circulations
A

circle of willis
internal carotid
vertebro-basilar

31
Q

The CEREBRAL PORTION
of the ICA

The terminal bifurcation of the ICA gives rise to the
____ and
____ arteries

  1. ____ supplies choroid plexus
    circulation of CSF (cerebrospinal fluid)
A

anterior
middle cerebral
anterior choroidal

32
Q

The inaccurately named “CIRCLE OF WILLIS” is a critical site of anastomosis between ____ and ____ circulations

A

vertebro-basilar

internal carotid

33
Q

MIDDLE
CEREBRAL
ARTERY

Courses thru
the ____where it branches and projects to many parts of the lateral cerebral cortex

Also supplies blood to the ____ and the ____

important in providing blood to the lateral aspect of the cerebral hemisphere. including the ____ ( important for language )

A

lateral (Sylvian) sulcus
anterior temporal lobe
insular cortex

right side

34
Q

ANTERIOR CEREBRAL
ARTERY

Supplies medial portions of the ____ lobe, ____ lobe and
____
and tract

POSTERIOR CEREBRAL
ARTERY

Supplies ____ lobe and ____

A

frontal
superior medial
olfactory bulb

occipital
thalamus

35
Q

Cerebral vasculature
The course and relationships of the major arteries at the base of the brain is important because of:
(1) Their physiological distribution to specific brain regions

(2) Their frequency of involvement in ____ or ____ caused by either occlusion
(____ strokes) or rupture (____ strokes) of
their branches; and

(3) Their potential for forming ____ which may
produce signs and symptoms of encroachment upon
adjacent ____ even before rupture

A

cerebral vascular
“strokes”
ischemic
hemorrhagic

aneurysms

36
Q 
Blood clots originating
from the \_\_\_\_ side of 
the heart or more distal sites of frequent thrombus formation, such as the \_\_\_\_ or \_\_\_\_, may embolize and precipitate
ischemic stroke
in branches of the
\_\_\_\_ and \_\_\_\_
A 
left
aortic arch
carotid bifurcation
ACA
MCA
37
Q

Ruptured ____ in the vicinity of the Circle of Willis have a high mortality rate

Rupture of ____ accounts for an estimated 5 percent of strokes

A

saccular (berry) aneurysms

basilar artery aneurysms

38
Q 
The
EXTERNAL
CAROTID
ARTERY
blood to the  \_\_\_\_ and  \_\_\_\_
A

face

scalp

39
Q 
1- \_\_\_\_
2- \_\_\_\_
 3- \_\_\_\_ headed towards tongue
4- \_\_\_\_
5- \_\_\_\_
6- \_\_\_\_
7- \_\_\_\_ gives blood to all our teeth
8- \_\_\_\_

SALFOPMS
some aggressive lovers find odd positions more stimulating

A 
superior thyroid
ascending pharyngeal
lingual
facial
occipital
posterior auricular
maxillary
superficial temporal
40
Q

The thyroid gland also receives blood from the
____
arteries arising from the
____

A

inferior thyroid

thyrocervical trunk

41
Q

Recall that ligation of the thyroid arteries in thyroidectomy endangers the ____

A

laryngeal nerves

42
Q

ASCENDING PHARYNGEAL

____ branch of the ECA

Arises from the deep surface of the artery and ascends between ____ and ____ to the base of the cranium

Pharyngeal branches (3-4) supply \_\_\_\_ and
\_\_\_\_ (bw superior and middle constrictors)

Palatine branch (variable)
to ____, ____ and
____.

A 
smallest
ICA
pharynx
constrictors
stylopharyngeus
soft palate
palatine tonsil
auditory tube
43
Q

Prevertebral
to longus capitis and longus colli

Inferior Tympanic
ascends thru the ____ to the medial wall of the middle ear

Neuro-meningeal

  • CN ____ (thru jugular foramen)
  • ____ meninges
A

tympanic canaliculus
IX-XII
PCF

44
Q

LINGUAL artery

Arises opposite the tip of the greater horn of the ____

Principal source of blood to the ____ and floor of the ____

____ LINGUAL
artery

____ artery
Hypoglossal
nerve assoc with sublingual artery

____ artery
we have several dorsal lingual arteries
Dorsal Lingual arteries (2-3): posterior dorsum of tongue and lingual tonsil, epiglottisis, palatoglossal arch, soft palate and sometimes the palatine tonsil

A 
hyoid
tongue
floor of the mouth
deep
sublingual
dorsal lingual
45
Q 
Sublingual
artery:
supplies the ..
• \_\_\_\_
(salivary gland)
• mandibular and buccal
\_\_\_\_
• \_\_\_\_ (muscle of
oral floor)
Deep Lingual
artery:
• inferior surface of \_\_\_\_
• \_\_\_\_ ( bilateral
contraction protrudes the tongue)
A

sublingual gland
gingivae
mylohyoid

tongue
genioglossus

46
Q

The facial artery is tortuous to facilitate
maximal depression of the ____

The facial artery enters the face near a shallow notch in the inferior border of the mandible some ____ centimeters anterior to the angle
of the mandible
____!

A

mandible
2-3
pulse point

47
Q

Facial
artery-
cervical branches

  1. Ascending Palatine
    to ____, ____, ____
  2. Tonsilar to ____ and ____
  3. Glandular (3-4) to the
    ____
  4. ____ to the chin and lower lip
A 
soft palate
palatine tonsil
auditory tube
lingual tonsil
tongue
submandibular gland
submental
48
Q

Abundant muscular branches supply the mimetic muscles

\_\_\_\_ artery
\_\_\_\_ nasal 
\_\_\_\_ labial
\_\_\_\_ abial
(FACIAL branches)

Anatomoses are numerous between corresponding contralateral branches of the ____ as well as with other ____ & ____ derivatives

A 
angular
lateral
superior
inferior
facial
ECA
ICA
49
Q

The labial arteries run between ____ and the labial mucosa

A branch of the larger ____ contributes to the complex anastomosis of blood vessels of the nasal septum to be discussed later

A

orbicularis oris

superior labial artery

50
Q

The ANGULAR artery anastomoses with branches of the ophthalmic artery as previously described, making a critical
anastomosis between ____ and ____ circulations

Periorbital anastomoses of the ____ branches with
• the ____ branch of the facial,
• the ____, and
• the ____ of the maxillary provide multiple opportunities for communications between the ____ and ____ arterial systems.

A

ECA
ICA

opthalmic artery
angular
superficial temporal
infraorbital branch
ICA
ECA
51
Q

With occlusion of the ____ at its origin, there will be collateral flow from these external carotid branches into the internal carotid via the ____, which can be both identified and quantified by ____

A

ICA
opthalmic artery
doppler ultrasonography

BS III, Module II (9 decks)

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